{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:43:32Z","timestamp":1792428212811,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":361,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study examines the association between musculoskeletal disorders, job strain index, work\u2010related fatigue, and burnout among hospital nurses. Additionally, the mediating roles of work\u2010related fatigue and burnout in the correlation between job strain and musculoskeletal disorders were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Musculoskeletal disorders often arise from high workloads and prolonged work hours among nurses. Despite extensive research, the definitive impact of psychological factors, work\u2010related fatigue, and burnout on musculoskeletal disorders remains inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study was conducted at a public hospital. The study adhered to STROBE guidelines and included 471 nurses who participated voluntarily and anonymously by completing a web\u2010based questionnaire. The data were collected from January to December 2022. The questionnaire covered demographics, job characteristics, the job control\u2013demand\u2013support model, work\u2010related fatigue, burnout, and other relevant factors. The mediating roles of work\u2010related fatigue and burnout in the relationship between job strain and musculoskeletal disorders were evaluated using Hayes Model 7.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Musculoskeletal disorders across nine body sites exhibited significant correlations with levels of job strain, work\u2010related fatigue, and burnout. Work\u2010related fatigue showed a significant association with burnout but did not directly associate with musculoskeletal disorders. Burnout, however, directly influenced the prevalence of musculoskeletal disorders. Notably, both work\u2010related fatigue and burnout served as mediators in the relationship between job strain and musculoskeletal disorders, with burnout being the primary contributor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given that burnout is identified as the principal contributing factor to musculoskeletal disorders among nurses, it is recommended to implement empowerment initiatives within nursing departments. Prioritizing the reduction of work\u2010related fatigue and burnout through tailored prevention programs for nurses is essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession<\/jats:title>\n                    <jats:p>The rising prevalence of musculoskeletal disorders calls for nurse managers to act promptly. They should implement intervention programs to reduce psychological stress and workload, enhance nursing management, and ensure an ergonomic workplace environment for nurses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/8819293","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T02:56:40Z","timestamp":1766977000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unraveling the Psychological Pathways Between Job Strain and Musculoskeletal Disorders: The Mediating Roles of Work\u2010Related Fatigue and Burnout Among Hospital Nurses"],"prefix":"10.1155","volume":"2025","author":[{"given":"Hsien-Hua","family":"Kuo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chieh","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4184-4333","authenticated-orcid":false,"given":"Hsien-Wen","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1002-1721","authenticated-orcid":false,"given":"Ping-Yi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2007.02.006"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2014.11.003"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2009.021766"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2022.2125178"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.15171\/ijoem.2018.1158"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/oem.57.3.211"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010467"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/oem.54.9.681"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2019.11.023"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-14-144"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0018720815581933"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2019.02.004"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2017.04.001"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.3233\/Wor-172534"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-022-00852-y"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2021.100033"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.2196\/68522"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/job.4030120704"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1348-9585.12244"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.5812\/mejrh.57480"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.1080\/10803548.2016.1147876"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1037\/\/1076-8998.3.4.322"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.2307\/2392498"},{"key":"e_1_2_15_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/Bf03000183"},{"key":"e_1_2_15_25_2","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm1001_02"},{"key":"e_1_2_15_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(87)90010-X"},{"key":"e_1_2_15_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqm036"},{"key":"e_1_2_15_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(94)90017-5"},{"key":"e_1_2_15_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/00140139408963698"},{"key":"e_1_2_15_30_2","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach","author":"Hayes A. 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