Factors Associated with Musculoskeletal Pain and Fatigue during Online Learning among Nursing Students

Abstract

Since the COVID-19 pandemic, nursing education has shifted to more online learning. This shift may cause some problems with musculoskeletal pain and fatigue. This cross-sectional study investigated the prevalence of musculoskeletal pain, fatigue, and associated factors from online learning among 234 nursing students in Bangkok, with data collected from January to March 2023. The instruments used were the Personal Data Sheet, the Health Status Form, the Online Learning Risk Assessment, the Single-Item Visual Analogue Scale for Fatigue, and the Nordic Musculoskeletal Questionnaire. Data were analyzed using a chi-square test, t-test, and logistic regression. Of the 234 participants, 222 (94.9%) were women, averaging 20.6 ± 1.3 years. They spent an average of 7.5 hours per day on online learning, with 87.6% sitting in chairs without armrests and backrests. Additionally, 86.3% spent over three hours online daily, 61.5% using tablets without separate keyboards as their main device, and 33.3% using mobile phones. Over the past six months, 80.8% of participants experienced musculoskeletal pain, and 79.9% experienced moderate to severe fatigue. Sitting with the head down for over 2 hours daily was the strongest predictor for musculoskeletal pain, while sitting in the same spot for over two hours predicted fatigue. During online learning, mus-culoskeletal pain and fatigue can be prevented through targeted interventions that encourage regular breaks to reduce prolonged sitting and ergonomic adjustments for healthier sitting posture. The study recommends adding ergonomic and self-care education to nursing curricula to prevent discomfort from prolonged sitting and poor posture, especially in online learning.