• Vol 10, No 4 (2019)
  • Industrial Engineering

The Prevalence of Musculoskeletal Complaints among Hospital Nurses and Nursing Home Caregivers in Indonesia

Hardianto Iridiastadi, Bayuardi Anggawisnu, Fatin Saffanah Didin, Putra Alif Ramdhani Yamin

Corresponding email: hiridias@vt.edu

Cite this article as:
Iridiastadi, H., Anggawisnu, B., Didin, F.S., Yamin, P.A.R., 2019. The Prevalence of Musculoskeletal Complaints among Hospital Nurses and Nursing Home Caregivers in Indonesia. International Journal of Technology. Volume 10(4), pp. 854-861
Hardianto Iridiastadi Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung 40132, Indonesia
Bayuardi Anggawisnu Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung 40132, Indonesia
Fatin Saffanah Didin Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung 40132, Indonesia
Putra Alif Ramdhani Yamin Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung 40132, Indonesia
Email to Corresponding Author


The jobs of hospital nurses and nursing home caregivers are often associated with risks of musculoskeletal disorders. Little is known, however, about the prevalence of such problems among nurses and caregivers in Indonesia. This study aims at determining the prevalence of musculoskeletal (MS) complaints experienced by caregivers in Indonesia and identifying relevant factors contributing to this problem. Standardized Nordic Questionnaires were distributed to 121 hospital nurses and nursing home caregivers, as a means of understanding the magnitude of the problem. Results of this study demonstrated that 75% of the respondents reported MS complaints (for any body parts) in the previous year. Roughly 40 to 50% of the respondents reported MS complaints of the upper and lower back. Complaints of the shoulder, neck, and right wrist were reported by about 30 to 40% of the respondents. Compared to their colleagues in the hospital, nursing home caregivers were six to eight times more likely to experience right shoulder problems and about three to four times more likely to develop lower back problems. Other working conditions resulting in an increased chance of MS problems included age, length of employment, and shift durations. It was suspected that poor working postures and excessive effort while handling the patients were two major factors that were in need of immediate attention. The findings of this study could be used as a basis for ergonomic interventions in both medical and home care settings. Such improvements may, in the long run, result in better morale, increased productivity, and a stronger bottom line for hospital and nursing home too.

Caregivers; Hospital; Musculoskeletal complaints; Nurses; Nursing homes


Regardless of the causes, physically disabled patients in hospitals and nursing homes are commonly assisted by nurses and caregivers. The majority of patient handling tasks are physical in nature (e.g., lifting, positioning, moving, transferring), and these activities are often associated with risks of musculoskeletal (MS) problems (Nelson, 2006; Warming et al., 2009). These problems have been reported in the relevant literature (e.g., Karahan et al., 2009), with poor (non-neutral) working postures and forceful exertions being important occupational risk factors. Injuries to the musculoskeletal system could recur (Cilliers & Maart, 2013), which may need a relatively long recovery time.

A number of investigations have studied the prevalence of MS complaints among workers in medical settings and noted several body parts which have especially greater prevalence (e.g., Smith et al., 2004). Ergonomic interventions and workplace improvements have been suggested (Kamioka & Honda, 2013), with varying results. While the prevalence of MS complaints among nurses and caregivers has been widely reported, the availability of such information relating to developing nations (such as Indonesia) is limited. It was also suspected that there were differences in task characteristics, when comparing nursing homes and typical public hospitals in Indonesia to those in developed countries. This investigation sought to determine the prevalence of MS complaints among nursing home caregivers and hospital nurses in Indonesia and, further, to identify factors associated with MS complaints. It was expected that the findings of this study could be used as a rationale for workplace improvements.



This study specifically sought to understand the prevalence of musculoskeletal problems among hospital nurses and nursing home caregivers. It was concluded in this research that a large majority of the workers had experienced injuries or complaints in the previous year. The body parts with the greatest number of incidents included the lower back, upper back, right shoulder, and the neck area. Nursing home caregivers tended to be associated with an increased likelihood of MS problems, followed by nurses working at inpatient care facilities. Other work factors seeming to contribute to the problems include longer shift hours, longer length of employment, and more senior workers suffering from MS problems. Those with higher BMIs were also related to higher ergonomic risks. Although not specifically addressed, poor posture and excessive effort during patient handling could be the two major factors influencing the high prevalence of MS problems. The findings of this study could be used as a basis for ergonomic interventions and, especially, further research in Indonesia addressing musculoskeletal injuries and complaints among hospital nurses and nursing home caregivers. It is expected that such interventions could improve the quality of working life among nurses and caregivers, and also improve the hospital and nursing home’s bottom line in the long run.


This research has been partially funded by the Ministry of Research, Technology, and Higher Education (Grant #: RT-2016-0375).


Bardak, A.N., Erhan, B., Gunduz, B., 2012. Low Back Pain among Caregivers of Spinal Cord Injured Patients. Journal of Rehabilitation Medicine, Volume 44(10), pp. 858–861

Cilliers, L., Maart, S., 2013. Attitudes, Knowledge, and Treatment of Low Back Pain amongst Nurses in the Eastern Cape, South Africa. African Journal of Primary Health Care Family Medicine, Volume 5(1), pp. 1–8

Crawford, J.O., 2007. The Nordic Musculoskeletal Questionnaire. Occupational Medicine, Volume 57(4), pp. 300–301

Dawson, A.P., Steele E.J., Hodges P.W., Stewan S., 2009. Development and Test-Retest Reliability of an Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E): A Screening Instrument for Musculoskeletal Pain. The Journal of Pain, Volume 10(5), pp. 517–526

Deakin, J.M., Stevenson, J.M., Vail, G.R., Nelson, J.M., 1994. The Use the Nordic Questionnaire in an Industrial Setting: A Case Study. Applied Ergonomics, Volume 25(3), pp. 182–185

Fincham, J.E., 2008. Response Rates and Responsiveness for Surveys, Standards, and the Journal. American Journal of Pharmaceutical Education, Volume 72(2), pp. 1–3

Finneran, A., Sullivan, L., 2010. Force, Posture, and Repetition Induced Discomfort as a mediator in Self-Paced Cycle Time. International Journal of Industrial Ergonomics, Volume 40(3), pp. 257–266

Holman, G.T., Ellison, K.J., Maghsoodloo, S., Thomas, R. E., 2010. Nurses’ Perception of How Job Environment and Culture Influence Patient Handling. International Journal of Orthopedic and Trauma Nursing, Volume 14(1), pp. 18–29

Jellad, A., Lajili, H., Boudokhane, S., Migaou, H., Maatallah, S., Frih, Z.B.S., 2013. Musculoskeletal Disorders among Tunisian Hospital Staff: Prevalence and Risk Factors. Journal of the Egyptian Rheumatologist, Volume 35(2), pp. 59–63

Kamioka, H., Honda, T., 2012. Low Back Pain in Female Caregivers in Nursing Homes. In: Low Back Pain

Karahan, A., Kav, S., Abassoglu, A., Dogan, N., 2009. Low Back Pain: Prevalence and Associated Risk Factors among Hospital Staff. Journal of Advanced Nursing, Volume 65(3), pp. 516–524

Kuorinka, I., Jonsson, B., Kilborn, A., Vinterberg, H., Biering-Sorensen, F., Andersson, G., Jorgensen, K., 1987. Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms. Journal of Applied Ergonomics, Volume 18(3), pp. 233–237

Lamothe, G., 2001. Adjusting the Mantel Haenzel Test Statistic and the Odds Ratio for Cluster Sampling. Department of Mathematics and Statistics, University of Ottawa

Lloyd-Sherlock P., 2009. Stroke in Developing Countries: Epidemiology, Impact, and Policy Implication. School of International Development, University of East Anglia

Mantel, N., Haenszel W., 1959. Statistical Aspects of Analysis of Data from Retrospective Studies of Disease. Journal of the National Cancer Institute, Volume 22(4), pp. 719–748

McAtamney, L., Corlett, E.T., 1993. Rula: A Survey Method for the Investigation of Work-Related Upper Limb Disorders. Journal of Applied Ergonomics, Volume 24(2), pp. 91–99

Nelson A., 2006. Safe Patient Handling and Movement: A guide for Nurses and Other Health Care Providers. Springer Publishing Company, USA

Nimbarte, A.D., 2014. Risk of Neck Musculoskeletal Disorders among Males and Females in Lifting Exertion. International Journal of Industrial Ergonomics, Volume 44(2), pp. 253–259

Owen, B.D., Keene, K., Olson S., 2002. An Ergonomic Approach to Reducing Back/Shoulder Stress in Hospital Nursing Personnel: A Five Year Follow Up. International Journal of Nursing Studies, Volume 39(3), pp. 295–302

Shields, L., Hartati, E.L., 2003. Nursing and Health Care in Indonesia. Journal of Advance
Nursing, Volume 44(2), pp. 209

Smith, D., Ning, R., Lin, K., Wang, R.S., 2004. Musculoskeletal Disorders among Professional Nurses in Mainland China. Journal of Professional Nursing, Volume 20(6), pp. 390–395

Warming, S., Precht, D.H, Suadicani, P., Ebbehoj, N.E., 2009. Musculoskeletal Complaints among Nurses Related to Patient Handling Tasks and Psychosocial Factors-based on Logbook Registration. Journal of Applied Ergonomics, Volume 40(4), pp. 569–576