A Cross-sectional Study Evaluating Grip Strength and Associated Factors in Turkish Nurses and Nursing Students

A Cross-sectional Study Evaluating Grip Strength and Associated Factors in Turkish Nurses and Nursing Students | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Cross-sectional Study Evaluating Grip Strength and Associated Factors in Turkish Nurses and Nursing Students Cemile Savci, Ayse Cil Akinci, Safiye Sahin, Sharon Atienza, Salem Dehom, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4670272/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 26 Aug, 2024 Read the published version in BMC Nursing → Version 1 posted 13 You are reading this latest preprint version Abstract Background Grip strength is a crucial indicator of overall muscle strength and is important for the physical demands of nursing. Objective This study aims to examine the differences in grip strength between staff nurses and nursing students and to identify factors associated with grip strength in nursing sample. Method This descriptive and analytical study collected data from nursing students and staff nurses in Turkey, from May 1 to September 30, 2022. A total of 200 staff nurses and 200 nursing students participated. Data were collected using a participant information form, the Perceived Stress Scale-4 (PSS-4), and the Nordic Musculoskeletal Questionnaire (NMQ). Additionally, researchers recorded anthropometric measurements and assessed grip strength using a digital hand dynamometer. Results Grip strength was similar across groups, with nearly half (48.8%) meeting or exceeding Turkish normative values. 79.5% of staff nurses and 66.0% of nursing students reported musculoskeletal (MSK) issues in the last 12 months. Correlation analysis indicated that grip strength negatively correlated with stress level and musculoskeletal complaints. Multiple linear regression identified height, waist-to-hip ratio, and neck circumference as significant predictors of grip strength, explaining 57% of the variance. Conclusion Grip strength was similar between staff nurses and nursing students, despite differences in age, BMI, and musculoskeletal issues. Height, waist-to-hip ratio, and neck circumference are key predictors of grip strength in this Turkish nursing sample. Understanding the factors influencing grip strength can help in designing targeted interventions to maintain and improve muscle strength in nursing professionals. grip strength staff nurses nursing student musculoskeletal complaints Introduction Grip strength is a measure of upper body strength that indicates overall muscular strength which predicts musculoskeletal health, disease development and progression, disability and mortality, or healthy aging( 1 , 2 ). Data on grip strength in different countries show an increase from childhood to early adulthood, a relatively steady increase in middle age and a decline from middle age onwards. Variation in average grip strength also varies geographically( 3 ). Dodds et al. (2016) reported that grip strength was lower in developing countries compared to developed countries. In the same study, it was found that individuals with larger body sizes had higher grip strength( 4 ). Globally, nurses are reported to be at risk of workplace injuries or musculoskeletal disorders leading to disability and causing nurses to leave the nursing workforce( 5 – 7 ). A meta-analysis of 42 studies found that the annual prevalence of workplace injuries or musculoskeletal disorders among nurses is 77.2%. The most common areas affected are lower back (59.5%), neck (53.0%), and shoulder (46.8%)( 8 ). Work-related musculoskeletal injuries and disorders are not only common among nurses and cause them to leave their jobs, but are also costly to diagnose and treat. A study developed a framework for estimating the economic burden of work injuries and diseases in selected European Union countries, revealing that Poland exhibits the highest overall costs as a percentage of GDP (10.4%), while the Netherlands has the highest per case costs (€75,342)( 9 ). Patient handling, lifting, and positioning are the primary risk factors for musculoskeletal injuries and disorders( 10 ). Nurses who are not physically fit or do not lead an active lifestyle may be at high risk( 11 ). Other factors associated with workplace injuries or musculoskeletal disorders include fatigue, years of work, consecutive shift schedule, variability of shifts, muscle mass, physical capacity, grip strength, and upper body strength( 12 – 15 ). Nursing students may also encounter unfamiliar, stressful environments and physically demanding workloads during clinical and laboratory practice. This may increase the risk of work-related musculoskeletal disorders in nursing students( 16 ). In a study conducted in Australia, nursing students were reported to experience symptoms of musculoskeletal disorders, and despite regular exercise, most of these students had poor to average health levels, and most also had poor to average grip strength( 17 ). The literature suggests that grip strength testing is a useful tool for assessing the functional capacity of healthcare workers( 12 ). Factors likely to affect grip strength include age, gender, height, weight, body mass index, working hours, working time in the profession, consecutive shifts, stress, exercise habits, and physical strength required during work in the clinical field( 1 , 3 , 4 , 15 , 17 , 18 ). Determination of grip strength and related factors will contribute to the development of recommendations for the planning of future interventions to increase nurses' job performance and career longevity, as well as protect the health of nursing students and currently working nurses. There are studies conducted in other countries to determine grip strength and related factors in nurses and nursing students( 12 , 17 , 18 ). However, there are only studies on the subject in different populations other than nurses and nursing students in Turkey ( 19 – 21 ). Therefore, in this study, we aimed to fill this gap on grip strength of nurses. In this study, the following questions were addressed: i) Is there any difference between nurses and nursing students in terms of grip strength. ii) Are demographic characteristics, exercise status, perceived stress, status of having musculoskeletal trouble in various body parts, and anthropometric measurements associated with the grip strength of nursing students and staff nurses? iii) What are the predictors of the grip strength in this sample of nursing students and staff nurses? Materials and methods Study design and sample This study was designed as a descriptive and correlational study. The data were collected from the nursing students attending the [removed for blind review], Turkey, between May 1 and September 30, 2022. The inclusion criteria for the study were as follows: be at least 18 years old; work actively as a nurse for at least six months or be a nursing student at the selected university; not have musculoskeletal trouble in the dominant hand, which is used for grip strength measurement; not be on vacation or rest during the study; and voluntarily agree to participate in the study. The study was conducted with 200 staff nurses and 200 nursing students. Power analysis was performed to determine the adequacy of sample size. For a multiple regression model with 15 predictors, the analysis indicated that a minimum of 139 participants would be necessary for a medium effect size (f² = 0.15), a significance level of 0.05, and a power of 0.80. Our sample size of 400 participants exceeds this requirement, indicating a robust sample size for the intended analyses. Data collection forms The data collection form included self-reported participant information and validated scales. Later, anthropometric variables and the grip strength of the participants were measured and recorded on the same form. Participant Information Form This form consisted of items related to the descriptive characteristics of the staff nurses and nursing students, including age, gender, educational status, nursing role, work time, work type, total working hours per week, leave of absence for any reason, exercise and relaxation habits, and status of musculoskeletal trouble in various body parts (such as the neck, shoulder, upper back, lower back, hip, etc.). Perceived Stress Scale 4 (PSS-4) This four-item scale is commonly used to measure the subjective stress of someone during the last month of health research. Each question is graded between 0 (never) and very often ( 4 ), and questions 2 and 3 are reverse-coded. The total score is determined by adding together the scores of each of the four items and can be between 0 and 16. While higher scores are correlated with more stress, lower scores are correlated with less stress ( 27 ). The Turkish validity and reliability study of the PSS-4 was performed by Eskin et al. and the Cronbach's alpha value was reported as 0.66( 22 ). In this study, it was calculated as 0.80. Nordic Musculoskeletal Questionnaire (NMQ) This questionnaire includes self-reported location (neck, shoulders, elbows, wrists/hands, upper and lower back, hips/thighs, knees, and ankles/feet) and severity of musculoskeletal symptoms during the past week up to the last 12 months. NMQ items include effect of symptoms on leisure/work activities, and whether or not healthcare was sought. The NMQ has good construct validity and test-retest reliability when compared to clinical history, is commonly used among nurses, and has previously been validated in Turkey with Cronbach’s alpha = 0.896( 23 – 28 ). In this study Cronbach’s alpha = 0.85. In our study, reported musculoskeletal (MSK) issues within the past 12 months were coded as 'yes' if participants reported having trouble in any part of their body. Conversely, if participants did not report trouble in any part of their body, their response was coded as 'no'. Upper MSK complaints were calculated based on the number of issues participants reported in their upper body parts (neck, shoulders, upper back, elbows, and wrists/hands) over the past 12 months. The possible range of complaints is 0 to 5. Similarly, lower MSK complaints were calculated for lower body parts (lower back, hips/thighs, knees, and ankles/feet), with a possible range of 0 to 4. The total number of MSK complaints was calculated by summing the upper and lower body complaints, resulting in a possible range of 0 to 9. Anthropometric Measurements Height, weight, waist circumference, hip circumference, neck circumference, and upper arm circumference were measured and recorded by researchers. After this, BMI, waist/hip ratio, and waist/height ratio were calculated. Grip strength measurement Grip strength was measured on the dominant hand of each participant using the Jamar digital dynamometer( 29 ). Before measuring hand grip strength, staff nurses and nursing students were asked to take a comfortable seated position, then squeeze the dynamometer as tight as they could for 4–5 seconds and relax. No other body movements were allowed during this time, according to a standardized study protocol. To obtain an average grip strength value, three consecutive measurements were made, and the average of these measurements was automatically calculated. The participant’s measurement results and the Turkish reference values were shared with them. Ethical considerations This study was conducted by the principles outlined in the Declaration of Helsinki. Ethics committee approval (Istanbul Medeniyet University Goztepe Training and Research Hospital Clinical Research Ethics Committee, December 22, 2021) and institutional permission (Istanbul Governor's Office, Provincial Health Directorate Health Services Presidency Research, Printed Publication, Announcement Content Evaluation Commission Decision dated 09.06.2022 and numbered E-15916306-604.01.01 (2022/12) were obtained prior to the implementation of the study. Staff nurses and nursing students were informed about the purpose of the study, and those who voluntarily agreed to participate in the study were asked to fill out the data collection form. Individuals who agreed to participate in the study were guaranteed the right to withdraw at any time. Data Analysis The SPSS 22 (Statistical Package for Social Sciences, Inc., IL, USA) program was used to analyse the data. Number, percentage, mean, standard deviation, and minimum and maximum values were calculated in descriptive statistics for categorical and continuous variables. Histograms were used to determine the conformity of the data to the normal distribution. As the distribution was normal, an independent sample t-test, and chi-square test were used to compare the nursing students and staff nurses. Pearson's correlation coefficient was used to examine the relationship between two normally distributed quantitative variables. To test the predictors of grip strength, multiple linear regression analysis was performed. The level of significance was considered as p < 0.05. Participants’ grip strength was compared to the published Turkish normative values by age and gender( 21 ). Results Descriptive statistics Table 1 a summarizes the characteristics of sample. The total sample ( N = 400) was evenly divided between staff nurses and nursing students. The gender distribution is similar across groups, with approximately 75% female and 25% male participants. Staff nurses are older on average (28.70 years) compared to nursing students (20.91 years). About 43.3% of participants reported exercising, with no significant difference between staff nurses and nursing students in exercise habits or intensity (p > 0.05). However, staff nurses reported more musculoskeletal (MSK) issues in the last 12 months (79.5% vs. 66.0%), with significantly higher MSK complaints overall and specifically in both upper and lower body regions (p < 0.05). Meditation or relaxation practices were reported by 11.0% of the participants, with staff nurses engaging in these practices more than nursing students (15.5% vs. 6.5%, p 0.05). Table 1 a Self-reported characteristics of participants All Participants (n = 400) Staff nurses (n = 200) Nursing students (n = 200) X 2 t -test Characteristic N (%) or M ( SD ) N (%) or M ( SD ) N (%) or M ( SD ) P value P value Gender 0.908 Female 301 (75.3%) 151 (75.5%) 150 (75%) Male 99 (24.8%) 49 (24.5%) 50 (25.0%) Age 24.80 (5.75) 28.70 (5.61) 20.91 (2.11) < .001 Exercise 0.267 Yes 173 (43.3%) 81 (40.5%) 92 (46.0%) 0.267 No 227(56.7%) 119(59.5%) 108(54%) Exercise minutes 1 57.64 (26.49) 57.31 (27.17) 57.93 (26.04) 0.88 Exercise Intensity 0.336 None 226 (56.5%) 120 (60.0%) 106 (53.0%) Low 13 (3.3%) 6 (3.0%) 7 (3.5%) Med 156 (39.0%) 73 (36.5%) 83 (41.5%) High 5 (1.3%) 1 (0.5%) 4 (2.0%) Reported MSK issues in the last 12 months 0.002 Yes 291 (72.8%) 79.5% (159) 66.0% (132) No 109(27.2%) 41(20.5%) 68(34%) All MSK complaints 2.50 (2.24) 3.20 (2.33) 1.81 (1.91) < .001 Upper MSK complaints 1.53 (1.42) 1.87 (1.44) 1.19 (1.30) < .001 Lower MSK complaints 0.975 (1.17) 1.33 (1.26) .62 (.95) < .001 Meditation/relaxation 0.004 Yes 44 (11.0%) 31 (15.5%) 13 (29.5%) No Days/week for meditation/relaxation 2.15 (.918) 2.09 (1.03) 2.29 (.611) 0.52 Perceived Stress Scale 7.45 (2.76) 7.33 (2.78) 7.57 (2.74) 0.385 1 Includes any participants who recorded minutes of exercise, regardless of their answer for exercise status Anthropomorphic measurements of participants are summarized in Table 1 b. Staff nurses have a higher average BMI (23.59) compared to nursing students (21.82), with corresponding higher average weight (65.60 kg for staff nurses vs. 60.97 kg for nursing students). Height is similar between the groups. Staff nurses also have larger waist circumferences (77.86 cm vs. 74.03 cm) and higher waist-to-hip (0.777 vs. 0.750) and waist-to-height ratios (0.468 vs. 0.442). Hip circumference is slightly higher in nurses, but not significantly different (p > 0.05). Neck circumference and upper arm circumference are both larger in nurses, with the latter being significantly different. Grip strength is similar between the groups. Of the total sample, 195 (48.8%) met or exceeded the median Turkish grip strength normative values for gender and age. Table 1 b Anthropomorphic measurements of participants All Participants ( N = 400 ) Staff nurses ( n = 200) Nursing students ( n = 200) t -test Characteristic M ( SD ) M ( SD ) M ( SD ) p value MI 22.71 (3.63) 23.59 (3.91) 21.82 (3.09) <. 001 Weight 63.28 (12.34) 65.60 (12.98) 60.97 (11.24) < .001 Height 166.60 (8.12) 166.20 (8.48) 167.01 (7.74) .316 Waist circumference 75.94 (10.31) 77.86(11.56) 74.03 (8.50) < .001 Hip circumference 99.19 (8.23) 99.86 (9.17) 98.52 (7.13) .104 Waist: Hip ratio 0.764 (0.066) 0.777 (0.073) 0.750 (0.056) < .001 Waist: Height ratio 0.455 (.057) 0.468 (.065) 0.442 (.045) < .001 Neck circumference 33.23 (3.26) 33.52 (3.27) 32.95 (3.22) .080 Upper arm circumference 26.78 (3.27) 27.18 (3.52) 26.37 (2.95) .013 Neck: Upper arm ratio 1.24 (.105) 1.24 (.112) 1.25 (.097) .243 Grip strength 1 31.42 (9.69) 31.65 (9.48) 31.19 (9.91) .636 N (%) N (%) N (%) Normal grip strength 2 195 (48.8%) 95(47.5%) 100(50.5%) 1 Grip strength in kilograms. 2 Met or exceeded median Turkish grip strength normative values for gender and age (Ekşioğlu, 2016). Correlation Analysis Table 2 presents the Pearson correlations between grip strength and various anthropometric measurements, exercise habits, meditation frequency, perceived stress scores, and the number of musculoskeletal (MSK) complaints. Table 2 Correlation of grip strength and independent characteristics Variable N 1 Correlation Coefficient 2 ( r ) p -value Age − .054 .286 BMI .224 < .001 Weight .545 < .001 Height .696 < .001 Waist circumference .421 < .001 Hip circumference .154 .002 Waist:Hip ratio .507 < .001 Waist:Height ratio .177 < .001 Neck circumference .647 < .001 Upper arm circumference .456 < .001 Neck: Upper arm ratio .074 .139 Exercise (min/wk) 174 .249 < .001 Meditation (days/wk) 44 .270 .070 Exercise Intensity (low, med, high) 174 .114 .133 Perceived Stress score − .195 < .001 # of MSK problems 291 − .132 .008 1 N = 400 unless otherwise indicated 2 Pearson correlation Among anthropometric variables, weight, height, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, neck circumference, and upper arm circumference demonstrated significant positive correlations with grip strength (p < 0.05). Exercise frequency was also positively correlated with grip strength while perceived stress scores and the number of MSK problems were negatively correlated. Variables such as age, meditation frequency, and exercise intensity did not show significant correlations. Predictors of Grip Strength Variables with an absolute r of 0.20 or higher were considered associated with grip strength ( 30 ), and added to the multiple linear regression analyses. In the first multiple linear regression analyses, BMI, weight, height, waist circumference, waist to hip ratio, neck circumference, upper arm circumference and minutes of exercise were added to the model as predictors of grip strength. Variance Inflation Factors (VIF) were checked to assess the level of multicollinearity between independent variables (Table 3 a). Table 3 a VIF Values of Predictors First Model Second Model Final Model Predictors VIF Values VIF Values VIF Values BMI 22.570 5.216 2.506 Height 10.375 2.098 1.943 Weight 36.933 Excluded Excluded Waist circumference 8.997 8.538 Excluded Waist-to-hip ratio 2.858 2.833 1.639 Neck circumference 3.230 3.215 3.215 Upper arm circumference 3.935 3.750 3.643 Exercise Minutes 1.182 1.145 1.127 Note: VIF = 1 shows no multicollinearity and 1–5 shows low level of multicollinearity. According to VIF values, VIF = 1 implies no multicollinearity, and 1 < VIF < 5 indicates low-level multicollinearity ( 30 ). Therefore, weight was excluded due to high multicollinearity. Then, multiple linear regression analysis was rerun and multicollinearity was checked again. Waist circumference were excluded due to high VIF value. After multicollinearity was eliminated, the final multiple linear regression analysis was performed and is shown in Table 3 b. In the final model, only height, waist to hip ratio, and neck circumference were significant positive predictors of grip strength, and explained 57% of the variance (Table 3 ). Table 3 b Regression analyses of variables correlated with grip strength Final Model Unstandardized Coefficients Standardized Coefficients Sig. B Std. Error Beta (Constant) -102.540 11.558 < .001 BMI − .139 .220 − .051 .529 Height .518 .084 .434 < .001 Waist-to-hip ratio 28.646 10.243 .182 .006 Neck circumference 1.024 .286 .326 < .001 Upper arm circumference − .187 .296 − .061 .529 Exercise Minutes .008 .019 .024 .660 R 2 = 0.587, Adjusted R 2 = 0.567 Discussion This study aimed to examine grip strength and its predictors in a sample of Turkish nurses. Initially, we aimed to determine whether there are differences in hand grip strength between nursing students and staff nurses. Then, we sought to investigate the relationship between grip strength and various factors, including demographic characteristics, anthropometric measurements, exercise habits, perceived stress levels, and the presence of musculoskeletal issues in different body parts. Lastly, we aimed to identify the predictors of grip strength within this nursing sample. The results, based on a Turkish nursing sample of 400, provide several insights into their grip strength and related factors. Firstly, grip strength was found to be similar between nursing student and staff nurses despite significant differences in age, reported musculoskeletal issues, and some anthropomorphic measurements of participants. In line with our results, in a cross-sectional study with 316 participants (18 to 59 years) at a large teaching hospital in India, mean grip strength did not significantly differ between nursing staff and nursing students( 31 ). In our study, staff nurses had higher BMI and weight compared to nursing students. In addition, the prevalence of MSK issues among nurses (79.5%) were higher than nursing students (66.0%) which is concerning. The significantly higher rates of MSK complaints in both upper and lower body among staff nurses highlight the physical demands and potential occupational hazards associated with nursing work( 6 ). These findings underscore the need for targeted ergonomic interventions and preventive strategies to reduce the risk of MSK disorders in nursing professionals( 32 ). However, the exercise habits, duration, and intensity were found to be similar between the two groups in our sample. This similarity in exercise patterns might explain the comparable grip strength results observed. Stress levels were found to be similar between staff nurses and nursing students that may be related to their respective roles and responsibilities. Interestingly, a higher percentage of staff nurses (15.5%) reported engaging in meditation or relaxation practices compared to nursing students (6.5%). This could reflect a greater awareness or need among staff nurses to manage stress and promote mental well-being, potentially as a coping mechanism for their demanding work environment( 33 ). Secondly, our study findings showed that grip strength was significantly correlated with several anthropometric measures, including BMI, weight, height, waist circumference, waist-to-hip ratio, neck circumference, and upper arm circumference. Existing literature also supports these findings. For example, a study conducted with 913 healthy young adults aged 18–30 years found that grip strength was significantly higher in overweight and obese participants compared to underweight individuals (p < 0.001)( 34 ). In their study, hand grip strength correlated significantly with weight, height, body mass index (BMI), mid-upper arm circumference (MAC), triceps skinfold thickness (TSF), waist circumference (WC), and neck circumference (NC) (p < 0.001). Additionally, among those who exercised, there was a positive correlation between grip strength and the duration of exercise, although not with exercise intensity and relaxation/mediation habits in our study. This suggests that both body composition and regular physical activity contribute to muscle strength( 35 ). Scores of perceived stress and number of reported MSK problems were negatively associated with grip strength in our study. Similarly, a cross-sectional study found that participants with grip strength at or above the national average had significantly lower odds of self-reported orthopaedic problems, indicating a 135% reduced likelihood of experiencing orthopaedic issues compared to those with grip strength below the national average( 32 ). Lastly, the multiple linear regression analysis identified height, waist-to-hip ratio, and neck circumference as significant predictors of grip strength, explaining 57% of the variance. In line with our study, grip strength was significantly associated with BMI and waist circumference, explaining 76% of the variance in Indian nursing sample( 31 ). In another study with a Turkish sample, mid-upper arm circumference (MAC), triceps skinfold thickness (TSF), and sex were found to be significant predictors of grip strength, explaining 55.6% of the variance( 34 ). Implications for nurses Understanding the factors influencing grip strength has some important implications for nursing practice. Since grip strength is an important indicator of overall muscle strength, interventions to maintain and improve grip strength can enhance nurses' ability to perform physically demanding tasks. Regular exercise programs should be promoted among nurses to sustain muscle strength and overall physical health. Additionally, ergonomic practices should be implemented and emphasized to minimize the risk of musculoskeletal issues, which were found to negatively correlate with grip strength. Stress reduction strategies are also crucial, as stress was identified as a negative factor influencing grip strength. These strategies could include mindfulness training, relaxation techniques, and providing support for work-life balance. By focusing on these areas, healthcare organizations can help ensure that nurses maintain the necessary physical strength and overall well-being required. Therefore, they can meet the demands of their roles, ultimately improving patient care and outcomes. Limitations of the study This study has several limitations that should be considered when interpreting the findings. First, the cross-sectional design prevents establishing causality between the predicting factors and grip strength. Second, the study was conducted in a specific geographic location and within specific institutions, which may limit the generalizability of the results. Third, self-reported data on exercise habits, stress levels, and musculoskeletal complaints may be subject to recall and social desirability biases. Therefore, this may affect the accuracy of interpretations. Fourth, we used the Perceived Stress Scale-4 (PSS-4) and Nordic Musculoskeletal Questionnaire (NMQ), which may provide a broad overview but may lack the depth of more comprehensive assessments. Finally, the study could not include other factors that could influence grip strength, such as dietary habits, sleep quality, etc. These factors could contribute to a broader understanding of grip strength. We recommend future researchers address these limitations by incorporating a more diverse sample, using longitudinal designs with mixed methods, and including additional variables to provide a more comprehensive analysis of the factors affecting grip strength in nursing professionals. Conclusion Grip strength, measured using standardized techniques, provides valuable insights into the muscular strength of individuals within this population. The nursing profession demands physical resilience and strength due to the nature of patient care activities, which often involve lifting, transferring, and supporting patients. Among the various indicators of physical capability, grip strength serves as a reliable measure of overall muscular strength and function, reflecting an individual's capacity for performing daily tasks and potential risks of musculoskeletal disorders. In this regard, understanding the grip strength of staff nurses and nursing students is crucial for assessing their physical preparedness for clinical practice in the context of Turkish healthcare settings. Declarations Ethics approval and consent to participate The ethics committee (Istanbul Medeniyet University Goztepe Training and Research Hospital Clinical Research Ethics Committee, December 22, 2021) approved this research. Following ethical approval, institutional permissions (Istanbul Governor's Office, Provincial Health Directorate Health Services Presidency Research, Printed Publication, Announcement Content Evaluation Commission Decision dated 09.06.2022 and numbered E-15916306-604.01.01 (2022/12) were granted to collect the data. Written informed consent to participate in the study was obtained from all participants. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This work was supported by the Loma Linda University School of Nursing Seed Funds [grant number 2190522]. Author contributions The conceptualization of this study was driven by L.R.R and A.C.A. Data collection was performed by C.S. Subsequently, data analysis were completed by S.A., S.D., L.R.R., and S.S. Manuscript was written by C.S., A.C.A., L.R.R., S.A., and S.S. Additionally, critical revisions for important intellectual content was driven by L.R.R. Ultimately, all authors have read and agreed to the published version of the manuscript. Acknowledgements The authors would like to thank the staff nurses and nursing students who participated to this study. References Soysal P, Hurst C, Demurtas J, Firth J, Howden R, Yang L, et al. Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies. Journal of sport and health science. 2021;10(3):290-5. Bobos P, Nazari G, Lu Z, MacDermid JC. Measurement properties of the hand grip strength assessment: a systematic review with meta-analysis. Archives of physical medicine and rehabilitation. 2020;101(3):553-65. Carney C, Benzeval M. 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The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties. Disability and rehabilitation. 2016;38(21):2153-60. Crawford JO. The Nordic musculoskeletal questionnaire. Occupational medicine. 2007;57(4):300-1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied ergonomics. 1987;18(3):233-7. Fang Y, Li S, Zhang Y, Zhang P, Wu H, Wang D. Test-retest reliability of Nordic Musculoskeletal Questionnaire in nurses. Zhonghua lao dong wei sheng zhi ye bing za zhi= Zhonghua laodong weisheng zhiyebing zazhi= Chinese journal of industrial hygiene and occupational diseases. 2013;31(10):753-8. Amin NA, Nordin RB, Noah R, Oxley J, Fatt QK. Work related musculoskeletal disorders in female nursing personnel: prevalence and impact. International Journal of Collaborative Research on Internal Medicine & Public Health. 2016;8(3):294-315. Trinkoff AM, Brady B, Nielsen K. Workplace prevention and musculoskeletal injuries in nurses. JONA: The Journal of Nursing Administration. 2003;33(3):153-8. Svens B, Lee H. Intra-and inter-instrument reliability of Grip-Strength Measurements: GripTrack™ and Jamar® hand dynamometers. The British journal of hand therapy. 2005;10(2):47-55. Senthilnathan S. Usefulness of correlation analysis2019. Available from: https://ssrn.com/abstract=3416918 Sadan V, Seetharaman B, Jesudoss I, Esther A, Roberts LR. Grip Strength Among Indian Nursing Students and Staff: A Cross-Sectional Study. Nursing: Research and Reviews. 2023;13(null):31-9. Harrity R, Semakula R, Dehom S, D'Errico E, Roberts L. Preserving the Bedside Nurse: Grip Strength and Orthopedic Problems Among Nurses and Nursing Students. Workplace Health Saf. 2023;71(6):276-81. Ramachandran HJ, Bin Mahmud MS, Rajendran P, Jiang Y, Cheng L, Wang W. Effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder among nurses: A systematic review and meta-analysis. J Clin Nurs. 2023;32(11-12):2323-38. Doğan G, Tokaç Er N, Öztürk ME, Meriç ÇS, Yilmaz HÖ, Yabanci Ayhan N. Hand grip strength in young adults: association with obesity-related anthropometric variables. Journal of Public Health. 2023. Seong JY, Ahn HY, Park Y, Shin S, Ha IH. Association Between Aerobic Exercise and Handgrip Strength in Adults: A Cross-Sectional Study Based on Data from the Korean National Health and Nutrition Examination Survey (2014-2017). J Nutr Health Aging. 2020;24(6):619-26. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 26 Aug, 2024 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 25 Jul, 2024 Reviews received at journal 24 Jul, 2024 Reviews received at journal 23 Jul, 2024 Reviews received at journal 22 Jul, 2024 Reviewers agreed at journal 22 Jul, 2024 Reviewers agreed at journal 20 Jul, 2024 Reviewers agreed at journal 19 Jul, 2024 Reviewers agreed at journal 19 Jul, 2024 Reviewers invited by journal 19 Jul, 2024 Editor invited by journal 08 Jul, 2024 Editor assigned by journal 08 Jul, 2024 Submission checks completed at journal 08 Jul, 2024 First submitted to journal 01 Jul, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4670272","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":331526931,"identity":"4339792c-16c7-408c-80c8-2e03433bb3f4","order_by":0,"name":"Cemile Savci","email":"","orcid":"","institution":"Istanbul Medeniyet University","correspondingAuthor":false,"prefix":"","firstName":"Cemile","middleName":"","lastName":"Savci","suffix":""},{"id":331526934,"identity":"ed511ab8-440f-4f9c-965c-7a5056ca294b","order_by":1,"name":"Ayse Cil Akinci","email":"","orcid":"","institution":"Tampa General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ayse","middleName":"Cil","lastName":"Akinci","suffix":""},{"id":331526936,"identity":"e529744f-d2a1-401d-a82d-92b29d7fa199","order_by":2,"name":"Safiye Sahin","email":"","orcid":"","institution":"Loma Linda University","correspondingAuthor":false,"prefix":"","firstName":"Safiye","middleName":"","lastName":"Sahin","suffix":""},{"id":331526943,"identity":"c4c0d216-9ad5-4f59-a3ef-4c3ae51a6f8e","order_by":3,"name":"Sharon Atienza","email":"","orcid":"","institution":"Loma Linda University","correspondingAuthor":false,"prefix":"","firstName":"Sharon","middleName":"","lastName":"Atienza","suffix":""},{"id":331526947,"identity":"b135d539-28b9-404c-b56f-a73ebc9b6008","order_by":4,"name":"Salem Dehom","email":"","orcid":"","institution":"Loma Linda University","correspondingAuthor":false,"prefix":"","firstName":"Salem","middleName":"","lastName":"Dehom","suffix":""},{"id":331526949,"identity":"1c0f195f-b239-4eba-889f-a298b6de0a91","order_by":5,"name":"Lisa R. Roberts","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsElEQVRIiWNgGAWjYBACPgYGNjCDn525AUgxE9bCBtFiwCDZzEiqFoPDRGuRPnzswcc9f+yNDzO2STBUWCc2ENTCl5ZuOOOZQeI2sJYz6URo4eExk+Y5YJBgBtLC2HaYSC1/DhjYGzeDtPwjVgvDAQPGDcwgLQ1EaWFLN+w5YJw44zBjs0XCsXRjglr4eZiPPfhxQM6ev7354I0PNdayBLWgggTSlI+CUTAKRsEowAUAiF40taEE4KEAAAAASUVORK5CYII=","orcid":"","institution":"Loma Linda University","correspondingAuthor":true,"prefix":"","firstName":"Lisa","middleName":"R.","lastName":"Roberts","suffix":""}],"badges":[],"createdAt":"2024-07-01 21:38:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4670272/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4670272/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-024-02269-1","type":"published","date":"2024-08-26T15:57:53+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":63821055,"identity":"082fa333-fd92-48e2-ad7c-5255e466e9b8","added_by":"auto","created_at":"2024-09-02 16:11:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":879444,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4670272/v1/e3a016c5-5498-4de2-afa1-ab895625dc27.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Cross-sectional Study Evaluating Grip Strength and Associated Factors in Turkish Nurses and Nursing Students","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGrip strength is a measure of upper body strength that indicates overall muscular strength which predicts musculoskeletal health, disease development and progression, disability and mortality, or healthy aging(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Data on grip strength in different countries show an increase from childhood to early adulthood, a relatively steady increase in middle age and a decline from middle age onwards. Variation in average grip strength also varies geographically(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Dodds et al. (2016) reported that grip strength was lower in developing countries compared to developed countries. In the same study, it was found that individuals with larger body sizes had higher grip strength(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGlobally, nurses are reported to be at risk of workplace injuries or musculoskeletal disorders leading to disability and causing nurses to leave the nursing workforce(\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). A meta-analysis of 42 studies found that the annual prevalence of workplace injuries or musculoskeletal disorders among nurses is 77.2%. The most common areas affected are lower back (59.5%), neck (53.0%), and shoulder (46.8%)(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Work-related musculoskeletal injuries and disorders are not only common among nurses and cause them to leave their jobs, but are also costly to diagnose and treat. A study developed a framework for estimating the economic burden of work injuries and diseases in selected European Union countries, revealing that Poland exhibits the highest overall costs as a percentage of GDP (10.4%), while the Netherlands has the highest per case costs (\u0026euro;75,342)(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePatient handling, lifting, and positioning are the primary risk factors for musculoskeletal injuries and disorders(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Nurses who are not physically fit or do not lead an active lifestyle may be at high risk(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Other factors associated with workplace injuries or musculoskeletal disorders include fatigue, years of work, consecutive shift schedule, variability of shifts, muscle mass, physical capacity, grip strength, and upper body strength(\u003cspan additionalcitationids=\"CR13 CR14\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Nursing students may also encounter unfamiliar, stressful environments and physically demanding workloads during clinical and laboratory practice. This may increase the risk of work-related musculoskeletal disorders in nursing students(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In a study conducted in Australia, nursing students were reported to experience symptoms of musculoskeletal disorders, and despite regular exercise, most of these students had poor to average health levels, and most also had poor to average grip strength(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe literature suggests that grip strength testing is a useful tool for assessing the functional capacity of healthcare workers(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Factors likely to affect grip strength include age, gender, height, weight, body mass index, working hours, working time in the profession, consecutive shifts, stress, exercise habits, and physical strength required during work in the clinical field(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Determination of grip strength and related factors will contribute to the development of recommendations for the planning of future interventions to increase nurses' job performance and career longevity, as well as protect the health of nursing students and currently working nurses. There are studies conducted in other countries to determine grip strength and related factors in nurses and nursing students(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, there are only studies on the subject in different populations other than nurses and nursing students in Turkey (\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Therefore, in this study, we aimed to fill this gap on grip strength of nurses.\u003c/p\u003e \u003cp\u003eIn this study, the following questions were addressed: i) Is there any difference between nurses and nursing students in terms of grip strength. ii) Are demographic characteristics, exercise status, perceived stress, status of having musculoskeletal trouble in various body parts, and anthropometric measurements associated with the grip strength of nursing students and staff nurses? iii) What are the predictors of the grip strength in this sample of nursing students and staff nurses?\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and sample\u003c/h2\u003e \u003cp\u003eThis study was designed as a descriptive and correlational study. The data were collected from the nursing students attending the [removed for blind review], Turkey, between May 1 and September 30, 2022. The inclusion criteria for the study were as follows: be at least 18 years old; work actively as a nurse for at least six months or be a nursing student at the selected university; not have musculoskeletal trouble in the dominant hand, which is used for grip strength measurement; not be on vacation or rest during the study; and voluntarily agree to participate in the study. The study was conducted with 200 staff nurses and 200 nursing students.\u003c/p\u003e \u003cp\u003ePower analysis was performed to determine the adequacy of sample size. For a multiple regression model with 15 predictors, the analysis indicated that a minimum of 139 participants would be necessary for a medium effect size (f\u0026sup2; = 0.15), a significance level of 0.05, and a power of 0.80. Our sample size of 400 participants exceeds this requirement, indicating a robust sample size for the intended analyses.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection forms\u003c/h2\u003e \u003cp\u003eThe data collection form included self-reported participant information and validated scales. Later, anthropometric variables and the grip strength of the participants were measured and recorded on the same form.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eParticipant Information Form\u003c/strong\u003e \u003cp\u003eThis form consisted of items related to the descriptive characteristics of the staff nurses and nursing students, including age, gender, educational status, nursing role, work time, work type, total working hours per week, leave of absence for any reason, exercise and relaxation habits, and status of musculoskeletal trouble in various body parts (such as the neck, shoulder, upper back, lower back, hip, etc.).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePerceived Stress Scale 4 (PSS-4)\u003c/strong\u003e \u003cp\u003eThis four-item scale is commonly used to measure the subjective stress of someone during the last month of health research. Each question is graded between 0 (never) and very often (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), and questions 2 and 3 are reverse-coded. The total score is determined by adding together the scores of each of the four items and can be between 0 and 16. While higher scores are correlated with more stress, lower scores are correlated with less stress (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The Turkish validity and reliability study of the PSS-4 was performed by Eskin et al. and the Cronbach's alpha value was reported as 0.66(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In this study, it was calculated as 0.80.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eNordic Musculoskeletal Questionnaire (NMQ)\u003c/strong\u003e \u003cp\u003eThis questionnaire includes self-reported location (neck, shoulders, elbows, wrists/hands, upper and lower back, hips/thighs, knees, and ankles/feet) and severity of musculoskeletal symptoms during the past week up to the last 12 months. NMQ items include effect of symptoms on leisure/work activities, and whether or not healthcare was sought. The NMQ has good construct validity and test-retest reliability when compared to clinical history, is commonly used among nurses, and has previously been validated in Turkey with Cronbach\u0026rsquo;s alpha\u0026thinsp;=\u0026thinsp;0.896(\u003cspan additionalcitationids=\"CR24 CR25 CR26 CR27\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). In this study Cronbach\u0026rsquo;s alpha\u0026thinsp;=\u0026thinsp;0.85. In our study, reported musculoskeletal (MSK) issues within the past 12 months were coded as 'yes' if participants reported having trouble in any part of their body. Conversely, if participants did not report trouble in any part of their body, their response was coded as 'no'. Upper MSK complaints were calculated based on the number of issues participants reported in their upper body parts (neck, shoulders, upper back, elbows, and wrists/hands) over the past 12 months. The possible range of complaints is 0 to 5. Similarly, lower MSK complaints were calculated for lower body parts (lower back, hips/thighs, knees, and ankles/feet), with a possible range of 0 to 4. The total number of MSK complaints was calculated by summing the upper and lower body complaints, resulting in a possible range of 0 to 9.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAnthropometric Measurements\u003c/strong\u003e \u003cp\u003eHeight, weight, waist circumference, hip circumference, neck circumference, and upper arm circumference were measured and recorded by researchers. After this, BMI, waist/hip ratio, and waist/height ratio were calculated.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eGrip strength measurement\u003c/strong\u003e \u003cp\u003eGrip strength was measured on the dominant hand of each participant using the Jamar digital dynamometer(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Before measuring hand grip strength, staff nurses and nursing students were asked to take a comfortable seated position, then squeeze the dynamometer as tight as they could for 4\u0026ndash;5 seconds and relax. No other body movements were allowed during this time, according to a standardized study protocol. To obtain an average grip strength value, three consecutive measurements were made, and the average of these measurements was automatically calculated. The participant\u0026rsquo;s measurement results and the Turkish reference values were shared with them.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003e This study was conducted by the principles outlined in the Declaration of Helsinki. Ethics committee approval (Istanbul Medeniyet University Goztepe Training and Research Hospital Clinical Research Ethics Committee, December 22, 2021) and institutional permission (Istanbul Governor's Office, Provincial Health Directorate Health Services Presidency Research, Printed Publication, Announcement Content Evaluation Commission Decision dated 09.06.2022 and numbered E-15916306-604.01.01 (2022/12) were obtained prior to the implementation of the study. Staff nurses and nursing students were informed about the purpose of the study, and those who voluntarily agreed to participate in the study were asked to fill out the data collection form. Individuals who agreed to participate in the study were guaranteed the right to withdraw at any time.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe SPSS 22 (Statistical Package for Social Sciences, Inc., IL, USA) program was used to analyse the data. Number, percentage, mean, standard deviation, and minimum and maximum values were calculated in descriptive statistics for categorical and continuous variables. Histograms were used to determine the conformity of the data to the normal distribution. As the distribution was normal, an independent sample t-test, and chi-square test were used to compare the nursing students and staff nurses. Pearson's correlation coefficient was used to examine the relationship between two normally distributed quantitative variables. To test the predictors of grip strength, multiple linear regression analysis was performed. The level of significance was considered as \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Participants\u0026rsquo; grip strength was compared to the published Turkish normative values by age and gender(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDescriptive statistics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003ea summarizes the characteristics of sample. The total sample (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;400) was evenly divided between staff nurses and nursing students. The gender distribution is similar across groups, with approximately 75% female and 25% male participants. Staff nurses are older on average (28.70 years) compared to nursing students (20.91 years). About 43.3% of participants reported exercising, with no significant difference between staff nurses and nursing students in exercise habits or intensity (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, staff nurses reported more musculoskeletal (MSK) issues in the last 12 months (79.5% vs. 66.0%), with significantly higher MSK complaints overall and specifically in both upper and lower body regions (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Meditation or relaxation practices were reported by 11.0% of the participants, with staff nurses engaging in these practices more than nursing students (15.5% vs. 6.5%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Stress levels (the average score of the PSS-4) were similar between the groups (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003ea\u003c/b\u003e Self-reported characteristics of participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll Participants\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;400)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStaff nurses\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNursing students\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e-test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e (%) or\u003c/p\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e (\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e (%) or\u003c/p\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e (\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e (%) or\u003c/p\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e (\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.908\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e301 (75.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e151 (75.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150 (75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e99 (24.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (24.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (25.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.80 (5.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.70 (5.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.91 (2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExercise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e173 (43.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81 (40.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92 (46.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e227(56.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119(59.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108(54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExercise minutes\u003c/b\u003e\u003csup\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e57.64 (26.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57.31 (27.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.93 (26.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExercise Intensity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e226 (56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e106 (53.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (3.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (3.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e156 (39.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73 (36.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83 (41.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (1.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (2.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReported MSK issues in the last 12 months\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e291 (72.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79.5% (159)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.0% (132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109(27.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41(20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68(34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAll MSK complaints\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.50 (2.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.20 (2.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.81 (1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUpper MSK complaints\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.53 (1.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.87 (1.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.19 (1.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLower MSK complaints\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.975 (1.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.33 (1.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.62 (.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMeditation/relaxation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (11.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (15.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (29.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDays/week for meditation/relaxation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.15 (.918)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.09 (1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.29 (.611)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceived Stress Scale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.45 (2.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.33 (2.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.57 (2.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003e1\u003c/sup\u003eIncludes any participants who recorded minutes of exercise, regardless of their answer for exercise status\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAnthropomorphic measurements of participants are summarized in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb. Staff nurses have a higher average BMI (23.59) compared to nursing students (21.82), with corresponding higher average weight (65.60 kg for staff nurses vs. 60.97 kg for nursing students). Height is similar between the groups. Staff nurses also have larger waist circumferences (77.86 cm vs. 74.03 cm) and higher waist-to-hip (0.777 vs. 0.750) and waist-to-height ratios (0.468 vs. 0.442). Hip circumference is slightly higher in nurses, but not significantly different (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Neck circumference and upper arm circumference are both larger in nurses, with the latter being significantly different. Grip strength is similar between the groups. Of the total sample, 195 (48.8%) met or exceeded the median Turkish grip strength normative values for gender and age.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eb\u003c/b\u003e Anthropomorphic measurements of participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAll Participants\u003c/span\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003eN\u0026thinsp;=\u0026thinsp;400\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eStaff nurses\u003c/span\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eNursing students\u003c/span\u003e\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e-test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCharacteristic\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eM\u003c/b\u003e \u003cb\u003e(\u003c/b\u003e\u003cb\u003eSD\u003c/b\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eM\u003c/b\u003e \u003cb\u003e(\u003c/b\u003e\u003cb\u003eSD\u003c/b\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eM\u003c/b\u003e \u003cb\u003e(\u003c/b\u003e\u003cb\u003eSD\u003c/b\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e \u003cb\u003evalue\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.71 (3.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.59 (3.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.82 (3.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;. 001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.28 (12.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.60 (12.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.97 (11.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e166.60 (8.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e166.20 (8.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e167.01 (7.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.316\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75.94 (10.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.86(11.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74.03 (8.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHip circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99.19 (8.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.86 (9.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98.52 (7.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.104\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist: Hip ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.764 (0.066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.777 (0.073)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.750 (0.056)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist: Height ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.455 (.057)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.468 (.065)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.442 (.045)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33.23 (3.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.52 (3.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.95 (3.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.080\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper arm circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.78 (3.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.18 (3.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.37 (2.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck: Upper arm ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.24 (.105)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.24 (.112)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.25 (.097)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.243\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrip strength\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.42 (9.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.65 (9.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.19 (9.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.636\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e \u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e \u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eN\u003c/b\u003e \u003cb\u003e(%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal grip strength\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195 (48.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95(47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100(50.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003e1\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eGrip strength in kilograms.\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003csup\u003e \u003cem\u003e2\u003c/em\u003e \u003c/sup\u003e \u003cem\u003eMet or exceeded median Turkish grip strength normative values for gender and age (Ekşioğlu, 2016).\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation Analysis\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the Pearson correlations between grip strength and various anthropometric measurements, exercise habits, meditation frequency, perceived stress scores, and the number of musculoskeletal (MSK) complaints.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eCorrelation of grip strength and independent characteristics\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCorrelation Coefficient\u003csup\u003e2\u003c/sup\u003e (\u003cem\u003er\u003c/em\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.286\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.545\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.696\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHip circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist:Hip ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.507\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist:Height ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.647\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper arm circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck: Upper arm ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExercise (min/wk)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeditation (days/wk)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.070\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExercise Intensity (low, med, high)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerceived Stress score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e# of MSK problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e\u003cem\u003e1\u003c/em\u003e\u003c/sup\u003e \u003cem\u003eN\u0026thinsp;=\u0026thinsp;400 unless otherwise indicated\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e \u003cem\u003ePearson correlation\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAmong anthropometric variables, weight, height, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, neck circumference, and upper arm circumference demonstrated significant positive correlations with grip strength (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Exercise frequency was also positively correlated with grip strength while perceived stress scores and the number of MSK problems were negatively correlated. Variables such as age, meditation frequency, and exercise intensity did not show significant correlations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of Grip Strength\u003c/h2\u003e \u003cp\u003eVariables with an absolute \u003cem\u003er\u003c/em\u003e of 0.20 or higher were considered associated with grip strength (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), and added to the multiple linear regression analyses.\u003c/p\u003e \u003cp\u003eIn the first multiple linear regression analyses, BMI, weight, height, waist circumference, waist to hip ratio, neck circumference, upper arm circumference and minutes of exercise were added to the model as predictors of grip strength. Variance Inflation Factors (VIF) were checked to assess the level of multicollinearity between independent variables (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003ea).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003ea\u003c/b\u003e VIF Values of Predictors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFirst Model\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSecond Model\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFinal Model\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePredictors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVIF Values\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVIF Values\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVIF Values\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.570\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.506\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.943\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExcluded\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExcluded\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.997\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.538\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExcluded\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaist-to-hip ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.639\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.215\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper arm circumference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.643\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExercise Minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.127\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cem\u003eNote: VIF\u0026thinsp;=\u0026thinsp;1 shows no multicollinearity and 1\u0026ndash;5 shows low level of multicollinearity.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to VIF values, VIF\u0026thinsp;=\u0026thinsp;1 implies no multicollinearity, and 1\u0026thinsp;\u0026lt;\u0026thinsp;VIF\u0026thinsp;\u0026lt;\u0026thinsp;5 indicates low-level multicollinearity (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Therefore, weight was excluded due to high multicollinearity. Then, multiple linear regression analysis was rerun and multicollinearity was checked again. Waist circumference were excluded due to high VIF value. After multicollinearity was eliminated, the final multiple linear regression analysis was performed and is shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003eb. In the final model, only height, waist to hip ratio, and neck circumference were significant positive predictors of grip strength, and explained 57% of the variance (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cstrong\u003eb\u003c/strong\u003e Regression analyses of variables correlated with grip strength\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eFinal Model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\" style=\"width: 18.6143%;\"\u003e\n \u003cp\u003eUnstandardized\u003c/p\u003e\n \u003cp\u003eCoefficients\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003eStandardized Coefficients\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\" rowspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 8.6867%;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\" style=\"width: 9.9276%;\"\u003e\n \u003cp\u003eStd. Error\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003eBeta\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e-102.540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e11.558\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e.529\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eHeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e.518\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e.434\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eWaist-to-hip ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e28.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e10.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eNeck circumference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e1.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e.286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e.326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eUpper arm circumference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e.529\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 17.3733%;\"\u003e\n \u003cp\u003eExercise Minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 6.3082%;\"\u003e\n \u003cp\u003e.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 10.1344%;\"\u003e\n \u003cp\u003e.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 19.3841%;\"\u003e\n \u003cp\u003e.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 22.9347%;\"\u003e\n \u003cp\u003e.660\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.587, Adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.567\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to examine grip strength and its predictors in a sample of Turkish nurses. Initially, we aimed to determine whether there are differences in hand grip strength between nursing students and staff nurses. Then, we sought to investigate the relationship between grip strength and various factors, including demographic characteristics, anthropometric measurements, exercise habits, perceived stress levels, and the presence of musculoskeletal issues in different body parts. Lastly, we aimed to identify the predictors of grip strength within this nursing sample. The results, based on a Turkish nursing sample of 400, provide several insights into their grip strength and related factors.\u003c/p\u003e \u003cp\u003eFirstly, grip strength was found to be similar between nursing student and staff nurses despite significant differences in age, reported musculoskeletal issues, and some anthropomorphic measurements of participants. In line with our results, in a cross-sectional study with 316 participants (18 to 59 years) at a large teaching hospital in India, mean grip strength did not significantly differ between nursing staff and nursing students(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). In our study, staff nurses had higher BMI and weight compared to nursing students. In addition, the prevalence of MSK issues among nurses (79.5%) were higher than nursing students (66.0%) which is concerning. The significantly higher rates of MSK complaints in both upper and lower body among staff nurses highlight the physical demands and potential occupational hazards associated with nursing work(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). These findings underscore the need for targeted ergonomic interventions and preventive strategies to reduce the risk of MSK disorders in nursing professionals(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). However, the exercise habits, duration, and intensity were found to be similar between the two groups in our sample. This similarity in exercise patterns might explain the comparable grip strength results observed. Stress levels were found to be similar between staff nurses and nursing students that may be related to their respective roles and responsibilities. Interestingly, a higher percentage of staff nurses (15.5%) reported engaging in meditation or relaxation practices compared to nursing students (6.5%). This could reflect a greater awareness or need among staff nurses to manage stress and promote mental well-being, potentially as a coping mechanism for their demanding work environment(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSecondly, our study findings showed that grip strength was significantly correlated with several anthropometric measures, including BMI, weight, height, waist circumference, waist-to-hip ratio, neck circumference, and upper arm circumference. Existing literature also supports these findings. For example, a study conducted with 913 healthy young adults aged 18\u0026ndash;30 years found that grip strength was significantly higher in overweight and obese participants compared to underweight individuals (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). In their study, hand grip strength correlated significantly with weight, height, body mass index (BMI), mid-upper arm circumference (MAC), triceps skinfold thickness (TSF), waist circumference (WC), and neck circumference (NC) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Additionally, among those who exercised, there was a positive correlation between grip strength and the duration of exercise, although not with exercise intensity and relaxation/mediation habits in our study. This suggests that both body composition and regular physical activity contribute to muscle strength(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Scores of perceived stress and number of reported MSK problems were negatively associated with grip strength in our study. Similarly, a cross-sectional study found that participants with grip strength at or above the national average had significantly lower odds of self-reported orthopaedic problems, indicating a 135% reduced likelihood of experiencing orthopaedic issues compared to those with grip strength below the national average(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLastly, the multiple linear regression analysis identified height, waist-to-hip ratio, and neck circumference as significant predictors of grip strength, explaining 57% of the variance. In line with our study, grip strength was significantly associated with BMI and waist circumference, explaining 76% of the variance in Indian nursing sample(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). In another study with a Turkish sample, mid-upper arm circumference (MAC), triceps skinfold thickness (TSF), and sex were found to be significant predictors of grip strength, explaining 55.6% of the variance(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eImplications for nurses\u003c/h2\u003e \u003cp\u003eUnderstanding the factors influencing grip strength has some important implications for nursing practice. Since grip strength is an important indicator of overall muscle strength, interventions to maintain and improve grip strength can enhance nurses' ability to perform physically demanding tasks. Regular exercise programs should be promoted among nurses to sustain muscle strength and overall physical health. Additionally, ergonomic practices should be implemented and emphasized to minimize the risk of musculoskeletal issues, which were found to negatively correlate with grip strength. Stress reduction strategies are also crucial, as stress was identified as a negative factor influencing grip strength. These strategies could include mindfulness training, relaxation techniques, and providing support for work-life balance. By focusing on these areas, healthcare organizations can help ensure that nurses maintain the necessary physical strength and overall well-being required. Therefore, they can meet the demands of their roles, ultimately improving patient care and outcomes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eThis study has several limitations that should be considered when interpreting the findings. First, the cross-sectional design prevents establishing causality between the predicting factors and grip strength. Second, the study was conducted in a specific geographic location and within specific institutions, which may limit the generalizability of the results. Third, self-reported data on exercise habits, stress levels, and musculoskeletal complaints may be subject to recall and social desirability biases. Therefore, this may affect the accuracy of interpretations. Fourth, we used the Perceived Stress Scale-4 (PSS-4) and Nordic Musculoskeletal Questionnaire (NMQ), which may provide a broad overview but may lack the depth of more comprehensive assessments. Finally, the study could not include other factors that could influence grip strength, such as dietary habits, sleep quality, etc. These factors could contribute to a broader understanding of grip strength. We recommend future researchers address these limitations by incorporating a more diverse sample, using longitudinal designs with mixed methods, and including additional variables to provide a more comprehensive analysis of the factors affecting grip strength in nursing professionals.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eGrip strength, measured using standardized techniques, provides valuable insights into the muscular strength of individuals within this population. The nursing profession demands physical resilience and strength due to the nature of patient care activities, which often involve lifting, transferring, and supporting patients. Among the various indicators of physical capability, grip strength serves as a reliable measure of overall muscular strength and function, reflecting an individual's capacity for performing daily tasks and potential risks of musculoskeletal disorders. In this regard, understanding the grip strength of staff nurses and nursing students is crucial for assessing their physical preparedness for clinical practice in the context of Turkish healthcare settings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethics committee (Istanbul Medeniyet University Goztepe Training and Research Hospital Clinical Research Ethics Committee, December 22, 2021) approved this research. Following ethical approval, institutional permissions (Istanbul Governor\u0026apos;s Office, Provincial Health Directorate Health Services Presidency Research, Printed Publication, Announcement Content Evaluation Commission Decision dated 09.06.2022 and numbered E-15916306-604.01.01 (2022/12) were granted to collect the data. Written informed consent to participate in the study was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the Loma Linda University School of Nursing Seed Funds [grant number 2190522].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe conceptualization of this study was driven by L.R.R and A.C.A. Data collection was performed by C.S. Subsequently, data analysis were completed by S.A., S.D., L.R.R., and S.S. Manuscript was written by C.S., A.C.A., L.R.R., S.A., and S.S. \u0026nbsp;Additionally, critical revisions for important intellectual content was driven by L.R.R. Ultimately, all authors have read and agreed to the published version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the staff nurses and nursing students who participated to this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSoysal P, Hurst C, Demurtas J, Firth J, Howden R, Yang L, et al. Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies. Journal of sport and health science. 2021;10(3):290-5.\u003c/li\u003e\n\u003cli\u003eBobos P, Nazari G, Lu Z, MacDermid JC. Measurement properties of the hand grip strength assessment: a systematic review with meta-analysis. Archives of physical medicine and rehabilitation. 2020;101(3):553-65.\u003c/li\u003e\n\u003cli\u003eCarney C, Benzeval M. Social patterning in grip strength and in its association with age; a cross sectional analysis using the UK Household Longitudinal Study (UKHLS). BMC Public Health. 2018;18:1-8.\u003c/li\u003e\n\u003cli\u003eDodds RM, Syddall HE, Cooper R, Kuh D, Cooper C, Sayer AA. Global variation in grip strength: a systematic review and meta-analysis of normative data. Age and ageing. 2016;45(2):209-16.\u003c/li\u003e\n\u003cli\u003eGilchrist A, Pokorn\u0026aacute; A. Prevalence of musculoskeletal low back pain among registered nurses: Results of an online survey. Journal of clinical nursing. 2021;30(11-12):1675-83.\u003c/li\u003e\n\u003cli\u003eLin SC, Lin LL, Liu CJ, Fang CK, Lin MH. Exploring the factors affecting musculoskeletal disorders risk among hospital nurses. 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A comprehensive systematic review of the literature. Journal of safety research. 2022;82:124-43.\u003c/li\u003e\n\u003cli\u003eRichardson A, McNoe B, Derrett S, Harcombe H. Interventions to prevent and reduce the impact of musculoskeletal injuries among nurses: A systematic review. International journal of nursing studies. 2018;82:58-67.\u003c/li\u003e\n\u003cli\u003eHarrity R, Semakula R, Dehom S, D\u0026rsquo;Errico E, Roberts L. Preserving the Bedside Nurse: Grip Strength and Orthopedic Problems Among Nurses and Nursing Students. Workplace Health \u0026amp; Safety. 2023;71(6):276-81.\u003c/li\u003e\n\u003cli\u003eThompson BJ. Does work-induced fatigue accumulate across three compressed 12 hour shifts in hospital nurses and aides? PLoS One. 2019;14(2):e0211715.\u003c/li\u003e\n\u003cli\u003eThompson BJ, Stock MS, Banuelas VK. Effects of accumulating work shifts on performance-based fatigue using multiple strength measurements in day and night shift nurses and aides. Human factors. 2017;59(3):346-56.\u003c/li\u003e\n\u003cli\u003eSadan V, Seetharaman B, Jesudoss I, Esther A, Roberts LR. Grip Strength Among Indian Nursing Students and Staff: A Cross-Sectional Study. Nursing: Research and Reviews. 2023:31-9.\u003c/li\u003e\n\u003cli\u003eElsayed AA. Work-related musculoskeletal disorders among nursing students during clinical training. Am J Nurs. 2019;7(6):952-7.\u003c/li\u003e\n\u003cli\u003ePugh JD, Cormack K, Gelder L, Williams AM, Twigg DE, Blazevich AJ. Exercise, fitness and musculoskeletal health of undergraduate nursing students: A cross‐sectional study. Journal of advanced nursing. 2019;75(10):2110-21.\u003c/li\u003e\n\u003cli\u003eMerchaoui I, Bouzgarrou L, Amri C, Akrout M, Malchaire J, El Mhamdi S, Chaari N. Determinants of grip strength in Tunisian nurses: A bicentric study. Recent Patents on Inflammation \u0026amp; Allergy Drug Discovery. 2016;10(1):54-60.\u003c/li\u003e\n\u003cli\u003eU\u0026ccedil;kun A\u0026Ccedil;, G\u0026uuml;venir AA, Yurdakul FG, G\u0026uuml;ler T, Sivas F, Bodur H. Hand grip strength in elderly rheumatoid arthritis patients. Duzce Medical Journal. 2019;21(3):210-3.\u003c/li\u003e\n\u003cli\u003eKılı\u0026ccedil; P, Pekcan G. Yetişkin bireylerde el kavrama g\u0026uuml;c\u0026uuml; referans değerleri. Beslenme ve Diyet Dergisi. 2012;40(1):32-42.\u003c/li\u003e\n\u003cli\u003eEkşioğlu M. Normative static grip strength of population of Turkey, effects of various factors and a comparison with international norms. Applied ergonomics. 2016;52:8-17.\u003c/li\u003e\n\u003cli\u003eEskin M, Harlak H, Demirkıran F, Dereboy \u0026Ccedil;, editors. Algılanan stres \u0026ouml;l\u0026ccedil;eğinin T\u0026uuml;rk\u0026ccedil;eye uyarlanması: g\u0026uuml;venirlik ve ge\u0026ccedil;erlik analizi. New/Yeni Symposium Journal; 2013.\u003c/li\u003e\n\u003cli\u003eKahraman T, Gen\u0026ccedil; A, G\u0026ouml;z E. The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties. Disability and rehabilitation. 2016;38(21):2153-60.\u003c/li\u003e\n\u003cli\u003eCrawford JO. The Nordic musculoskeletal questionnaire. Occupational medicine. 2007;57(4):300-1.\u003c/li\u003e\n\u003cli\u003eKuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-S\u0026oslash;rensen F, Andersson G, J\u0026oslash;rgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied ergonomics. 1987;18(3):233-7.\u003c/li\u003e\n\u003cli\u003eFang Y, Li S, Zhang Y, Zhang P, Wu H, Wang D. Test-retest reliability of Nordic Musculoskeletal Questionnaire in nurses. Zhonghua lao dong wei sheng zhi ye bing za zhi= Zhonghua laodong weisheng zhiyebing zazhi= Chinese journal of industrial hygiene and occupational diseases. 2013;31(10):753-8.\u003c/li\u003e\n\u003cli\u003eAmin NA, Nordin RB, Noah R, Oxley J, Fatt QK. Work related musculoskeletal disorders in female nursing personnel: prevalence and impact. International Journal of Collaborative Research on Internal Medicine \u0026amp; Public Health. 2016;8(3):294-315.\u003c/li\u003e\n\u003cli\u003eTrinkoff AM, Brady B, Nielsen K. Workplace prevention and musculoskeletal injuries in nurses. JONA: The Journal of Nursing Administration. 2003;33(3):153-8.\u003c/li\u003e\n\u003cli\u003eSvens B, Lee H. Intra-and inter-instrument reliability of Grip-Strength Measurements: GripTrack\u0026trade; and Jamar\u0026reg; hand dynamometers. The British journal of hand therapy. 2005;10(2):47-55.\u003c/li\u003e\n\u003cli\u003eSenthilnathan S. Usefulness of correlation analysis2019. Available from: https://ssrn.com/abstract=3416918 \u003c/li\u003e\n\u003cli\u003eSadan V, Seetharaman B, Jesudoss I, Esther A, Roberts LR. Grip Strength Among Indian Nursing Students and Staff: A Cross-Sectional Study. Nursing: Research and Reviews. 2023;13(null):31-9.\u003c/li\u003e\n\u003cli\u003eHarrity R, Semakula R, Dehom S, D\u0026apos;Errico E, Roberts L. Preserving the Bedside Nurse: Grip Strength and Orthopedic Problems Among Nurses and Nursing Students. Workplace Health Saf. 2023;71(6):276-81.\u003c/li\u003e\n\u003cli\u003eRamachandran HJ, Bin Mahmud MS, Rajendran P, Jiang Y, Cheng L, Wang W. Effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder among nurses: A systematic review and meta-analysis. J Clin Nurs. 2023;32(11-12):2323-38.\u003c/li\u003e\n\u003cli\u003eDoğan G, Toka\u0026ccedil; Er N, \u0026Ouml;zt\u0026uuml;rk ME, Meri\u0026ccedil; \u0026Ccedil;S, Yilmaz H\u0026Ouml;, Yabanci Ayhan N. Hand grip strength in young adults: association with obesity-related anthropometric variables. Journal of Public Health. 2023.\u003c/li\u003e\n\u003cli\u003eSeong JY, Ahn HY, Park Y, Shin S, Ha IH. Association Between Aerobic Exercise and Handgrip Strength in Adults: A Cross-Sectional Study Based on Data from the Korean National Health and Nutrition Examination Survey (2014-2017). J Nutr Health Aging. 2020;24(6):619-26.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"grip strength, staff nurses, nursing student, musculoskeletal complaints","lastPublishedDoi":"10.21203/rs.3.rs-4670272/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4670272/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGrip strength is a crucial indicator of overall muscle strength and is important for the physical demands of nursing.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aims to examine the differences in grip strength between staff nurses and nursing students and to identify factors associated with grip strength in nursing sample.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eThis descriptive and analytical study collected data from nursing students and staff nurses in Turkey, from May 1 to September 30, 2022. A total of 200 staff nurses and 200 nursing students participated. Data were collected using a participant information form, the Perceived Stress Scale-4 (PSS-4), and the Nordic Musculoskeletal Questionnaire (NMQ). Additionally, researchers recorded anthropometric measurements and assessed grip strength using a digital hand dynamometer.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eGrip strength was similar across groups, with nearly half (48.8%) meeting or exceeding Turkish normative values. 79.5% of staff nurses and 66.0% of nursing students reported musculoskeletal (MSK) issues in the last 12 months. Correlation analysis indicated that grip strength negatively correlated with stress level and musculoskeletal complaints. Multiple linear regression identified height, waist-to-hip ratio, and neck circumference as significant predictors of grip strength, explaining 57% of the variance.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eGrip strength was similar between staff nurses and nursing students, despite differences in age, BMI, and musculoskeletal issues. Height, waist-to-hip ratio, and neck circumference are key predictors of grip strength in this Turkish nursing sample. Understanding the factors influencing grip strength can help in designing targeted interventions to maintain and improve muscle strength in nursing professionals.\u003c/p\u003e","manuscriptTitle":"A Cross-sectional Study Evaluating Grip Strength and Associated Factors in Turkish Nurses and Nursing Students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-31 12:12:18","doi":"10.21203/rs.3.rs-4670272/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-25T06:04:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-24T10:01:04+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-23T21:39:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-22T13:09:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92364616472021417206474230629938572285","date":"2024-07-22T07:27:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"118429147621799354127339121851965969752","date":"2024-07-20T20:46:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"186009420447852549259725149639087816790","date":"2024-07-19T20:56:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"190620944624262129776695718191288986141","date":"2024-07-19T14:21:20+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-19T13:16:56+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-07-08T11:41:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-08T11:40:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-08T11:40:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-07-01T21:27:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a7897903-47ed-4095-a32a-e3066a2b685f","owner":[],"postedDate":"July 31st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-09-02T16:03:16+00:00","versionOfRecord":{"articleIdentity":"rs-4670272","link":"https://doi.org/10.1186/s12912-024-02269-1","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2024-08-26 15:57:53","publishedOnDateReadable":"August 26th, 2024"},"versionCreatedAt":"2024-07-31 12:12:18","video":"","vorDoi":"10.1186/s12912-024-02269-1","vorDoiUrl":"https://doi.org/10.1186/s12912-024-02269-1","workflowStages":[]},"version":"v1","identity":"rs-4670272","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4670272","identity":"rs-4670272","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}