Stress and musculoskeletal symptom of undergraduates

대학생의 스트레스와 근골격계 증상 관련성

  • Received : 2015.11.21
  • Accepted : 2016.03.01
  • Published : 2016.03.31


Objectives: The study aimed to determine the prevalence of and the relationship between stress and musculoskeletal symptoms among undergraduate students. Methods: The convenience sampling method was used for this cross-sectional survey that was conducted from June 16, 2014 to June 21, 2014. A total of 223 subjects (88 men, 135 women) participated in the study and completed a comprehensive self-administered questionnaire requesting information on demographics, medical history, lifestyle, and musculoskeletal symptoms. The Depression Anxiety Stress Scale (DASS) was also administered to the subjects. A total of 223 subjects from 12 universities completed the questionnaires; the data obtained was used for the final statistical analysis. Results: Women had a higher prevalence of stress and musculoskeletal symptoms. Adjusting for sex and age, subjects who were stressed had a 2.85-fold higher risk of musculoskeletal symptoms than subjects who were not stressed. Stratified analyses by sex also showed that women had a higher risk of musculoskeletal symptoms (Modified OR 2.98, 95% CI 1.38-6.45). Conclusions: We found a positive association between stress and musculoskeletal symptoms in undergraduate students; sex differences were present. Further dose-response relationship between stress and musculoskeletal symptoms will be identified by a longitudinal study with a larger sample size.


stress;musculoskeletal abnormality;sex difference;undergraduate students


  1. Akin A. & Cetin B. (2007). The Depression Anxiety and Stress Scale (DASS): The study of Validity and Reliability. Educational Sciences: Theory & Practice, 7(1), 260-268.
  2. Baron, S., Hales, T., & Hurrell, J. (1996). Evaluation of symptom surveys for occupational musculoskeletal disorders. American Journal of Industrial Medicine, 29(6), 609-617.<609::AID-AJIM5>3.0.CO;2-E
  3. Cho, C. Y., Hwang, I. S., & Chen, C. C. (2003). The association between psychological distress and musculoskeletal symptoms experienced by Chinese high school students. The Journal of Orthopaedic and Sports Physical Therapy, 33(6), 344-353.
  4. Choi, K. W. (2014). Factors related to self-rated health in adolescents: findings form the Korea Youth Panel Survey. Korean Journal of Health Education and Promotion, 31(3), 39-51.
  5. Hong, S. W., Uhm, D. C., & Jun, M. H. (2010). Job stress and work-related musculoskeletal symptoms of 119 emergency medical technicians. Korean Journal of Occupational Health Nursing, 19(2), 223-235.
  6. Hupert, N., Amick, B. C., Fossel, A. H., Coley, C. M., Robertson, M. M., & Katz, J. N. (2004). Upper extremity musculoskeletal symptoms and functional impairment associated with computer use among college students. Work, 23(2), 85-93.
  7. Jang, E. Y., Kim, S. J., & Lee, J. H. (2004). The association between daily hours of computer use, posture, stress and musculoskeletal symptoms in university students. The Journal of Ewha Nursing, 38, 90-109.
  8. Jenkins, M., Menendez, C. C., Amick, B. C., Tullar, J., Hupert, N., Robertson, M. M., & Katz, J. N. (2007). Undergraduate college students' upper extremity symptoms and functional limitations related to computer use: a replication study. Work, 28(3), 231-238.
  9. Kim, H. M. (2005). The effect of yoga on cardio-pulmonary function, musculoskeletal function and perception of health status of some students in college. The Korean Journal of East West Science, 8(1), 15-30.
  10. Kim, J. H. (2012). The mediating effects of self-control and health promoting lifestyle in the relationship between life stress and adjustment to college life among college students(master's thesis). The Graduate School of Ewha Womans University.
  11. Kim, M. H. (2013). Factors affecting mental health among college students-sassang constitution and ego State centered approach. Journal of Korean Public Health Nursing, 27(3), 564-577.
  12. Kim, S. J., Chai, S. K., Lee, K. W., Park, J. B., Min, K. B., Kil, H. G., Lee, C., & Lee, K. J. (2014). Exposure-response relationship between aircraft noise and sleep quality: a community based cross-sectional study. Osong Public Health and Research Perspectives. 5(2), 108-114.
  13. Kwon, S. B., Yi, Y. J., Han, H. J., Cho, K. S., Lim, N. Y., Lee, E. H., Son, H. M., Park, Y. S., Kim, J. H., & Kang, H. S. (2012). Leg Length Inequality, Habitual Posture, and Pain in Women's College Students. Journal of muscle and joint health. 19(1), 27-36.
  14. Lee, C. H. (2007). The causes of stress and coping strategies among university students(master's thesis). Graduate School of Public Health Daegu Haany University.
  15. Lee, E. H. (2004). Testing for moderating effects of coping style with structural equations: life stress and depressive symptoms among college students. Korean Journal of Health Psychology, 9(1), 25-48.
  16. Lee, H. J. (2012). The effect of examination stress on the somatization among korean elementary school students(master's thesis). Incheon National University.
  17. Lee, K. W. (2007). Relations between depression, anxiety, stress and the concentration of urinary hydroxyproline and Proline(Doctoral dissertation). Yonsei University.
  18. Lee, M. S. (2014). The effect of working environment and socio-psychological factors of physiotherapists on musculoskeletal symptom(master's thesis). Graduate School of Health Science, Eulji University.
  19. Lim, S. O., & Kim, H. H. (2011). The moderating effects of professional identity on the relationship between job stress and burnout of care workers from care facilities. Journal of Korean Social Welfare Administration, 13(3), 151-176.
  20. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney. Psychology Foundation.
  21. Ministry of Employment and Labor. (2004). Musculoskeletal Disorders Prevention Services Manual.
  22. Murberg, T. A., & Bru, E. (2004). School-Related Stress and Psychosomatic Symptoms among Norwegian Adolescents. School Psychology International, 25(3), 317-332.
  23. Nam, M. Y. (2010). The role of teacher efficacy in the correlation between special education teachers' job stress and burnout(master's thesis). Graduate School of Education at Chungang University.
  24. Nieuwenhuijsen, K., de Boer, A. G., Verbeek, J. H., Blonk, R. W., & van, F. J. (2003). The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems. Occupational and environmental medicine, 60(Suppl 1), i77-82.
  25. Bernard, B. P. (Ed.). (1997). Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back (No. 97-141). Cincinnati, OH, USA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.
  26. Noh, E. K., Park, J., & Choi, C. H. (2010). Relationship between high school students' awareness of mental health and subjective quality of sleep. Korean Journal of Health Education and Promotion, 27, 67-74.
  27. Oh, G. H. (2009). The relationship between life stress and physical/ mental health among college students(master's thesis). Sahmyook University.
  28. Oh, H. S. (2008). The study on relationship between school stress and stress coping behavior & mental.physical health about students of high school(master's thesis). Graduate school of Education, Kangwon National University.
  29. Page, R. M., & Suwanteerangkul, J. (2009). Self-rated health, psychosocial functioning, and health-related behavior among Thai adolescents. Pediatrics International, 51(1), 120-125.
  30. Park, J. K. (2014). Musculoskeletal disorder symptom factors and control strategies in general hospital nurses. Journal of Korean Society of Occupational and Environmental Hygiene, 24(3), 371-382.
  31. Park, K. C., Lee, K. J., Park, J. B., Min, K. B., & Lee, K. W. (2008). Association between occupational stress and depression, anxiety, and stress symptoms among white-collar male workers in an automotive company. Annals of Occupational and Environmental Medicine, 20(3), 215-224.
  32. Piercealla, E. A., & Keimb, M. C. (2007). Stress and coping strategies among community college students. Community College Journal of Research and Practice, 31(9), 703-712.
  33. Statistic Korea. (2013). Korean Social Trends 2013.
  34. Towbes, L. C. & Cohen, L. H. (1996). Chronic stress in the lives of college students: scale development and prospective prediction of distress. Journal of Youth and Adolescence, 25(2), 199-217.
  35. Tremblay, S., Dahinten, S., & Kohen D. (2003). Factors related to adolescents' self-perceived health. Health Reports, 14(Suppl), 7-16.
  36. Tyerman A., & Humphrey, M. (1983). Life stress, family support and adolescent disturbance. Journal of Adolescence, 6(1), 1-12.
  37. Yoo, J. H., Ro, H. L., & Lee, M. Y. (2008). The musculoskeletal pain and inconvenient feeling during hand instruments with mannequin and intra-oral cavity in dental hygiene students. Journal of the Korean Society of Physical Medicine, 3(4), 247-254.
  38. Yoon, J. W., Yi, K. J., Kim, S. Y., Oh, J. G., & Lee, J. T. (2007). The relationship between occupational stress and musculoskeletal symptoms in call center employees. Annals of Occupational and Environmental Medicine, 19(4), 293-303.