## 4 Discussion  
This study investigated the prevalence of fatigue, anxiety, and depression among nurses. Nurses reported overall fatigue at a rate of 24.7%, which is lower than the 30.5% complaint rate of construction workers [18] but higher than the 21.1% complaint rate of automobile production workers [22]. In addition, the rate of complaints of depression among nurses was 36.4%, which was lower than the rate of complaints of 48.2% among construction workers [18]. On the other hand, 6.3% of nurses complained of anxiety, which was higher than 4.3% of construction workers [18]. In this study, binary logistic regression analysis was conducted to derive factors influencing the overall fatigue, anxiety, and depression of nurses, respectively. Factors influencing overall fatigue were shift types, vibration, awkward posture, repetitive motion, back pain, and upper limb pain. Regarding back pain, nurses who complained of back pain were 2.818 times more likely to complain of overall fatigue than nurses who did not. This is supported by research indicating that workers who report back pain also experience more overall fatigue compared to those who do not [41]. Nurses who reported experiencing upper limb pain were 4.044 times more likely to experience overall fatigue than those who did not. This finding is consistent with research that workers who complain of upper limb pain complain of overall fatigue more than those who do not [40]. In the case of shift work, rotating shift nurses were 3.052 times more likely to complain of overall fatigue than day duty nurses. This is consistent with research showing that workers on rotating shifts experience more fatigue than those who do not [41; 11]. In the case of vibration, nurses exposed to more than 4 h were 5.191 times more likely to complain of overall fatigue than \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline
**Variables** & **N** & **Complaint Rate (\%)** & **B** & \(p\)**-Value** & **OR** &
\begin{tabular}{c} **95\% C.I. for OR** \\ **Lower** & **Upper** \\ \hline Occupation & & & & 0.071 & & \\ Nurses (ref) & 277 & 33.9\% & & & & \\ Nursing assistants & 185 & 40.0\% & 0.399 & 0.071 & 1.490 & 0.967 & 2.298 \\ Working experience (years) & & & & 0.064 & & & \\ \textless{}3 (ref) & 142 & 43.0\% & & & & \\ 3\textless{}6 & 154 & 29.2\% & \(-\)0.595 & 0.019 * & 0.552 & 0.335 & 0.908 \\ \textgreater{}6 & 166 & 37.3\% & \(-\)0.323 & 0.189 & 0.724 & 0.447 & 1.173 \\ Establishment & & & & 0.059 & & & \\ Clinic (ref) & 232 & 32.8\% & & & & & \\ Hospital & 230 & 40.0\% & 0.440 & 0.059 & 1.552 & 0.983 & 2.451 \\ Working hour/week & & & & 0.042 * & & & \\ \textless{}41 (ref) & 281 & 33.1\% & & & & & \\ \textgreater{}41 & 181 & 41.4\% & 0.455 & 0.042 * & 1.576 & 1.016 & 2.445 \\ Infection & & & & 0.005 * & & & \\ \textless{}2 h (ref) & 404 & 33.2\% & & & & & \\ 2\textless{}4 h & 27 & 51.9\% & 0.748 & 0.069 & 2.112 & 0.944 & 4.727 \\ \textgreater{}4 h & 31 & 64.5\% & 1.146 & 0.004 * & 3.147 & 1.428 & 6.932 \\ Lower limb pain & & & & 0.011 * & & & \\ No (ref) & 392 & 33.2\% & & & & & \\ Yes & 70 & 54.3\% & 0.707 & 0.011 * & 2.028 & 1.179 & 3.488 \\ Constant & & & \(-\)1.066 & \textless{}0.001 * & 0.344 & & \\ \hline \hline \end{tabular}  
* significant at 0.05, ref = reference, OR = odds ratio, C.I. = confidence interval.  
\end{table} 
Table 3: Results of binary logistic regression analysis with depression. nurses exposed to less than 2 h. This is in line with studies that show that workers exposed to vibration are prone to overall fatigue [43; 44]. In the case of awkward posture, nurses exposed for more than 4 h showed 3.120 times compared to nurses exposed for less than 2 h. This aligns with studies showing that working in an awkward posture increases symptoms of overall fatigue [45; 46]. Repetitive movements were 2.464 times higher in nurses exposed for 2-4 h than those exposed for less than 2 h. This finding is consistent with the results of a study that shows that overall fatigue increases with repetitive movements [47].