en <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:72.0pt 193.5pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Aims:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> Chronic musculoskeletal disorders often negatively impact quality of life, with pain and sleep disturbances being major contributors. Nurses play a pivotal role in implementing pain management strategies, which may indirectly influence quality of life through sleep quality. This study aimed to investigate the effect of pain management strategies employed by nurses on the quality of life in adults with chronic musculoskeletal disorders, with sleep quality as an intermediary parameter.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:72.0pt 193.5pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Instrument & Methods:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> This cross-sectional study was conducted with 280 adults attending the outpatient rehabilitation clinic of a university hospital in Najaf City. Participants were selected based on eligibility criteria and surveyed using the Pain Management Inventory-Nurse Version, the Pittsburgh Sleep Quality Index, the WHOQOL-BREF, and a sociodemographic questionnaire. Data were analyzed using descriptive statistics, Pearson correlation coefficient, and mediation analysis (PROCESS macro, Model 4). </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:72.0pt 193.5pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Findings:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> Pain management strategies were positively associated with quality of life (r=0.53, p<0.01) and negatively associated with poor sleep quality (r=-0.46, p<0.01). Sleep quality was also negatively related to quality of life (r=-0.58, p<0.01). Mediation analysis confirmed that sleep quality partially mediated the relationship between pain management and quality of life (indirect effect &beta;=0.23, 95% CI: 0.14-0.34).</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="tab-stops:72.0pt 193.5pt"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> Effective nurse-led pain management improves the quality of life in patients with chronic musculoskeletal disorders, in part due to enhanced sleep quality.</span></span></span></span></span></span> Pain Management,Nurses,Sleep Quality,Quality of Life,Musculoskeletal Diseases,Mediation Analysis, 131 137 http://ijwph.ir/browse.php?a_code=A-10-2307-1&slc_lang=en&sid=3 H.I. Faris 1003194753284600379571 1003194753284600379571 Yes Department of Laboratory and Clinical Sciences, Faculty of Pharmacy, Jabir Ibn Hayyan University for Medical and Pharmaceutical Sciences, Najaf, Iraq M.O. Khanjary 1003194753284600379716 1003194753284600379716 No Department of Adult Nursing, Faculty of Nursing, Al-Ameed University, Karbala, Iraq S.H. Badr 1003194753284600379717 1003194753284600379717 No Department of Pediatric Nursing, Faculty of Nursing, Al-Ameed University, Karbala, Iraq B.H. Hussein 1003194753284600379570 1003194753284600379570 No Department of Adult Nursing, Altoosi University College, Najaf, Iraq