臺灣博碩士論文加值系統

背景與目的：由於職業的多樣化，以及電腦應用層面的普及，電腦已成為多數人的作業輔助工具。國外對於電腦使用人員肌肉骨骼的相關研究不少，不過種族與生活形態相異，卻未能完全以為國內之依據。事實上，國內有關電腦使用者之姿勢與肩頸與上肢肌肉骨骼不適之研究尚未多見。因此，本研究之目的，即在了解電腦作業人員之肩頸與上肢肌肉骨骼不適盛行狀況及其相關影響因子。
方法：本研究選取打字業者、某電信公司話務員、某醫學中心書記、批價、資訊人員，共計198人。採取橫斷性研究，利用一對一問卷面訪和現場工作環境觀察及量測紀錄，問卷內容包括取得人口學資料、疾病史、工作史、個人主觀症狀、工作現況描述。
結果：研究樣本198份中，以女性居多(87.9%)。表示有症狀之部位，以頸部為最高佔74.7%，其次為肩部平均為58.3%，其中，右肩盛行率(63.1%)高於左肩(53.5%)，再者為右上肢平均為33.6%。有174位至少一個部位發生不適佔87.9%(174/198)。而經過逐步邏輯迴歸分析後，在各研究族群中，「與工作環境之軟體相關因素」以及「與工作環境之硬體相關因素」對於頸部、肩部和右上肢部位症狀有較顯著的相對危險性。而「個人因素」的「身高」愈高則與非滑鼠使用者發生頸部不適的相對危險性有增加的趨勢。另外，「工作姿勢因素」則與工作上不論是否使用滑鼠之族群其發生右上肢部位不適亦有顯著的相對危險性。
結論：研究結果顯示電腦使用者頸部、肩部與右上肢肌肉不適的盛行率較相關文獻略高。而不適症狀的發生，仍主要與工作環境之軟、硬體因素有顯著的相關性。因此，制定良好的工作時程與改善電腦工作站環境的配置，並配合增進電腦使用者職業病預防保健的認知，對於減少電腦使用者頸部、肩部與右上肢症狀發生皆有助益。

Background and purpose
For occupational diversification, more and more people rely on computer to achieve effectiveness. Although there are lots of studies on the musculoskeletal of computer users abroad, but few studies about Neck /Shoulder and Upper limb disorders among computer users in Taiwan. Therefore, the objective of this cross-sectional study was to examine the evidence that associates Neck/Shoulder and Upper limb musculoskeletal disorders of computer users with work-related factors.
Methods and Materials
The study group included data entry operators, telephone operators and computer engineers among 198 workers by one-on-one interview questionnaires and observing the current working environment.
Result
Among 198samples, female has 87.9% weight. The prevalences of neck, shoulder and that of right upper limb disorders are 74.7%, 58.3% and 33.6% respectively. Among shoulder disorder workers, the prevalence of right shoulder disorder(63.1%) is higher than that of left shoulder(53.5%) respectively. Also, 87.9%(174/198) interviewees are having at least multiple symptoms. After stepwise logistic regression analysis, we have the following three findings:
1. positive correlation between software/hardware conditions and problems with neck, shoulder, and right upper limb.
2.positive correlation between height and neck problems for those who do not use mouse.
3.positive correlation between working posture and right upper limb.
Conclusion
The results of study indicated the prevalence of neck and shoulder disorders were very high among computer users. The main reason for those problems are working software/hardware factors, there is a strong correlation between these two issues. Our suggestions to prevent occurrence of neck, shoulder and right upper limb musculoskeletal disorders among computer users are to make a proper working organization and to enhance ergonomic workstation configurations.

第一章緒論
第一節研究背景…………………………………………………………..1
第二節研究動機…………………………………………………………..2
第三節研究目的…………………………………………………………..4
第四節研究流程…………………………………………………………...5
第二章文獻探討
第一節累積性肌肉骨骼不適………………………………..……………7
第二節與電腦操作有關之累積性肌肉骨骼不適…………………….…..9
第三節頸部、肩部與右上肢之危險因素………………………………...11
第三章研究材料與方法
第一節研究架構…………………………………………………………22
第二節名詞定義…………………………………………………………23
第三節研究對象選取……………………………………………………30
第四節研究設計…………………………………………………………31
第五節訪員訓練…………………………………………………………39
第六節資料處理與分析方法……………………………………………40
第四章研究分析結果
第一節描述性分析…….…………………………………………………42
第二節相關性分析…………….…………………………………………50
第三節研究族群危險因素相對危險性評估………………...…………..59
第五章討論與建議
第一節頸部、肩部和右上肢自覺症狀盛行率討論…………………74
第二節各部位相關因子之相對危險性探討……..……………………77
第三節其他結果之討論………………………………………………….86
第四節建議………………………………………………………...……..89第五節研究限制………………………………………………………….92第六章結語…………………………………………………………………….
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附錄 訪視問卷

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