臺灣博碩士論文加值系統

背景：職業肌肉骨骼之傷害(WMSDs)是現今社會逐漸重視之議題。特殊教育教師及教師助理除了一般教學外，還需要為有特殊教育需要學童提供大量照護服務，需要大量體力勞動，引致肌肉骨骼傷害，唯這群族群卻常被忽視。本研究之目的為調查此族群之 WMSDs 盛行率、傷害部位，並探討 WMSDs 與個人及工作相關 背景變項之關聯。
方法：本研究工具採自編之職業傷害問卷，包含背景變項、職業相關之肌肉骨骼傷害情形及人因工程危險因子等三部份。本研究發放 558 份問卷，有效回收問卷388 份，回收率近 86%。統計後發現邏輯斯迴歸分析顯示「特殊學校之工作年資>66 個月」、「服務學生的障別-多重障礙」及「協助更換尿布-有」均與 WMSDs盛行率有高度相關。相反，「午休時間-有」及「一起同班服務伙伴-有」、「進行課程轉換時有安排休息時間」及「運動習慣-有」均較不易罹患 WMSDs。對工作的影響方面，BMI 指數範圍過重、入職前已罹患職業性肌肉骨骼傷害都與工作影響呈正相關。研究也發現使用支持性護具如護腰能減低 WMSDs 盛行率的相關性，使用相對應之支持性護具與該身體部位之疼痛有負相關關係，而使用支時性護具對所有身體部位之疼痛均有負相關關係，此結論反映出護具能減底減低
WMSDs 盛行率的相關性。
結論：特殊教育教師及教師助理為 WMSDs 高風險族群，以腰下背、肩膀及手腕為前三位好發身體部位。本研究結果建議提倡重視個人健康等健康資訊、適切工時規劃、改善師生比例、加強正確工作姿勢之訓練課程，以降低特殊教育專業人員之肌肉骨骼傷害。在未來之研究中可探討針對此族群需要特別設計之支持性護
具開發，使用性前後之 WMSDs 盛行率之變化等，以利減低此族群之 WMSDs之發生率。

Background: Work-related musculoskeletal disorders (WMSDs) affect working population all over the world. This issue draws more and more attention from experts such as physicians, politicians, etc. Special education personnel who serve students with disabilities often experience physical strains; however, WMSDs have been overlooked in this population. The objectives of this study were to investigate the work-related ergonomics-associated factors in this population and to evaluate their correlation with the WMSDs prevalence. Methods: A questionnaire with four domains, namely demographics, prevalence of past work-related musculoskeletal disorders, prevalence of present work-related musculoskeletal disorders, and ergonomic factors, designed by our research team was delivered to educators who work in special education schools. Results: Almost 86 % of the 388 special education school teachers and teacher’s aides in this study experienced musculoskeletal disorders. The lower back, shoulder, and wrist were the three most affected regions. A logistic regression analysis revealed that the participants’ background factors, more than5.5 years of experience (odds ratio [OR] = 4.090, 95 % CI: 1.350-12.390), students with multiple disorders (OR = 2.412, 95 % CI: 1.100-5.287), and other work-related ergonomic factors (assistance in diaper changing and others duties), were strongly associated with the prevalence of WMSD. Nap habit (OR = 0.442, 95 % CI: 0.230-0.851) and having teaching partners in the same class (OR = 0.486, 95 % CI: 0.250-0.945) resulted in low possibility of acquiring WMSDs. The use of supportive devices was associated with a low WMSD prevalence. From the result, we found that by using supportive devices, the results would be negative correlated with pain in that body region. From the correlation analysis we also found that if the subject feel pain in one body part, he/she also feel pain in others body parts in different pain level. Conclusions: The present study revealed an association between WMSDs and specific job features among teachers and teacher’s aides in special education schools. Future efforts should emphasize examining safe student-handling ergonomics, formulating policies regarding student-teacher ratio, incorporating mandatory break times at the workplaces, and promoting personal health for preventing work-related injuries. For the further study, particularly designed supportive devices could be researched for this population and WMSDs prevalence before and after using supportive devices could be done in the further study.

指導教授推薦書
論文口試委員會審定書
誌謝 iii
摘要 iv
Abstract v
壹、緒論 1
1.1職業傷害 1
1.2特殊學校老師 2
1.3特殊需要兒童 4
1.4待答問題 6
貳、文獻探討 7
叄、研究方法 12
3.1 研究流程 12
3.2研究對象 12
3.3 研究工具 13
3.3.1 專家內容效度 15
3.3.2 信度分析 15
3.3.3 問卷之發放與追蹤 16
3.3.4 資料處理 16
肆、結果與討論 19
4.1 描述性統計 19
4.1.1 個人相關變項 19
4.1.2 盛行率 20
4.1.3 人因工程因子調查 21
4.1.4 工作現況需求 21
4.2 邏輯斯回歸分析及相關分析 22
4.2.1 職業性肌肉骨骼傷害發生率之邏輯斯回歸分析 22
4.2.2 不同部位之疼痛之相互關係 23
4.2.3 護具、輔具使用與疼痛之相互關係 23
4.2.4 疼痛影響工作程度與人因因子之相互關係 23
伍、結論與建議 25
5.1 與職業性肌肉骨骼傷害罹患率相關之因子 25
5.2 部位性職業性肌肉骨骼傷害之人因因子 27
5.3輔具及護具相關的因子 27
5.4 罹患職業性肌肉骨骼傷害影響工作程度與人因因子之相關性 28
5.5 受試者之質性回饋 29
5.6 特教專業人員與其他專業人員WMSD的差異 31
5.7 研究限制 32
5.8後續規劃 34
參考書目 58
附錄一、問卷 61
附錄二、專家效度評分表 68


表目錄
表 一、研究問卷發放一覽表 36
表 二、填答者學歷、畢業科系、薪資 (N=388) 37
表 三、服務學生類別 38
表 四、特教老師及教師助理工作時數與天數 39
表 五、職業性肌肉骨骼傷害發生率 40
表 六、肌肉骨骼不適分佈情 41
表 七、特殊教育教師及教師助理之個及工作因子 43
表 八、特殊教育教師及教師助理職業性肌肉骨骼傷害人因因子 44
表 九、影響工作程度與BMI指數之相關性 46
表 十、邏輯斯回歸: 個人/特殊學校資料及職業職業性肌肉骨骼傷害人因因子 47
表 十一、影響工作程度與最高學歷之相關性 48
表 十二、影響工作程度與BMI指數之相關性 49
表 十三、影響工作程度與前職傷部位之相關性 50
表 十四、影響工作程度與負責年級之相關性 51
表 十五、BMI水平分佈圖 52
表 十六、特教教師及教師助理人因工程因素 53
表 十七、工作現況需求調查 54
表 十八、身體各部份疼痛之相互關係 55
表 十九身體各部份疼痛與支持性護具之相互關係 56
表 二十、BMI指數與影響工作之相互關係 57

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