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研究生(外文):Feng, Shih-Hsiang
論文名稱(外文):Preventive Strategies Initiative of Metabolic Syndrome for Staff Working in Tri-Service General Hospital in Taipei
指導教授(外文):Lin, Jing-DingLoh, Ching-Hui
外文關鍵詞:Metabolic syndromeworkplace health promotionOttawa charterpreventive strategieshospital’s staff
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在臺灣地區代謝症候群(metabolic syndrome, MS)所引發的相關疾病而造成的死亡人數已經超過惡性腫瘤,並形成醫療體系沈重的經濟負擔。導致MS的因素除了可能是先天的遺傳外,最主要原因就是後天不健康的生活型態,而醫院員工群體工作忙碌、身心壓力大,且普遍運動量不足,再加上忙碌的工作類型導致不良的飲食習慣,極可能為罹患MS之高危險群。本研究主要目的為分析醫院員工代謝症候群之盛行情形與防治策略初探。資料收集區分為兩部分,第一部份以三軍總醫院員工91至94年度健康檢查資料庫為研究對象,分析代謝症候群盛行現況:第二部分以渥太華健康促進憲章(Ottawa Charter for Health Promotion)為架構,根據三軍總醫院員工MS盛行率現況,應用德菲法(Delphi method)收集十一位三軍總醫院健康促進委員的意見,進而建立三軍總醫院MS防治策略。研究發現,三軍總醫院員工MS盛行率為10.1%,男性顯著高於女性,並與年齡呈正相關,勤務類員工的MS盛行率最高;在MS相關指標中,以總膽固醇異常盛行率最高。在建立MS防治策略方面,為提升員工對MS認知,可以運用專題演講,並根據員工的性別與年齡,發展進一步之因應策略;員工之同事與親友,可以建立穩固之支持力量,協助員工改變不良生活型態,並且鼓勵員工參加醫院內各種健康促進的團體;醫院應成立防治小組以集中運用各項資源,並且建立有效之監控機制,協助員工控制體重;改善醫院運動環境,消除員工運動之障礙,並且提供健康飲食,數量足且種類豐富之蔬果;在提供預防服務方面,針對飲食、運動與減重等議題建立諮詢的管道。本研究建議如下:1.豐富健康檢查報告,提供員工必要之資訊,2.瞭解員工生活型態,應特別著重男性且高年齡層之員工,3.將MS相關資訊運用於員工在職教育。
Metabolic syndrome (MS), a cluster of metabolic disorders, is becoming increasingly common and causing huge economic burden of medical care system in Taiwan. Besides genes, many studies show that the causes of MS are unhealthy lifestyle. The hospital employees’ working characteristics are likely to be unhealthy and stressful; they are prone to be the high risk group of MS. The aims of this thesis were to investigate the prevalence and the characteristics of MS among Tri-Service General Hospital (TSGH) staff in Taiwan, and to initiate the preventive strategies for MS. We used a cross-sectional analysis to exam the prevalence and the characteristics of MS based on the data of routine health check-up of TSHG’s staff from 2001 to 2005. According to the above results, we initiated preventive strategies by using Delphi method and Ottawa Charter for Health Promotion to concrete the experts’ suggestions on MS prevention. The results showed that the prevalence of MS was 10.1%, increased along with age and male gender among the staff. In term of working characteristics, those staff in logistic work has the highest prevalence in MS. The strategy of how to empower staff about preventing MS knowledge, the experts suggested enforce the education about MS in hospital. The members around staffs, such as families, superintendent and co-workers, should create supportive environments in order to change staffs’ unhealthy lifestyle. The strategy of weight management, the hospital should help the staffs to control weight effectively and to set up a monitoring system and to provide enough vegetable and fruits in hospital’s restaurants. The MS prevalence of staffs had the same characteristics as other studies. In order to manage MS successfully, the study suggests strengthening a multidisciplinary approach to implement the preventive strategies in hospitals.
第一章緒論 1
第一節 研究背景 1
第二節 研究動機 2
第三節 研究目的 3
第二章文獻探討 4
第一節 代謝症候群的診斷標準 4
第二節 代謝症候群的流行病學 8
第三節 醫院員工的健康狀態 11
第四節 代謝症候群的防治策略 12
第五節 渥太華健康促進憲章 14
第六節 跨理論模式 16
第七節 德菲法 17
第三章研究方法及步驟 18
第一節 研究架構 18
第二節 研究對象 19
第三節 研究設計 20
第四節 操作型定義 20
第五節 資料庫統計分析方法 21
第六節 德菲法研究 22
第四章 研究結果 26
第一節 人口學特質 26
第二節 盛行率分佈特徵 27
第三節 第一次德菲法結果 32
第四節 第二次德菲法結果 43
第五章 討論 54
第一節 盛行率分佈特徵 54
第二節 防治策略的應用 55
第三節 研究限制 62
第六章結論與建議 64
第一節 結論 64
第二節 建議 65
第三節 後續研究方向 65
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