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研究生:黃尹俊
研究生(外文):Jack Yin-Chun Huang
論文名稱:救護技術員嗜睡程度與救護安全之相關性探討
論文名稱(外文):Association between Sleepiness and EMS Safety Outcome among EMS Providers in Taiwan
指導教授:陳維恭陳維恭引用關係
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:醫務管理學系碩士在職專班
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:80
中文關鍵詞:緊急救護救護技術員救護安全
外文關鍵詞:EMSEMTEMS Safety
相關次數:
  • 被引用被引用:1
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  • 下載下載:26
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目標:119救護技術員提供民眾遭遇緊急傷病時的及時的第一線緊急救護,但因備勤時間過長,研究指出約有70%具有睡眠不良情形。嗜睡為睡眠不良之具體生理現象,其不僅影響工作表現,更危害工作安全。本研究主要探討119救護技術員嗜睡程度與救護安全之相關性。
方法:利用問卷調查法取得研究資料,抽樣方法採用便利抽樣。問卷含四大構面:人口學特徵、服勤狀況、愛普沃斯嗜睡量表、救護安全量表。受試者共500名,分別隸屬於台灣北中南東41隊專責救護隊之救護員,並依其2014年9至11月值勤實況匿名填答;所得資料使用複回歸及羅吉斯回歸進行分析。
結果:問卷總計回收399份(回收率為79.8%),有效問卷為347份(69.4%)。其中36.9%的受試者屬輕度嗜睡、39.2%屬過度嗜睡。多變量分析結果顯示,嗜睡程度越嚴重,救護安全表現越差:受傷構面(P<0.05)、異常事件構面(P<0.05)、安全忽視行為構面(P<0.01)。此外,相對於正常的受試者,過度嗜睡者具有2.2倍的受傷風險(OR = 1.95, 95% CI = 1.07-4.71)、2.4倍針紮風險(OR = 2.44, 95% CI = 1.08-5.52)、2.6倍未執行呼吸道處置風險(OR = 2.63, 95% CI = 1.05-6.57)。
結論:本研究呈現台灣2014年9月至11月119救護員嗜睡程度與救護安全之相關,希望提供決策者有效資訊,做為未來制訂相關政策,提升救護安全之參酌。


Background: Prior research reported that sleepiness impaired staff''s performance in various occupations and increased adversities in health care fields. However, the impact of daytime sleepiness on pre-hospital emergency medical service is still unknown.
Objective: The aim of this study was to investigate association between sleepiness and self-reported EMS safety outcomes among EMTs in Taiwan.
Methods: In this cross-sectional study, a convenience sampling design was used . Structured questionnaires were administrated in early Dec 2014, measuring respondent''s status within the past 3 months. Sleepiness and EMS safety outcomes were measured with the Epworth Sleepiness Scales and a modified 25-item EMS Safety Inventory, respectively. Inferential statistic was calculated with Multiple regression and Logistic regression.
Results: We received 399 surveys from 41 EMS squads located in northern, central, southern, and eastern Taiwan (79.8% response rate). 36.9% and 39.2% of respondents were identified as mild daytime sleepiness and excessive daytime sleepiness. Multivariate analysis showed the more sleepiness status, the worse safety outcome in main safety dimension: injury (P < 0.05), adverse event (P < 0.05), and safety compromised behaviors (P < 0.01). Compared to normal group, excessive sleepiness respondent had higher risk of injury (OR = 1.95, 95% CI = 1.07-4.71), needle stick (OR = 2.44, 95% CI = 1.08-5.52), and disestablished airway of OHCA (OR = 2.63, 95% CI = 1.05-6.57).
Conclusion: The association between EMT''s daytime sleepiness and EMS safety outcomes in Taiwan has been identified. It carries policy implications for EMS Safety.


Acknowledgement ii
Abstract (Chinese) iii
Abstract (English) iv
Tables of Contents v
List of Tables vii
List of Figures viii
Chapter 1: Introduction 1
1.1 Study Background 1
1.2 Research Questions 4
1.3 Study Purpose 5
Chapter 2: Literature Review 6
2.1 Safety in EMS System 6
2.2 Circadian rhythm and Shift Worker 10
2.3 The general effect of poor sleep 11
2.4 The effect of poor sleep in general healthcare field 13
2.5 The Effect of Sleepiness in the Healthcare Field 15
2.6 Summary 17
Chapter 3: Methodology 18
3.1 Study Process 19
3.2 Conceptual Framework 20
3.3 Research Hypotheses 21
3.4 Study Subjects 22
3.5 Research Instrument 23
3.6 Measurements(Variables) 27
3.7 Analytical Methods 34
Chapter 4: Results 35
4.1 Sample description 36
4.2 Sleepiness 37
4.3 Safety outcomes 38
Chapter 5: Discussion 53
5.1 Sleepiness 54
5.2 Safety outcome 55
5.3 Health Status and Certification versus Safety 56
5.4 Managing Sleepiness versus Safety 57
5.5 Workload versus Safety 58
Chapter 6: Conclusion and Recommendations 59
6.1 Conclusion 59
6.2 Recommendations 60
6.3 Research Limitations 61
Bibliographies 62
Appendices 68
A1.Questionnaires 68
A2.the Scale of CVI Result 72
A3.Ethical Approval 80


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