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研究生:陳念娸
研究生(外文):Nien-Chi Chen
論文名稱:醫療工作者工作時間與健康狀態之相關性研究
論文名稱(外文):Correlation between Health Care Workers’Working Hours and Their Health Status
指導教授:謝幸燕謝幸燕引用關係
指導教授(外文):Hsing-Yen Hsieh
學位類別:碩士
校院名稱:義守大學
系所名稱:醫務管理學系
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:2017
畢業學年度:105
語文別:中文
論文頁數:87
中文關鍵詞:醫療工作者工作時間超時工作健康風險
外文關鍵詞:health care workerworking hourworking overtimehealth risk
相關次數:
  • 被引用被引用:6
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目的:探討目前大型醫院醫護人員普遍出現的超時工作現象,是否會影響員工的身體及心理健康風險。
方法:以南部某區域醫院的所有醫療工作者為樣本,利用普查方式在醫院進行年度健康檢查時發放問卷,共發放2788份,回收2294份問卷,排除遺漏值後,樣本數為1900人,有效回收率為68.15%,再使用去連結後之次級資料進行回溯性研究分析。
結果:全院醫療工作人員研究樣本平均年齡為35.29 歲,一週工作時數超過40小時者佔 61.7%;一日工作時數超過8小時者佔42.8%。健康風險包括心理健康、工作疲勞、心血管疾病及肥胖。心理健康(以華人健康量表CHQ-12施測)4分以上之比例為8.1%;工作疲勞量表(使用勞動部工作相關過勞量表)分三級,中度、重度程度佔全部40.2%;十年內罹患心血管疾病之風險估算值參考中華民國心臟學會使用佛朗明翰量表(Framingham risk score施測)平均百分比為2.24%;身體質量指數(BMI)平均為23.67,超過正常值的比例為44.8%。迴歸分析結果顯示超時工作對心理壓力、工作疲勞及心血管風險發生率有顯著影響。
結論:每日工作時間對心理壓力、工作疲勞感及身體質量指數有顯著影響,但對威脅生理的健康狀態(心血管風險)無顯著影響。建議院方改善醫療工作者的心理壓力及工作疲勞感、提倡健康促進來降低BMI、針對健康風險族群較高的對象並安排後續的關懷計畫,以降低臺灣醫護人員的健康風險、創造優質的職場環境。
Objectives: To explore whether working overtime, which is prevalent among health care workers in large-scale hospitals in Taiwan, jeopardizes their physical and mental health.
Methods: Health care workers in a regional hospital in Southern Taiwan were targeted. Questionnaires were distributed to the workers when they underwent an annual health examination in the hospital. A total of 2788 copies were distributed and 2294 were returned. After responses with missing values were excluded, 1900 valid responses were collected, yielding a valid response rate of 68.15%. Anonymized secondary data were then used to conduct retrospective analysis.
Results: The average age of the research sample was 35.29 years. Among the studied subjects, 61.7% worked more than 40 hours a week, and 42.8% worked more than 8 hours a day. Health status including psychological health, work-related fatigue, cardiovascular diseases, and obesity were analyzed. Subjects who scored 4 points or higher in the 12-item Chinese Health Questionnaire for measuring mental health accounted for 8.1%; those who attained moderate and severe levels of work-related fatigue in the overwork scale developed by the Ministry of Labor accounted for 40.2%. Subjects’ 10-year risk of developing cardiovascular diseases calculated according to the Framingham risk score was 2.24% on average. Their average body mass index (BMI) was 23.67 and 44.8% of the subjects’ BMI exceeded the healthy weight range. Regression analysis results indicated that working overtime had significant effects on psychological stress, work-related fatigue, and risks of cardiovascular diseases.
Conclusion: Working overtime correlates with negative impacts on psychological stress, work-related fatigue, and BMI, but no significant effect is noted on physical health ( risks of cardiovascular diseases) among health care workers. In order to accommodate favorable workplace environments, hospital managers need to take action to enhance health-promoting behavior for those who works overtime to alleviate psychological stress and fatigue, to arrange health management plans for workers with high risk health status including increased BMI level.
致 謝...........i
摘 要...........ii
Abstract...........iii
目 錄...........iv
表 目 錄...........vii
圖 目 錄...........ix
第一章 緒論...........1
第一節 研究背景與動機...........1
第二節 研究目的...........4
第三節 研究流程...........5
第二章 文獻探討...........6
第一節 超時工作...........6
一、工作時間定義及其認定...........6
二、超時工作的定義...........9
三、國際超時定義...........10
四、臺灣超時定義...........12
第二節 超時工作影響健康...........14
一、超時工作影響健康之文獻探討...........15
二、過勞的定義...........20
第三節 健康風險評估...........22
一、華人健康量表(CHQ-12)...........23
二、工作相關過勞量表...........25
三、佛朗明翰心血管風險評估...........28
四、身體質量指數...........32
第三章研究方法...........34
第一節 研究架構...........34
第二節 研究假設...........34
第三節 研究設計...........35
第四節 研究對象...........35
第五節 研究工具...........35
第六節 研究變項及操作型定義...........37
第七節 資料處理與統計分析...........39
第四章 研究分析與結果...........40
第一節 描述性統計分析...........40
一、研究對象基本資料分析...........40
二、研究對象工作型態分析...........42
三、各變項之連續分佈情況...........43
四、研究對象健康風險分析...........44
五、心理壓力(CHQ-12)分佈情況...........46
六、工作相關疲勞分佈情況...........48
七、身體指標分佈情況...........49
第二節 推論性統計分析...........51
一、Pearson相關性...........51
二、工作時間之有無超時分組對健康風險t檢定表...........53
第三節 階層迴歸分析...........54
一、工作時間對健康風險之階層迴歸分析...........54
第五章 討論與建議...........56
第一節 研究結果與討論...........56
一、醫療工作者之工作時間...........56
二、控制變項與健康風險之關係...........56
三、工作時間與健康風險之關係...........58
第二節 研究限制...........60
第三節 研究建議...........61
一、未來研究建議...........61
二、問卷內容格式建議...........62
第四節 研究結論...........63
參考文獻...........64
一、中文文獻...........64
二、英文文獻...........67
附錄...........72
一、中文文獻
中華民國勞動部(2016)。一例一休、週休兩例?一次搞懂!2016/12/14.
中華民國勞動部(2016)。勞動基準法權益簡介。
毛義方、蔡忠融、徐雅媛、徐儆暉、毛鏡琪、盧士一、陳美蓮(2011)。我國醫院員工超時與輪班研究,勞工安全衛生研究季刊;19(2),223-232。
王昭儀(2006)。醫學中心護理人員之勞動條件對其工作壓力、工作負荷及疲勞影響之研究。未出版之碩士論文,國立台灣大學,台北市。
石東生、陳秋蓉、張振平(2004)。93年度受僱者工作環境安全衛生調查。行政院勞工委員會勞工安全衛生研究所,台北市。
行政院主計處 (2009): 人力資源調查統計,網路:http://www.dgbas.gov.tw/ct.asp?xItem=28980&ctNode=3247
行政院勞工委員會(2010):勞動檢查-檢查年報。取自日期2010 年,網路:http://www.cla.gov.tw/cgi-bin/siteMaker/SM_themePro?page=4e15159a。
行政院勞工委員會(2011):勞動統計調查-勞工工作與生活平衡調查,網路:http://statdb.cla.gov.tw/html/svy00/0005menu.htm。
行政院勞工委員會勞工安全衛生研究所(1994):工作環境安全衛生狀況調查報告-受僱者認知調查。行政院勞工委員會勞工安全衛生研究所,台北市。
行政院衛生署(2007)。醫師法。
行政院衛生署國民健康局(2007):成人(20歲以上)代謝症候群之判定標準。
吳元暉(2011)。超時工作影響睡眠品質,健康世界,23。
吳若瑄(2011)。工時變遷與過長工時對健康的影響。未出版碩士論文,國立台灣大學公共衛生學院健康政策與管理研究所,台北市。
吳淑君、黃明宣、宋素真(2008)。南部某醫學中心護理人員延遲下班之分析,榮總護理;25(1),31-37。
李人岳(2011年4月30日)。<錢少事多睡不飽>!「上班族」怨<爆肝換窮忙>。【中廣新聞網】。取自http://abcde580514.pixnet.net/blog/post/57094360-%E9%8C%A2%E5%B0%91%E4%BA%8B%E5%A4%9A%E7%9D%A1%E4%B8%8D%E9%A3%BD-%E4%B8%8A%E7%8F%AD%E6%97%8F%E6%80%A8%E3%80%8C%E7%88%86%E8%82%9D%E6%8F%9B%E7%AA%AE%E5%BF%99%E3%80%8D。
張慧蘭、盧美秀、林秋芬(2010)。應屆畢業新進護理人員離職相關因素之探討,醫護科技期刊;12(3),161-172。
莊曜美(2015)。社區衛生工作人員健康生活方式與生活品質之相關性研究。未出版碩士論文,國立臺北護理健康大學護理系,台北市。
許宸嫚(2012)。醫師長工時/輪班與其個人健康及病患安全之文獻回顧。未出版碩士論文,國立台灣大學公共衛生學院公共衛生碩士學位學程 ,台北市。
陳仲達、張瑋玲、林育正、蕭舒庭、雷侑蓁、鄭尊仁(2005)。工作型態與心血管疾病相關之研究─以醫院病患為例,勞工安全衛生研究季刊;14(1),36-47。
勞動部(2017)。勞動基準法。
勞動部勞工保險局全球資訊(2013):雇主的責任,網路: http://www.bli.gov.tw/sub.aspx?a=Hx9pJcVjo5M%3D
勞動部職業安全衛生署(2014)。異常工作負荷促發疾病預防指引(第一版)。網址:http://www.osha.gov.tw/media/3030/%E7%95%B0%E5%B8%B8%E5%B7%A5%E4%BD%9C%E8%B2%A0%E8%8D%B7%E4%BF%83%E7%99%BC%E7%96%BE%E7%97%85%E9%A0%90%E9%98%B2%E6%8C%87%E5%BC%95.pdf。
曾韋禎(2016)。勞基法修正案三讀 勞工落實週休二日、全國國假一致,自由時報; 2016/12/6
黃景燦(2013)。從美國醫師調查反思臺灣醫療環境現況。臺灣醫界,56(4);50-53。
黃麗玲 、黃薇瑄、葉德豐、鍾燕宜、林川雄、黃建財(2015)。護理人員超時工作與疲勞之相關性分析,休閒運動保健學報;8(1),10-25。
葉婉榆、鄭雅文、陳美如、邱文祥(2008)。職場疲勞量表的編製與信效度分析,台灣衛誌;27(5),349-364。
鄒孟婷、黃偉新(2013)。社區職場之過勞相關因素分析及執行困難之探討,中華職業醫學雜誌;20(1),25-38。
鄭雅文、吳宣蓓、翁裕峰(2011)。過勞職災的認定爭議與政策因應:日本經驗對台灣的啟示,台灣衛誌;30,301-15。
鄭雅文、葉婉榆、林宜平(2007)。台灣職場疲勞問題的社會性,台灣衛誌;26,251。
羅士翔、陳文慶、柯景塘、王榮德(2007)。工作過勞致死之定義及診斷基準,台北醫學雜誌;4,95-102。
羅元婷、羅慶徽、林金定、呂學琳、朱明若、林雅雯、賴朝英、徐尚為、陳宏一(2006)。某醫學中心推動「健康促進醫院」計畫:職場工作環境與醫院員工健康狀況之研究,中華職業醫學雜誌;13(3),143-156。
劉念怡(2012)。護理人員生活品質的相關因素探討,未出版碩士論,國立臺北護理健康大學護理研究所,台北市。
鄭夙芬、鄭期緯、陳武宗、黃洽鑽(2006)。高高屏地區社區運動團體參與者健康信念、組織參與與身心健康之研究,衛生教育學報;26,1-31。

二、英文文獻
Accreditation Council for Graduate Medical Education. Available at:http://www.acgme.org/acWebsite/dutyHours/dh_dutyHoursCommonPR.pdf.
Chan D.W.,Chan TSC (1983). Reliability, validity and the structure of the general health questionnaire in a Chinese context. Psychological Medicine, 13,363-371.
Cheng Y, Chen IS, Chen CJ, Burr H, Hasselhorn HM .(2013). The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions. Journal of Psychosomatic Research ;74: 213-220.
Cheng Y, Huang HY, Li PR, Hsu JH. (2011).Employment insecurity, workplace justice and employees’ burnout in Taiwanese employees: a validation study. International Journal of Behavioral Medicine; 18(4): 391-401.
Cheng Y, Luh WM, Guo YL.(2003) Reliability and Validity of the Chinese Version of the Job Content Questionnaire (C-JCQ) in Taiwanese Workers. International Journal of Behavioral Medicine, 10(1): 15-30.
Cheng, T. A. & Williams, P. (1986).The design and development of a screening questionnaire (CHQ) for use in community studies of mental disorders in Taiwan . Psychological Medicine , 16 , 415-422 .
Cleeman, JI: Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):86-97.
Dembe, A., Erickson, J., Delbos, R., & Banks, S. (2005 ). The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. Occupy Environ Med, 62(9), 588-597.
Emer S.(2004). On behalf of the Conference Expert Committee. Promoting heart health-a European consensus. Background paper prepared by theIrish Presidency for a meeting in Cork, Ireland. Eur J Cardiovasc Prevention Rehab ; 11:87-100.
Fredriksson, K., Alfredsson, L., Köster, M., Thorbjörnsson, C. B., Toomingas, A., Torgén, M., et al. (1999). Risk factors for neck and upper limb disorders: results from 24 years of follow up. Occupational and Environmental Medicine, 56(1), 59-66.
Gumenyuk, V.,Roth, T.,Drake CL(2012): Circadian phase ,sleepiness, and light exposure assessment in night workers with and without shift work disorder. Chronobiology Int. 29(7):28-36.
Hall, Mc. L. (2005). Quality work environments for nurse and patient safety. Boston: Jones and Bartlett.
Harb, F.,Hidalgo, M.P., Martau, B.,(2014): Lack of exposure to natural light in the workplace is associated with physiological, sleep and depressive symptoms. Chronobiology Int. 26:1-8.
Harrington JM.(2001) Health effects of shift work and extended hours of work. Occupy Environ Med,58,68-72.
Howard SK, Gaba DM, Rosekind MR, Zarcone VP.(2002). The risks and implication of excessive daytime sleepiness in resident physicians. Acad Med;77(10):1019-25.
Hulst , M.D., Veldhoven, M.V. & Beckers, D.(2006). Overtime and need for recovery in relation to job demands and job control. Journal of Occupational Health, 48,11-19.
James PS,Robert CL(2007).Occupational Stress.In:Joseph LaDou eds.Current Occupational& Environmental Medicine. 4th ed. New York: McGraw-Hill:84-90.
Kim MJ,Lee JH,Duffy JF(2013).Circadian Rhythm Sleep Disorders.J Clin Outcomes Manag:20(11):13-28.
Knutsson, A., Akerstedt, T., & Jonsson, B. G. (1988). Prevalence of risk factors for coronary artery disease among day and shift workers. Scandinavian Journal of Work, Environment and Health, 14(5), 317-321.
Lam TP, Wong JG, Ip MS, Lam KF, Pang SL.(2010). Psychological well-being of interns in Hong Kong: what causes them stress and what helps them. Med Teach;32(3):e120-6.
Leung L, Becker CE.(1992). Sleep deprivation and house staff performance.J Occup Med;34(12):53-60.
Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals DOI: http://dx.doi.org/10.1016/S0140-6736(15)60295-1 Published: 19 August 2015
McCann, D. (2005). Working time laws: A global perspective. Findings from the ILO’s conditions of work and employment database.
Ming-Chin Yang, Yi-Fan Li, Shi-Lun Wei. (2007).An Analysis of the Work Hours and Related Factors Associated with Attending Physicians and Residents in Teaching Hospital. J Med Education;11(3):22-33.
Ming-Chin Yang, Yi-Fan Li, Shi-Lun Wei.(2007) An Analysis of the Work Hours and Related Factors Associated with Attending Physicians and Residents in Teaching Hospital. J Med Education,11(3),22-33.
Murray A, Pounder R, Mather H, Black DC.(2005). Junior doctor’shift and sleep deprivation. BMJ .。
Nakanishi, N., Nakamura, K., Ichikawa, S., Suzuki, K., & Tatara, K. (1999). Lifestyle and the development of hypertension: a 3-year follow-up study of middle-aged Japanese male office workers. Occupational Medicine, 49(2),109-114.
OECD Employment Outlook (1998). Working Hours : Latest Trends and Policy Initiatives,5, 153-188.
Owens JA, Veasey SC, Rosen RC.(2001). Physician, heal thyself: sleep,fatigue and medical education. Sleep;24(5):493-5.
P. W. F. Wilson et al(1998): Prediction of Coronary Heart Disease Using Risk Factor Categories. Framingham Heart Study, National Heart, Lung, and Blood Institute Special Report, Circulation ; 97:18.37-47.
Pan A,Schernhammer ES,Sun Q,et al.(2011): Rotating night shift work and risk of type 2 diabetes:two prospective cohort studies inwomen. PloS Med.8(12):e1001141.
Park, J., Yi, Y., & Kim, Y. (2010). Weekly work hours and stress complaints of workers in Korea. American Journal of Industrial Medicine, 53(11),1135-1141.
Pascal P, Damien M.(2001). Third European survey on working conditions 2000. European Foundation for the Improvement of Living and Working Conditions , Dublin, European Foundation.
Peisah C, Latif E, Wilhelm K, Williams B.(2009). Secrets to psychological success: why older doctors might have lower psychological distress and burnout than younger doctors. Aging MentHealth ;13(2):3-7.
Peter W.F. Wilson, MD; Ralph B. D’Agostino, PhD; Daniel Levy, MD; Albert M. Belanger, BS; Halit Silbershatz, PhD; William B. Kannel, MD.(1998). Circulation Prediction of Coronary Heart Disease Using Risk Factor Categories;97:1837-1847
Philibert I.(2005). Sleep loss and performance in residents and nonphysicians: a meta-analytic examination. Sleep;28(11):392-402.
Phillips GB.(1977). Relationship between serum sex hormones and glucose, insulin and lipid abnormalities in men with myocardial infarction. Proc Natl Acad Sci USA;74(4):29-33.
Pimenta, A. M., Beunza, J. J., Bes-Rastrollo, M., Alonso, A., López, C. N., Velásquez-Meléndez, G., et al. (2009). Work hours and incidence of hypertension among Spanish University graduates: the Seguimiento Universidad de Navarra prospective cohort. Journal of Hypertension,27(1), 34-40
Robbins, SP (2003). Organizational Behaviors. Pearson Education, Inc, 19, 555-576.
Robbins,S.P.(1996). Organization behavior:Concept ,controversies,applications.New
Rosen IM, Gimotty PA, Shea JA, Bellini LM.(2006). Evolution of sleep quantity,sleep deprivation,mood disturbances,empathy,and burnout among interns. Acad Med;81(1):82-85.
Sato Y, Miyake H, Thériault G.(2009). Overtime work and stress response in a group of Japanese workers. Occup Med (Lond);59(1):9-14.
Shirom A, Melamed S, Toker S, Berliner S, Shapira I.(2005). Burnout and health: current knowledge and futureresearch directions. Int Rev Ind Organ Psychol ;20:269-309.
Vandenberghe, R., Huberman, A.M. preventing teacher (1999). Understanding and bornout:A sourcebook of international research and practice. Cambridge:Cambridge University Press.
Veasey S, Rosen R, Barzansky B, Rosen I, Owens J.(2002). Sleep loss and fatigue in residency training: a reappraisal. JAMA ;288(9):16-24.
Vimalananda VG,Palmer JR,Gerlovin H,etal(2015): Night-shift work and incident diabetes among African-American women. Diabetologia.
World Health Organization. Health Promoting Hospitals Information Package. Geneva. World Health Organization.1998: 3-4.
Yajnik CS, Yudkin JS. The Y-Y paradox(2004). Lancet. 363:163. PMID 14726172.
Yeh WY, Cheng Y, Chen C-J, Hu P-Y,(2007). Kristensen TS. Psychometric properties of the Chinese version of Copenhagen Burnout Inventory among employees in two companies in Taiwan. International Journal of Behavioral Medicine, 14(3): 126-133.
Zhao I,Bogossian F,Turner C(2012). A cross-sectional analysis of the association between night-only or rotating shift work and overweight/obesity among female nurses and midwives. J Occup Environ Med.;54(7):834-840.
Zisapel N(2001).Pathophysiology and Potential Approaches to Management.Circadian rhythm sleep disorders :15(4): 11-28.
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