護理人員為醫療照顧體系中最主要的人力資源，然而護理作業的沈重生理負荷與工作特性常是造成護理人員下肢肌肉骨骼傷害的主要原因，因此，如何減緩職業性肌肉骨骼傷害發生，減少下肢生理工作負荷，為確保護理人員工作健康及維持有效護理人力的基礎。
此論文研究分為三大部分：第一、檢視台灣臨床護理人員工作健康狀況，透過工作能力與生活品質問卷調查瞭解哪些關鍵因子影響護理人員工作健康及生活品質。第二、評估市售專用護士鞋及彈性襪，提出建議護理人員穿著之鞋具，減輕下肢肌肉骨骼負荷。此外，由於臨床護理人員均以女性為主，第三部分將討論性別與步行速度對於下肢工作負荷在生理、生物力學及心理物理等各項指標之影響。
本論文主要發現包括：年齡、生理工作負荷及工作環境為影響台灣護理人員工作健康的主要原因。在改善護理人員下肢負荷方面，建議護理鞋選擇需同時考量鞋墊足弓、鞋底材質、鞋跟厚度、鞋楦形狀等設計，同時加上彈性襪穿著，有助於減緩護理人員下肢肌肉骨骼不舒適。此外，性別與行走速度對於下肢肌肉骨骼在生理、生物力學及主觀心理物理變化上均有不同的影響，評估下肢工作負荷時因考慮到性別與行走速度因子對於下肢肌肉骨骼的影響。

Nursing professionals are the largest employee group in healthcare industry. Heavy physical loading and the substantial characteristics of nursing work are critical factors to induce the musculoskeletal disorders of lower extremity. Thus, preventing work-related musculoskeletal disease (WMSDs) and minimizing the physical workload of lower extremity are essential for improving nurse’s working health and maintaining quality nursing workforce.
Three topics are discussed in this study. First, through the questionnaire survey, some critical factors affecting nurse’s working health and quality of life have been identified. Secondly, commercial-available nurse’s footwear including shoe and compression hosiery are evaluated and specific footwear features are suggested to reduce discomfort of lower extremity. Owing to nursing professionals are mostly females, the third part of this study discusses the effect of gender and walking speed on physical workload of lower extremity.
The main findings of this study include that age, physical workload and work environment are the critical elements affecting the working health of nurses. Alleviating the physical workload of lower extremities, specific footwear design including a footbed with arch support, outsole materials, thickness, shoe last and heel height should be emphasized. Wearing compression hosiery has a positive effect to reduce musculoskeletal discomfort of lower extremity. Moreover, the effect of gender and walking speed should be taken into consideration for interpreting the physical workload of lower extremity.

摘要…… I
Abstract… II
誌謝…… III
Table of Content IV
Table List VI
Figure List VII
Chapter 1 Introduction 1
1.1 Background 1
1.2 Problem statement 5
1.3 Dissertation framework 7
Chapter 2 Literature review 9
2.1 Work-health interactions of nurses 9
2.2 Occupational hazards of nurses 13
2.3 Work-related musculoskeletal disorders among nurses 15
2.4 Physical workload of lower extremity 19
Chapter 3 Work ability and quality of life for nurses 22
3.1 Methods 22
3.2 Results 26
3.3 Discussions 32
Chapter 4 Footwear evaluation for nurses 38
4.1 Methods 38
4.2 Results 46
4.3 Discussions 52
Chapter 5 Physical workload of lower extremity 56
5.1 Methods 56
5.2. Results 61
5.3 Discussions 68
Chapter 6 Conclusions 71
References 74
Appendix I Questionnaire 84

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