照顧服務員肌肉骨骼危害調查與作業姿勢評估

Measurement of work posture and Musculoskeletal disorders survey among nursing assistants

施碧旻(Pi-Min Shih)

指導教授 ： 林彥輝

中山醫學大學/健康管理學院/職業安全衛生學系碩士班/碩士(2016年)

摘要

本研究透過問卷調查與拍攝工作現場作業姿勢的方式，進行照顧服務員之肌肉骨骼傷害調查與評估。本研究共進行190份問卷與10個作業場所之照顧服務員現場作業姿勢拍攝，問卷內容包括受訪者基本資料、工作內容與健康狀況及移位輔具設施使用狀況等，作業場所現場作業姿勢拍攝影片將利用OWAS進行編碼分析。
　　研究結果顯示，從事此行業之前，有81.48%的照顧服務員無肌肉骨骼不適症狀；但從事此行業之後，有92.06%的照顧服務員出現肌肉骨骼不適症狀。過去一年曾經發生肌肉骨骼不適症狀的部位，以下背/腰部（69.47%）、右肩膀（47.89%）、左肩膀（44.21%）及頸部（37.89%）最高。照顧服務員工作內容中，以搬移（含上、下床）感到身體負荷最大、最累、最嚴重；另病患轉移位方式以徒手操作（79.23%）為主，其次是使用非動力驅動輔具（18.58%）。
　　OWAS分析結果發現照顧服務員其身體部位姿勢之重複性比例，以頭頸部前傾、背部前彎、背部彎曲且扭轉、腿部雙腳站立腿彎曲及腿部單腳站立單腿彎曲，其OWAS值屬於AC2，有顯著性的危害。其工作姿勢屬AC2及AC3行動等級，佔全體AC1∼AC4百分比的44.50%，有立即改善之必要性。
　　照顧服務員在照護過程中，大多以背部前彎且扭轉居多，建議工作姿勢必須盡可能保持上身正直，避免低頭和彎腰，減少頭頸和腰部受力程度的身體姿勢；並給予工作者適當的休息時間，避免因徒手抬舉搬運、移動被照護者所造成的肌肉骨骼危害風險。

關鍵字

照顧服務員 ； 肌肉骨骼不適 ； OWAS ； 轉移位 ； 輔具

並列摘要

Via surveys and videotaping of the working postures of caregivers on-the-job, this study investigates and evaluates the musculoskeletal injuries suffered by the caregivers. A total of 190 surveys were collected and images of caretakers from 10 working locations were acquired. Questions in the survey include basic information, job content, health condition, the usage of transferring assistive devices. The operating posture on-the-job was captured on video, which was analyzed by OWAS through coding analysis.
　　Results revealed that prior to practicing the occupation of caregiver, 81.48% of the caregivers did not suffer from muscular or skeletal discomfort. However, 92.06% of the caregivers reported that after practicing this occupation, they experienced musculoskeletal discomfort. Within the past year, discomfort was most prevalent in the lower back/waist (69.47%), right shoulder (47.89%), left shoulder (44.21%), and the neck (37.89%) area. Of the different job contents, transferring (including on and off the bed) resulted in the heaviest burden on the body, was the most tiresome to perform, and was the most critical. Furthermore, transferring of patients was performed mostly with bare hands (79.23%), followed by the use of non-powered assistive devices (18.58%).
　　Result from OWAS analysis revealed that the most repetitive body posture employed were head/neck forward leaning, back forward bending, back bending and twisting, standing and bending on two straight legs, and standing and bending on one straight leg. The OWAS score of these postures is AC2, which is considered significantly harmful. Of all working postures, those with scores of AC2 and AC3 account for 44.50% of all postures scored AC1 to AC4. Thus, immediate improvements are necessary.
　　During the caregiving process, the caregivers most often adopted back forward bending and twisting postures. It is thus suggested that for work postures, the upper body should be kept upright and lowering of the head or bending of the waist should be avoided. Body postures that reduce the workload on the head/neck and waist should be used. Also, adequate resting time should be allocated and carrying items using bare hands or transferring the person being taken care of should be prevented in order to reduce the hazardous risk of musculoskeletal damage.

並列關鍵字

Nursing Assistants ； Musculoskeletal discomfort ； OWAS ； patient handling ； assistive devices

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