某醫學中心推動“健康促進醫院”計劃：職場工作環境與醫院員工健康狀況之研究

Health Promoting Hospital Initiative in One Taipei's Medical Center: The Characteristics of Workplace Environments and Employees' Health

羅元婷(Yuan-Ting Lo) ； 羅慶徽(Ching-Hui Loh) ； 林金定(Jin-Ding Lin) ； 呂學琳(Hsueh-Lin Lu) ； 朱明若(Corida-M. Chu)林雅雯(Ya-Wen Lin) ； 賴朝英(Chia-Im Lai) ； 徐尚為(Shang-Wei Hsu) ； 陳宏一(Hong-I Chen)

《中華職業醫學雜誌》 13卷3期 (2006/07) Pp. 143-156

https://doi.org/10.30027/CJOM.200607.0002

摘要

健康促進醫院是世界衛生組織在1990年代起始於歐洲的健康促進運動，主要是整合健康促進的理論與策略，增進醫院員工、病人及家屬和社區居民的健康。本研究主要是參考國外推行健康促進醫院之實行過程，實際在此家醫院推動健康促進醫院，初期以醫院員工為主要的目標群體並以發展職場健康促進計畫為主，員工屬於醫院的重要資產之一，提供給員工一個安全且健康的工作環境醫院責無旁貸。本篇文章主要目的在於調查醫院員工目前因工作所產生的健康問題為何，以及員工自覺職場中所存在的物理性、化學性和保護性的危害因素為何，並根據上述之研究結果提供此家醫院關於職場健康促進議題之規劃。本研究採用橫斷性研究，以結構式問卷調查的方式來進行資料收集，總計回收有效問卷為649份，回收率為81.3%，回收問卷之性別和服務職稱與母群分佈無異。研究結果發現：21.7%的員工每週工作時數超過50小時，且大多數為醫生，73.1%回答有因為工作而引起健康上的問題，前三項分別是以頭頸、上背部不適、疲勞和下背部不適，半數的員工回答健康問題仍然存在，79.8%員工自覺工作環境有物理性危害，以空氣不流通佔37.3%為最多，34.9%自覺有化學性危害因素則，以抗癌藥物佔29.5%為最多，24.8%認為環境中缺乏保護性因素，其中無足夠的職業訓練與缺少個人保護裝備各佔37.7%。邏輯斯迴歸分析發現控制其它便項後有無工作所引起的健康問題與性別和工作環境有無物理性危害因素，有統計上的顯著意義，男性比女性顯著有較低之工作所引起的健康問題(OR=0.3，95%CI=0.16-0.58)，工作環境中覺得有物理性危害因素者，比沒有物理性危害因素者顯著有較高之工作所引起的健康問題(OR=3.11，95%CI＝2.01-4.82)。綜合上述的研究結果，本研究建議此醫院相關職場健康促進計畫為：減少超時工作，建立適當的輪班制度；改善員工人體工學之危害；改善院內空調；建立完善化療藥物防護機制與準則，以及加強職業安全訓練並提供員工所需之安全防護設施。

關鍵字

健康促進醫院 ； 職場健康促進 ； 醫療工作者 ； 醫院危害因素

並列摘要

Health promoting hospitals (HPH), a movement supported by the World Health Organization, initiated by Europe Region in the late 1990's. A HPH incorporates the concepts, value and standards of health promotion in order to improve health for hospital's staff, patients, relatives and communities. This paper aimed to investigate the perception of hospital's staff toward on the working related health problems and examine the environmental factors in the hospital. A cross-sectional survey was conducted to analyze 649 subjects in one medical center in Taipei and response rate was 81.3% from this hospital in 2002. We found that 21.7% of employees worked over 50 hours per week and 73.1% of the staff complained that they had work-related health problems. Half of the employees expressed that their work-related health problems had not been solved. There were 79.8% of the staff stated that workplace had many physical hazardous factors, such as poor air circulation (37.3%), chemical hazardous factors (34.9%) and 29.5% considered that chemotherapy drugs effect. Among the respondents, 24.8% of thought that the workplace lacked appropriate protection initiatives such as having not enough safety trainings and lacking personal protective equipment. In the analysis of logistic regression model, the physical environment and gender were statistical significant to the staff's health. Male had less work-related health problems than the female subjects (OR=0.3, 95%C.I=0.16-0.58). The physical hazardous environments in the workplace had higher work-related health problems than did not have the physical hazardous conditions (OR=3.11, 95%CI=2.01-4.82). In conclusion, the workplace health promotion projects in this hospital should redesign the working hours and develop reasonable shift work schedules for the employees, to improve ergonomic design for staff, improve quality indoor air, to establish principles for protection chemotherapy drugs, to improve occupational health safety training, and to support them enough personal protective equipment in the workplace.

並列關鍵字

Health promotion hospital ； workplace health promotion ； hospital worker ； hospital hazardous factors