影響上肢損傷職災勞工在工作強化訓練後的生活品質之因子

Factors Related to Quality of Life after Work- Hardening in Workers with Occupational Injury in Upper Extremity

楊尚育(Shang-Yu Yang) ； 康鈞雅(Chung-Ya Kang) ； 張哲豪(Jer-Hao Chang)

《臺灣職能治療研究與實務雜誌》 12卷2期 (2016/12) Pp. 79-88

https://doi.org/10.6534/jtotrp.2016.12(2).79

摘要

目的：一、驗證因職災而導致上肢受傷的勞工個案，醫療穩定後參加工作強化訓練前後之上肢失能、疼痛酸麻程度與生活品質之相關性。二、探討年齡、介入時數、工作強化訓練前後上肢失能、疼痛酸麻症狀等變項對於工作強化訓練前後之生理及心理生活品質的影響。方法：取自台灣南部某工作強化中心2010年10月至2013年4月之病例，採病例回溯的方式。收案條件：1.診斷為上肢功能受損之職災個案；2.醫療狀況穩定並完成4周以上工作強化訓練。共得病例32份。收集個案在工作強化訓練前後之上肢失能程度（上肢失能問卷Disabilities of the arm, shoulder and hand questionnaire）、疼痛與酸麻程度（視覺類比量表Visual Analogue Scale）、生活品質生理範疇及心理範疇（台灣簡明版世界衛生組織生活品質問卷WHO Quality of Life-BREF）。統計分析包含描述性統計、Pearson相關係數與逐步回歸。結果：有26位男性與6位女性，平均年齡43.8歲。工作強化介入時間平均約為60小時。以訓練前（後）生活品質生理範疇與心理範疇為依變項，年齡、介入時數、訓練前（後）之上肢失能程度、疼痛程度、酸麻程度為自變項。結果指出：在工作強化訓練前，生活品質生理範疇的顯著影響變項為上肢失能程度與酸麻程度；生活品質心理範疇的顯著影響變項則為酸麻程度。經工作強化訓練後，生活品質生理範疇的顯著影響變項為上肢失能程度與年齡；生活品質心理範疇的顯著影響變項則為上肢失能程度。結論：此結果提醒職能治療人員在介入上肢功能損傷職災勞工時，致力減輕疼痛與酸麻程度並減少上肢失能，可以有效提高個案之生活品質。

關鍵字

職災勞工 ； 生活品質 ； 上肢失能 ； 工作強化

並列摘要

Objective: First, it is to examine the correlations between upper extremity disability, the degree of pain and numbness and quality of life in workers with occupational injury in upper extremity. Second, it is to investigate the influence of the age, hours of work-hardening, upper extremity dysfunction, pain and numbness to physical and psychological domains of quality of life before and after work-hardening training. Methods: The retrospective study reviewed the work-hardening records from 32 subjects in a Taiwan work-hardening center during 2010 to 2013. All of the subjects were workers occupational injury in upper extremity injury and completed work-hardening training. The data of disabilities of the arm, shoulder and hand (DASH) questionnaire, the degree of pain and numbness and the physical and psychological domains of the World Health Organization Quality of Life (WHOQOL) questionnaire before and after work hardening were collected. Statistical analysis included descriptive statistics, Pearson correlation coefficient and stepwise regression. Results: There were 26 males and 6 females, and average age was 43.8 years old. Average intervention hour was about 60 hours. The findings indicated that before work hardening the numbness and DASH were the significant variables for the physical domain in WHOQOL; the numbness was the significant variable for the psychological domain in WHOQOL. After work hardening, both the age and DASH were the significant variables for the physical domain in WHOQOL, and the DASH was the significant variable for the psychological domain in WHOQOL. Conclusion: In order to improve the quality of life for the workers with upper extremity injury, the findings suggested that occupational therapists could make effort to reduce the degree of upper extremity disability and alleviate their pain and numbness.

並列關鍵字

Worker with occupational injury ； Quality of life ； Upper extremity disability ； Work hardening