輪班人員工作負荷對健康之影響：工時控管與衛教介入效果之探討

本研究採用橫斷面與縱斷面之兩項研究設計，探討輪班工作機制下影響個人十年內心血管疾病發病風險可能因素，以及提供介入「健康管理措施」對改善工作負荷、過勞、心血管疾病發病風險的成效分析。橫斷面研究對象為北部某製造業輪班基層作業人員，總計有效樣本共491位。研究結果顯示每月加班時數、工作負荷、工作過勞、十年內心血管疾病發病風險彼此間是有顯著正相關（除了每月加班時數與工作過勞間之正向關係是未達顯著）。而研究證實輪班工作人員工作負荷是有顯著正向預測十年內心血管疾病發病風險，與過往研究結果相符，本研究更進一步證實工作過勞是有效中介工作負荷與十年內心血管疾病發病風險二者間之正向關係。工作負荷者不必然都會為十年內心血管疾病發病的高風險者，仍應視此負荷量是否導致輪班者工作過勞。此外，縱斷面研究對象是針對同一家公司從事輪班基層作業人員與行政人員，透過問卷收集評值為心血管疾病好發風險高者，總計有效樣本共491位，包含輪班人員330位、行政人員161人。對他們進行加班工時管控，限制一年期間不得有任何加班，且同步給予他們醫護理人員的健康衛教，期滿一年時間進行健康成效分析。研究結果顯示介入「健康管理措施」後，個人相關過勞、工作相關過勞、工作負荷、十年內心血管疾病發病風險、職業促發腦心血管疾病之風險均獲得顯著改善。企業為了提升勞工整體健康，適時採行強制管理措施如每月加班工時的控管是有其必要性。同時，醫護人員的衛教，教導高風險勞工應正視自身健康，優先健康改善並維持才有機會增加個人在工作層面的表現與經濟狀況的提升。

關鍵字

工作負荷；工作過勞；十年內心血管疾病發病風險

並列摘要

This study adopted both cross-sectional and longitudinal research designs to explore potential factors affecting the onset of cardiovascular diseases within 10 years among people working in shifts. A health management intervention was implemented to analyze its effectiveness in reducing labor workloads, alleviating burnout from overwork, and lowering cardiovascular disease onset risks. In the cross-sectional research, entry-level employees working in shifts of a manufacturing company in northern Taiwan were recruited as the participants to collect 491 valid samples. The results revealed that monthly overtime hours, workload, burnout from overwork, and 10-year onset risks of cardiovascular diseases were positively correlated. Only the correlation between monthly overtime hours and burnout from overwork was nonsignificant, whereas the remaining correlations were significant. This study also confirmed the workload of shift workers as a significant and positive predictor of 10-year onset risks of cardiovascular diseases, supporting the results reported by previous scholars. Additionally, this study verified that burnout from overwork effectively mediated the relationship between workload and 10-year onset risks of cardiovascular diseases. Although not all shift workers with a high workload are at a risk of cardiovascular disease onset within 10 years, attention should nevertheless be paid to prevent overwork among such workers. In the longitudinal research, entry-level shift workers and administrative workers were recruited from the same company. A questionnaire was distributed to identify those at high risks of developing cardiovascular diseases. A a total of 491 valid samples (i.e., 330 shift workers and 161 administrative workers) were collected. An intervention was implemented in which their overtime hours were controlled by prohibiting them to work overtime for 1 year, during which health education was provided to them by healthcare personnel. After the intervention, the health conditions of these workers were examined to demonstrate significant improvements in their personal burnout from overwork, work-related burnout from overwork, workload, 10-year onset risks of cardiovascular diseases, and risks of work-induced cerebral cardiovascular diseases. To improve the health of their employees, companies must implement mandatory management measures such as timely control of monthly overtime hours. Additionally, health education provided by healthcare personnel must teach high-risk workers to pay more attention to their health, prioritize their health over work, and practice health maintenance behavior. This allows them to improve their job performance and financial well-being.