健康促進計畫對職場工作者健康之影響-不同企業規模之運動介入策略與評估

The health effects of workplace health promotion program-Evaluation of exercise intervention strategies in different sizes of worksite

蔡瀚輝(Han-Hui Tsai)

指導教授 ： 陳叡瑜

臺北醫學大學/公共衛生暨營養學院/公共衛生學系暨研究所/博士(2013年)

https://doi.org/10.6831/TMU.2013.00078

摘要

研究目的：本研究目的在探討不同規模企業健康體能推廣策略對職場工作者健康效益之影響。本研究以提高認知、教育、健康體能介入、建立能力、支持環境與認可與獎勵等六項策略設計不同規模企業的職場健康體能推廣計畫，並採用類實驗法(quasi-experimental design)實施職場運動介入課程，探討運動介入對職場健康之效益。

研究方法：本研究共分兩部分：第一部分以中小企業職場為對象，評估中小企業運動介入策略對勞工體適能、肌肉骨骼疼痛、心血管疾病因子與自覺健康況等指標之改善效果；第二部分以大型企業職場為對象，評估大型企業運動介入策略對勞工過勞與代謝症候群改善之效果，並探討運動、過勞與代謝症候群之相關性。本研究透過舉辦健康促進教育訓練及說明會聯絡企業相關單位或雇主，廣邀不同規模企業勞工參與健康體能推廣計畫。第一部分研究以群落式介入(community-based intervention)方式集結中小企業勞工來參與健康體能推廣計畫，並於介入前後實施肌肉骨骼疼痛與自覺健康問卷調查及體適能測驗，探討運動介入對中小企業勞工健康指標之影響。共有133位中小企業勞工參與行前教育訓練與說明會，85位參與後續之12週運動介入課程，其中48位參與者自願選擇對照組別。第二部分研究以駐點介入(On-site Intervention)方式執行於該大型企業內部進行健康體能推廣計畫，並實施工作壓力與過勞問卷調查及收集受試者代謝症候群指標，探討運動介入、過勞與代謝症候群因子之相關性。共有109位勞工自願參與此研究計畫，其中38位勞工自願加入對照組別、36位勞工自願加入低強度運動組與35位勞工加入高強度運動組。

研究結果：第一部分研究結果發現，運動組別較能改善頸肩/脖子(18.8%) 、手/腕部(17.4%)、下背部(21.7%)與上背部(8.7%)等肌肉骨骼傷害(p＜0.05)。運動頻率高之組別較能提升體適能指標與降低心血管疾病相關因子(p＜0.05)。運動課程參與次數與運動介入後BMI及安靜心跳差異有統計上顯著的正向關係(p＝0.02)；參與次數每增加一次，BMI差異增加0.02分與安靜心跳差異增加0.3下。運動介入後，在調整相關干擾因子，運動組別勞工自覺一般健康較對照組別勞工顯著改善(p＝0.02)。第二部分研究結果發現， 高強度運動組別較能改善個人與工作相關過勞、腰圍與收縮壓之指標(p＜0.05)。個人與工作相關過勞變項亦與運動介入後收縮壓差異有顯著關係(p＜0.05)。在調整相關干擾因子後，高強度運動組可顯著減低3.23公分之腰圍及13.44毫米汞柱之收縮壓，低強度運動組可顯著減低2.43公分之腰圍及7.81毫米汞柱之收縮壓；運動介入變項亦修飾了個人與工作相關過勞對收縮壓的關係性(p＜0.05)。運動介入可使大型企業勞工減低個人與工作相關過勞，進而改善代謝症候群相關因子。

結論：職場運動介入為職場健康促進計畫有效之工具之一，建立運動習慣能改善健康生活型態及職場相關健康因子。本研究針對不同規模企業擬定運動介入推廣策略，藉以提升職場勞工健康體能，並改善了不同規模企業勞工肌肉骨骼疼痛、腰圍、收縮壓、個人與工作相關過勞及心血管疾病等健康危害因子。本研究示範了可行性的運動介入策略，並提供給未來職場健康促進計畫推廣之參考。

關鍵字

中小企業 ； 大型企業 ； 職場運動介入策略 ； 代謝症候群因子 ； 心血管疾病危險因子 ； 肌肉骨骼傷害 ； 工作壓力

並列摘要

Objective: To explore the effectiveness of workplace physical fitness program strategies in Taiwan’s enterprises. In this study, the 12-weeks workplace physical fitness programs were developed by six strategies for different sizes of enterprise, which included raising awareness, education, conduct local physical activity programmes and initiatives, build capacity, supportive environment, and recognition/awards, and its benefits evaluated.

Methods: The study was divided into 2 parts for different sizes of enterprises. In the first part of study, small and medium-sized enterprise (SMEs) exercise intervention was conducted to evaluate the exercise effects on physical fitness indicators, self-reported health status, cardiovascular risk factors, and musculoskeletal disorders. In the second part of study, large-sized enterprise exercise intervention was conducted to evaluate the exercise effects on burnout and metabolic syndrome. Orientations were conducted and employees were invited to participate in 12-weeks physcial fitness programs along with instruction promotion the importance of lifestyle and exercise for individual health. Quasi-experimental study design was conducted for exercise intervention to evaluate the effects of physical fitness intervention on different size of enterprises. Workplace health-related indicators are measured to compare the difference between pre and post intervention. In the first part of study, 133 SMEs workers completed the structured questionnaire but only 85 joined the exercise program as the exercise group. The remaining 48 employees chose not to participate in the program, and they served as the control group. In the second part of study, there were 109 large-sized enterprise workers in the orientation that agreed to join the study program and voluntarily assigned into three different exercise groups. The control group consisted of 38 workers, the low-intensity group consisted of 36 workers, and the high-intensity group consisted of 35 workers.
Results: In the first part of study results, after the community-based intervention, physical fitness indicators and cardiovascular risk factors were significantly improved, and improvements in musculoskeletal disorders were seen in reduced neck pain (18.8%), wrist pain (17.4%), and upper/lower back pain (8.7% and 21.7%, respectively). Cardiovascular risk factors showed a significant improvement related to frequent participation in the program (p＝0.02), BMI and resting heart rate differences had increased by 0.02 points and 0.3 mmHg. The exercise group also reported a significant difference in overall health (p＝0.02). In the second part of study results, after on-site intervention, the indicators of burnout and metabolic syndrome components were significantly improved in higher level of intensity groups, and the improvement were expressed in reduction of waist circumference, systolic blood pressure, person burnout and work-related burnout. A dose-response of burnouts and metabolic syndrome components with exercise intensity are shown (p<0.05). Metabolic syndrome components were independently associated with burnout and exercise intensity in the crude model. After adjustment for potential confounders, waist circumference and systolic blood pressure differences showed significant associations with high and low-intensity group (p < 0.05).

Conclusion: The effective workplace physical fitness promotion strategies were established in different sized of Taiwan’s enterprises. Investigation of the relationship between the exercise intervention and health indicators is evaluated in the study. This exercise program may serve as a future health promotion strategies for different sizes of enterprise.

並列關鍵字

Small and medium-sized enterprises ； Large-sized enterprises ； Workplace physical fitness promotion strategies ； Cardiovascular risk factors ； Musculoskeletal disorders ； Work stress

參考文獻

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