到院前救護人員下背痛研判

Evaluation of Low Back Pain among Emergency Medical Technician

葉文彬(Wen-Bin YEH)

指導教授 ： 莊弘毅

高雄醫學大學/健康科學院/職業安全衛生研究所/碩士(2011年)

摘要

背痛是相當常見的職業病，原因與工作姿勢不良或是長時間固定姿勢等所致。背痛，其定義包含疼痛不適、酸痛、疲乏、等感覺。救護人員因工作搬運病或是在局限空間內以不良姿勢進行急救或心肺復甦術(CPR)等問題造成肌肉骨骼之不適，尤其是背痛。職業引起的背痛除了和個人因素，姿勢及工作量以外，在其它研究亦發現背痛與工作滿意度及壓力有關。職業引起的背痛在其它行業別已有相關的研究，但對於救護人員的背痛卻鮮少被研究及重視。本研究探討國內救護人員背痛的盛行率。背痛與個人因素，工作項目，工作滿意度及工作壓力的相關性。

　　本研究於民國100年4月至6月間，針對南台灣某一縣及市的救護人員進行橫斷式問卷調查，有效問卷回收數目428份，有效問卷回收率79.3%。內容著重於過去一年內肌肉骨骼不適，工作滿意度及工作壓力等相關問題。其資料以描述性統計表示，並以單變項邏輯迴歸分析，分別比較背痛與非背痛人員對於的各項危險因子之相關性。本研究結果顯示救護技術員在過去一年內肌肉骨骼不適的的盛行率為73.8%，其中背痛盛行率為65.2%。救護人員之工作型態為較低之工作控及中等偏高之工作心理負荷。

　　背痛的各相關因子分析中發現，背痛與工作年資，使用擔架，使用自動電擊器，徒手搬運病人及於工作控制中的決策自主權有關。本篇研究可以發現南部地區救護人員背痛的情形相當普遍及與因多種因素引起。

關鍵字

背痛 ； 到院前救護人員 ； 工作壓力

並列摘要

ABSTRACT

Occupational back injuries are a major health problem in developed countries for workers who are required to have repeated forceful movement and heavy lifting.
Emergency Medical Technician (EMT) is an occupational group at risk of back pain problems. There are many studies examined factors related to back pain among other health professionals, especially of nurses and hospital workers, but few studies have focus on factors related to back pain among EMT.

The aims of this dissertation were to: 1) Describe the work-life and demographic factors of EMT; 2) describe the occupational stress, occupational satisfaction and social supports of EMT; 3) Identify the subsets of factors associated with back pain.

In order to complete the above objectives, a non-experimental, correlational design was used in this study. This study utilized a sample of 428 male firefighters completed the Minnesota Satisfaction Questionnaire (MSQ) and Chinese version of Job Content Questionnaire (C-JCQ).

A questionnaire was sent to a total of 540 EMT of Kaohsiung City, and 428 EMT (response rate 79.3%) completed the questionnaire, and two-third (65.2%) of EMT reported back pain. From the analysis of intrinsic job satisfaction utilizing MSQ, the most important factor for intrinsic satisfaction in these EMT is busy at work. The most important factor for extrinsic satisfaction in these EMT is inadequate work promotion. From C-JCQ, the difference between “skill discretion” and “decision authority” is significantly different as analyzed by paired t-test (t=13.72, p<0.001)

From C-JCQ the difference between “skill discretion” and “decision authority” is significantly different as analyzed by paired t-test (t=13.72, p<0.001). The average score for each question of the dimension “psychological demand” is 2.88+0.48, which shows the psychological strain is high. According to the Karasek’s model of “demand-control”, high psychological demand belongs to high job strains work,

Stepwise logistic regression shows that the set of factors related to back pain included years of work from 5-10 years, automatic electrical defibrillator use, manually lifting the patient, and decision authority (R2 =0.2630, p=0.023). No statistically significance with supervisor support, age, level of education and EMT levels.

並列關鍵字

low back pain ； emergency medical technician ； job stress

參考文獻

REFERENCES

1.Young, K.M., and Cooper, C.L. Occupational stress in the ambulance service: a diagnostic study. Health and Manpower Management. 1997; 23(4-5): 140-147.

2.Cydulka, R.K., Emerman, C.L., Shade, B., and Kubincanek, J. Stress levels in EMS personnel: a national review. Prehospital Disaster Medicine. 1997; 12(2): 136-140.

3.Letendre, J., Robertson, M., Eaton, C., and Nguyen, C. Ergonomic Assessment of the Patient Compartment of British Columbia Ambulances – A Participatory User Centred Design Approach. Simon Fraser University, 1999; Kinesiology 486 (Human Factors in Industrial Design), Student Project.

4.Lavender, S.A., Conrad, K.M., Reichelt, P.A., Meyer, F.T., Johnson, P.W. Postural analysis of paramedics simulating frequently performed strenuous work tasks. Applied Ergonomics. 2000; 31: 45-57.