公共衛生人員工作壓力及身心健康之探討--以台南縣衛生局、所人員為例

Public Health Personnel's Job Stress and Physical and Mental Health --Tainan County Health Bureau and Health Station as Example

蔡玲珊(Ling-San Tsai)

指導教授 ： 張永源

高雄醫學大學/健康科學院/公共衛生學研究所碩士在職專班/碩士(2004年)

摘要

近年來民眾對健康保健需求的層次不斷提升，殷切期望獲得良好質與量的醫療保健服務，而政府亦因民眾需求實施各種衛生保健措施，期盼促進民眾的健康，及提高民眾預防疾病的知識與能力。但政府推行的各項措施，均需基層衛生單位之公共衛生人員執行，提供給社區民眾的保健措施，包括：婦幼衛生、家庭計畫、預防注射、傳染病防治、疫情調查、癌症轉介追蹤---等。員工所面臨的壓力勢必存在，工作時間過長、工作壓力過大、缺乏休閒時間、影響著工作情緒、態度、服務品質、及績效，長期處於壓力狀態下會使人身體緊繃，而對如此工作環境，他們的壓力如何？如何因應？身心健康狀況如何？期盼藉此研究提供公共衛生主管及人員管理上之參考。

本研究以橫斷式調查法，以台南縣衛生局、所242人員為對象，以OSI-2為調查工具，探討公共衛生人員的工作壓力及身心健康情形及因應行為，所得資料以SPSS for Window 10.2版套裝軟體，運用次數分佈、平均數、標準差、t檢定、單因子變異數、皮爾森積差相關分析、LSD事後比較、逐步迴歸分析。

結果：(一)、公共衛生人員性質以女姓居多79.2%，平均年齡為42.39歲，教育程度以大專畢業居首位70.3%、已婚87.6%、主管人員7.6%、做不完的工作帶回家做以一週多於二次36.6%、工作年資平均14.46年、以偶而有運動居多佔40.2%、有5.5%吸菸、9.8%的人有喝酒習慣、有47.7%的人有時會考慮離職。

結果：(二)、公共衛生人員對工作壓力感受，依其得分高低結果以個人責任排名第一、工作負荷為第二、組織氣氛排名第三、工作瑣事排名第四、人際關係排名第五。量表分佈以因你的錯誤所造成的後果排名第一、工作和上級要求有衝突排名第二、在家仍掛念工作為排名第三、必須冒險為第四、上司的領導與支持不當為第五。

結論與建議：
1.壓力感受在不同婚姻上並無達顯著性差異。
2.A型行為風格在性別間並無達顯著性差異。
3.女性在身心健康狀況比男性差(較不健康)、對壓力感受高於男性。
4.主管人員在身心健康狀況比專業人員及一般行政人員較健康。
5.學歷越高越傾向A型行為風格。
6.工作年資與壓力感受並無達顯著性差異。
7.不同職別在壓力感受並無達顯著性差異。
8.對身心健康相關因素進行複迴歸分析：可解釋身體健康總變異數百分比(R²)為21.4%、
可解釋心理健康總變異數百分比(R²)為10.2%。

建議：
一.妥善運用壓力因應策略：透過一些休閒活動抒解內心的焦慮或憂鬱反應，等情緒平穩後問題就能迎刃而解。
二.機構內部管理：改善組織互動方式與溝通狀況，不僅可以增進組織的和諧，改善組織氣氛，增強人際關係，可以減輕模糊而降低壓力。

關鍵字

職業壓力指標 ； 工作壓力 ； A型性格

並列摘要

Background and objectives：People’s demand for health and hygiene has been continuously increased to a higher level in recent years, and hence the masses avidly expect to acquire medical service in better quality and quantity. Government also implements hygienic measures of all sorts due to this kind of demand in hopes of the promotion of people’s health and their knowledge and capability for disease prevention. But those advocated – by – government measures offering to community people, which in clude maternal &child health, family plan, vaccination, infection control, disease survey, cancer referral, and so forth, should be enforced by public health staff of basic health departments. Therefore, pressure faced by the staff is bound to exist. Problems such as excessive laboring hours, pressure of work, and lack of leisure time can affect the staff’s emotion , attitude, quality of service, and efficiency of work. Being under pressure in the long term will make people strained. So wo wonder how their pressures are and how to deal with .Still how are their states of health in both mind and should？ We hope that by this research report we can offer some advice of management to public health administrators and staff.
Methods：This research adopts cross-section survey, with 242 members of Tainan County Health Bureau and Departments as the subjects and OSI-2 as the tool, to discuss public health staff’s pressure of work and state of health, and solution to their problems. The result obtained in processed by using soft ware, SPSS for windows 10.2, using frequeney, percentage, mean, standard deviation (SD),t-test,One-Way ANOVA,pearsons correlation coefficient for data analysis.
Results：Result（－）Female make up 79.2﹪of public health staff, whose average age is 42.39 years old. College graduates rank the first （70.3﹪）in terms of education. 87.6﹪of them are married.7.6﹪are administrators. 36.6﹪bring home their unfinished work more than twice a week. I lein average of working experiemce is 14.46 years . 40.2﹪exercise from time to time, which make up the most part. 5.5﹪smoke. 9.8﹪are in the habit of drinking. And 47.7﹪consider to leave their positions sometimes.
Result（＝） The staff’s feelings toward pressure of work are placed according to the result of scores from high to low. They are as follows 1st interpersonal relationship, 2nd burden of work, 3rd the balance between work ＆ family , 4th personal responsibility, 5th atmosphere of the organization. As for gague distribution; effect resulted from your fault 1st, clash between job and demand from high –ranked 2nd, thinking about work while being at home 3rd, having to pick up adventure 4th, improper leadership and support from officials 5th。
Conclusion：
(1) The female personnel's health conditions are worse than the male personnel's and the pressure on the former is significantly higher than the latter.
(2) The higher an employee's educational background is, the higher the tendency
of his/her behavior type A is.
(3) The health conditions of the executives are better than those of professional
Suggestion：
一.Maneuver the proper finesse for dealing with stresses and strains.
二.The intrumal management of facilities：
Ameliorate the interactive methods and boost the organizational rapport.

並列關鍵字

work stress ； Occupational stress indicator ； type Apersonality

參考文獻

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