勞工健康保護規則修訂前後職護健康促進執行之比較

Comparison of the health promotion practices among occupational health nurses - before and after the amendments of the Labor Health Protection Regulation

李寶玉(Bao- Yu Lee)

指導教授 ： 李素幸

共同指導教授 ： 蘇世斌

長榮大學/健康科學學院/職業安全與衛生學系(所)/碩士(2014年)

https://doi.org/10.6833/CJCU.2014.00210

摘要

我國「勞工健康保護規則」在100年1月21日大幅修訂，明確規範職業衛生護理人員（簡稱職護）的角色及資格，也期望有助於職場健康之促進。此法規範事業單位在一定員工人數以上必須聘用專職護理人員執行規定項目，此一措施不僅能讓更多護理人員進入事業單位服務，也能促使事業單位更積極執行職場健康促進活動。本研究目的在了解職護推動職場健康促進之現況，及法規公告前後職場健康促進執行之變化。
本研究邀請全國事業單位護理人員學會之600位會員，以及台南、高雄二都未參與學會之130位事業單位職護來參與問卷填答，共回收有效問卷331份。問卷內容包括人口學資料、任職公司概況、職業衛生護理訓練經驗、職場健康促進執行現況及法規修訂前後職場健康促進業務的變化等五大部份。資料以SPSS 12.0統計套裝軟體進行分析。
本研究結果顯示，七成三的職護過去兩年參加繼續教育課程時數低於50小時，無法參與繼續教育訓練研習的主要因素是上課地點太遠、太忙及缺乏課程訊息等。在職場健康促進實施現況上，健康飲食、舒壓及減重為前三大常見項目；活動經費主要來自公司；健康促進活動後有八成九的職護會進行成效檢討，最常以健康檢查結果、問卷收集及減重公斤數等方式來進行評估。
法規修訂後公司健康促進活動之變化，在高層重視程度、經費、活動次數及護理人力無明顯變化，但有變化的公司大多是朝向增加的方向；在變化上以職護自覺角色重要性的增加最高，而經費的增加最低。檢視公司特質與法規修訂前後之變化，相對於民營公司，公營公司變化較低，尤其經費幾乎不變。整體而言，南部、科學園區、>3000人、及高科技製造業等特質的公司，在變化增加比例上最高。
本研究顯示勞工健康保護規則的修訂有助於提升職護的角色，而且對於職場健康促進的推行也具有正向的影響，然而職場健康促進的經費及人力變化較少，在此情境下，建議職場健康促進之推行要結合外在資源，例如參與中央及地方政府的健康促進活動，以補內在經費及人力之不足。

關鍵字

職場 ； 職場健康促進

並列摘要

Recently, Labor Health Protection Regulation was amended on the date of January 21st, 2011, which explicitly normalized the role and qualifications of occupational health nurses (OHNs) in expectation of assisting promotion of workplace health. This law required companies with designated number of employees to hire full-time OHNs. In so doing, more OHNs were able to enter the workplace and companies would implement more workplace health promotion programs. This study aims to understand the current situations how OHNs implement workplace health promotion (WHP) and to observe the changes on implementations of WHP before and after the amendment of the regulation.
This study invited for participation 600 members of the Taiwan Association of Occupational Health Nurses (TAOHN) and 130 OHNs from outside the association and working in the area of Tainan and Kaohsiung Cities. In total, this study collected 331 valid questionnaires. The contents of the questionnaires included demographics, characteristics of companies, OHN trainings, and workplace health promotion programs, and the changes before and after the admentments of the law. Statistical software SPSS was applied to analyze the data.
The results showed that 73% of the OHNs received less than 50 hours of continuing education in the past two years. The main reasons for not being able to attend the education included too long to reach the location, busy at work, and lack of course information. Healthy diet, stress relief and weight loss were the three most commonly seen health promotion program. While most of the funding for WHP came from the organizations. At the end of the health promotion programs, 89% of OHN would further assess the effectiveness of the program, mostly by health
As a whole, after amendments of the regulation appeared no obvious change upon the attitudes of high-ranking managers, budget, number of activities and OHN manpower. the companies had changed for their health promotions, mostly toward the direction of increase. More findings were that the importance of the OHN role increased most noticeably, but budget was the least increase. Looking into the characteristics of companies we found that, relative to private companies, public companies appeared to have the smallest changes, especially in budget. Overall, companies located in the southern part of Taiwan, situated in the science parks, hiring equal or greater than 3000 employees, or classified as high-tech manufacturing industry were having higher proportion of increases.
This study revealed that the amendments of the Labor Health Protection Regulation helped to advance OHN role in the workplace and showed positive influence on the implementation of WHP. And yet little change was shown in the area of budget and manpower. Under such circumstances, we suggest that implementation of WHP should combine resources from outside the workplace, such as participation in the WHP programs carried out by the central and local governments, in order to compensate for the lack of budget and manpower in the company.

並列關鍵字

workplace ； workplace health promotion

參考文獻

江東亮、余玉眉（1994）。「健康促進：國民健康的新方向」。中華公共衛生雜誌，13（8），381-387。

朱明若、李姣姿（2001）。「全球化之下工作壓力對職工身心健康之影響及整合性的對策」。台灣衛誌,20（6），413-422。

林金定、羅慶徽、蔡艷清、嚴嘉楓、朱明若（2006）。職場健康促進計畫評估初探。中華職業醫學雜誌，13（1），1-7。

秦唯珊、洪筱瑩、郭浩然、徐畢卿﹙2004﹚。認識職業衛生護理人員之現況工作。中華職業醫學雜誌，11﹙4﹚，217-228。

陳芬苓（2005）。企業規模與實施職場健康促進之調查研究。台灣管理學刊，5(1)，149-168。