營造業勞工的健康識能與健康行為之探討

Health Literacy and Health Behavior of Workers in the Construction Industry

姜安憶(An-Yi Chiang)

指導教授 ： 鄭惠珠

義守大學/醫學院/醫務管理學系/碩士(2017年)

摘要

目的：健康識能可測量民眾對於健康訊息的獲取、理解、評讀與應用能力，而營造業勞工在各類勞工中被認為工作類型及生活型態可能是最具健康危害的一群，因此，本研究欲探討營造業勞工的健康識能，並瞭解其健康行為情形。
方法：本研究為橫斷性研究，以南部地區(台南、高雄、屏東) 20歲以上之營造業勞工為對象，收案期間為2017年2月至5月，並以方便取樣進行收集。本研究採用2009-2012年歐洲健康識能量表─中文版做為研究工具，內容上分別為基本資料、健康行為調查及健康識能量表(HLS-EU-Q47)；資料分析除描述性統計外，並利用健康識能指標公式計算，同時也進行健康識能與健康行為之相關及差異檢定。
結果：本研究共發出350份問卷，回收312份，回收率為89.1%，受訪者平均年齡為45.5±13.9歲，平均BMI為24.5±3.7，高中職以上的教育程度有64.1%(n=200)，抽菸者為49.4%(n=154)、嚼檳榔者為15.1%(n=47)、飲酒者有49.4%(n=154)及缺乏運動習慣50%(n=156)，自覺健康狀況為普通以上93.9%(n=293)，但有31.4%(n=98)受訪者卻無收集健康資訊頻率。健康識能平均分數為31.8±5.6分；人口學特性、健康行為與健康識能進行單因子變異數分析和獨立樣本t檢定；基本資料中，工作職稱、年齡、教育程度、月所得與健康識能達顯著差異( p < .05)；健康行為調查中，抽菸、運動頻率、自覺健康狀況、收集健康資訊頻率與健康識能達顯著差異(p < .05)，在Spearman’s相關性中，健康識能與年齡(p <.01)呈現負相關；健康識能與教育程度(p <.01)、月所得(p < .01)、運動頻率(p <.01)、自覺健康狀況(p <.01)、收集健康資訊頻率(p < .01)皆呈現顯著正相關。
結論：本研究受訪營造業勞工的整體平均健康識能程度，在分級上屬於「有問題」的，此結果與Duong 等人在2015年測量臺灣民眾的健康識能分數(34.4±6.6)相較為低。然而，從受訪者營造業勞工中，就診費用使用較少、也較少有長期的健康問題和健康限制活動，且自覺健康狀況較佳，這反映出本受訪營造業勞工的健康狀況，可用「健康工人效應」來說明。如同其他研究顯示，本研究也發現受訪的營造業勞工有較高的比例會抽菸、嚼檳榔、飲酒，並且缺乏運動、很少會收集健康相關資訊。整體而言，營造業勞工之健康識能有必要更提升，並改善抽菸、嚼檳榔和喝酒的行為，增加衛生教育、健康知識以及加強疾病篩檢和健康檢查，使營造業勞工達到健康促進的效果。

關鍵字

健康識能 ； 健康行為 ； 營造業勞工 ； 健康危害行為 ； 歐洲健康識能量表

並列摘要

Objective: Health literacy (HL) had been defined as the social skill to measure the motivation and ability of individuals to gain, understand and use information in ways which promote and maintain good health. Workers of the construction industry are considered to be the higher risk group with the unhealthy behaviors and low grade of HL, in both work form and life style among all kinds of laborers. Therefore, the aim of this study was to investigate the relationship between the grades of HL and the health behavior in workers of construction industry.
Method: Cross-sectional study design was conducted via convenience sampling method among target group of over 20-year-old construction workers living in southern Taiwan from February to May in 2017. European Health Literacy Survey Questionnaire was adopted by this research, including demographic information, health behavior and HLS-EU-Q47. Qualitative data analysis, HL-index score, independent sample t-test, one-way ANOVA and Spearman correlation analysis were applied to assess the health literacy scale.
Result: In this study, a total of 350 questionnaires were issued and 312 were collected. The response rate was 89.1%. The average age of respondents was 45.5±13.9 years-old. The general average body mass index was 24.5±3.7. The average rate of participants receiving education above high school was 64.1% (n=200). The medical expenses is less than 2,200 NT$ and was 78.5% (n=245). The share of the smokers was 41.3% (n=129), betel nut chewers was 15.1% (n=47), alcohol consumer was 49.4% (n=154) and 50%(n=156) lack of exercise habits. Their general perception of health was 93.9% (n=293), which is above average, but 31.4% (n=98) of those did not frequently gather health information. The means of HL-score of the participants was 31.8±5.6. Demographic characteristics, health behavior and health literacy were analyzed by one-way ANOVA and independent samples t-test. In terms of demographic information, including job titles, age, education, monthly income and health awareness differed significantly (p <.05). Concerning health behavior, smoking, frequent exercise, awareness of health status, frequency of gathering health information and health literacy were different significantly (p <.05). In Spearman's correlation analysis, health literacy was negatively in respect of age (p <.01). On the other hand health literacy and educational background (p < .01), monthly earnings (p <.01), exercise frequency (p <.01), awareness of health status (p <.01), frequency of gathering health information (p <.01) showed significant positive correlation.
Conclusion: The overall average of health literacy among Taiwanese construction workers in the study was low (HL-score: 34.4±6.6), compared to the study of Duong in 2015. These indicators demonstrated the health condition of construction workers. They spent less medical expenses and were less likely to suffer from long-term health problems and limited activities caused by health problems. This shows that they perceived a better condition of their health status, indicating a “Healthy Worker Effect.” Smoking, betel nut chewing, alcohol consumption and lack of exercising are positively correlated with low health literacy. Therefore it is necessary to enhance healthy industry knowledge for construction workers, for example, getting rid of smoking, betel nut chewing and drinking, broadening health knowledge and strengthening health education, disease screening and health checks to produce a better health effect.

並列關鍵字

health literacy ； health behavior ； construction worker ； health risk behavior ； HLS-EU-Q

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