三軍總醫院推動“健康促進醫院”計畫：員工健康狀況、吸菸情形與其影響因素分析

The Development of Health Promoting Hospitals in Tri-Service General Hospital: Profile of Staff's Health, Smoking Status and the Determinations

羅元婷(Yuan-Ting Lo) ； 羅慶徽(Ching-Hui Loh) ； 林金定(Jin-Ding Lin) ； 徐尚為(Shang-Wei Hsu) ； 呂學琳(Hsueh-Lin Lu) ； 嚴嘉楓(Chia-Feng Yen) ； 朱明若(Corida M. Chu) ； 林雅雯(Ya-Wen Lin) ； 賴朝英(Chia-Im Lai) ； 陳宏一(Hong-I Chen)

《醫療品質》 3卷2期 (2006/06) Pp. 10-19

https://doi.org/10.29759/HQ.200606.0002

摘要

健康促進醫院是世界衛生組織在1990年代起始於歐洲的健康促進運動，主要是整合健康促進的理論與策略，增進醫院員工、病人及家屬和社區居民的健康。台北市衛生局於民國91年11月首度舉辦「健康醫院評鑑」，足見政府對此之重視，然而國內目前缺少此相關之研究，因此本研究主要是參考國外推行健康促進醫院之實行過程，並融入台北市健康醫院評鑑項目，實際在三軍總醫院推動健康促進醫院，初期以醫院員工為主要的目標群體，本篇主要目的在於瞭解三軍總醫院員工目前之健康狀態和吸菸情形與影響因素，藉以界定推動員工之健康促進議題。本研究採用橫斷性研究，總計2586名員工依服務職稱採分層抽樣抽出798名員工為本研究之樣本，以結構式問卷調查的方式來進行資料收集，總計回收有效問卷為649份，回收率為81.3%。研究結果發現：21.7%的員工每週工作時數超過50小時，將近半數的員工普遍認為自己是健康的，22%的員工在最近的一年罹息慢性病，其中以呼吸道疾．色和十二指腸潰瘍為主，員工每日僅攝取1次蔬果佔45.8%為最多；6.0%的員工為吸菸者；影響吸菸的因素以男性、行政人員吸菸的機率較高。綜合上述的研究結果，本研究建議三總相關健康促進計畫為：(1)減少超時工作，建立適當的輪班制度，(2)員工慢性病定期追蹤與治療，(3)建立健康飲食文化，增加新鮮蔬果之供應，(4)行政人員的戒菸計畫，以增進員工的健康。

關鍵字

健康促進醫院 ； 健康醫院評鑑 ； 醫院員工 ； 健康促進

並列摘要

Health promoting hospitals (HPH), a movement supported by the World Health Organization, initiated by Europe Region in the late 1990's. A HPH incorporates the concepts, value and standards of health promotion in order to improve health for hospital's staff, patients, relatives and communities. The first healthy hospital accreditation in November 2002 in Taiwan was commenced by the Department of Health, Taipei City Government. However, there are few researches in HPH in Taiwan. Therefore, we conducted HPH program in Tri-Service General Hospital in Taipei based on the guideline of WHO Europe and the Health Hospital Accreditation in Taipei city. Hospital staff was the first target group in the HPH plan. This paper aimed to describe staff's health status, smoking and its determinations to identi1y the health promotion issues. There were 2586 employees and subjects were stratified sampling divided by types of hospital's employees. The sample included 798 employees. Data was collected by a structured questionnaire. There was a response of 649 and response rate was 81.3%. The results show that there were 21.7% of employees working over 50 hours per week and almost half staff considered they were healthy. There were 22% staff accompanied by chronic diseases currently and most of that had respiratory problems and duodenal ulcer. Almost 45.8% staff consumed fruits and vegetables only once a day. With regard to smoking statue, 6.0% staff were smokers. Among these smokers, 31.6% of staff wanted to stop smoking. In the analysis of logistic regression model, the gender and types of hospital's employees were statistical significant to the smoking. An association between smoking and gender (male versus female) showed a significantly higher risk (OR, 4.58; 95% C.I. 1.92-10.91). In addition, administrative staff had higher smoking rate than other types of hospital's employees; physicians, nurses and others (versus administrative staff), the ORs were 0.18 (95% C.I. 0.07-052), 0.22 (95% C.I. 0.08-0.60) and 0.72 (95% C.I. 0.22-2.34), respectively. In conclusion, health promotion strategies for this hospital need to redesign the working hours, to develop reasonable shift work schedules for employees, to monitor and follow up the medication of chronic diseases of the employees, to increase the accessibility of healthy diet such as: fruits and vegetables in hospital, and to implement smoking cessation program for the administrative staff.

並列關鍵字

Health promoting hospital ； healthy hospital accreditation ； hospital staff ； health promotion