簡易檢索 / 詳目顯示

研究生: 吳宜臻
Wu, Yi-Chen
論文名稱: 職能治療師對職業災害勞工醫療復健之專業知能
Professional Competency of Occupational Therapists in Medical Rehabilitation for Workers with Occupational Accidents.
指導教授: 吳亭芳
Wu, Ting-Fang
口試委員: 張彧 陳貞夙 吳亭芳
口試日期: 2021/07/21
學位類別: 碩士
Master
系所名稱: 復健諮商研究所
Graduate Institute of Rehabilitation Counseling
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 112
中文關鍵詞: 職能治療職業災害醫療復健專業知能
英文關鍵詞: occupational therapy, occupational accidents, medical rehabilitation, professional competency
研究方法: 調查研究
DOI URL: http://doi.org/10.6345/NTNU202101373
論文種類: 學術論文
相關次數: 點閱:77下載:16
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 職能治療師提供之醫療復健是職業災害勞工重建服務中的一部分,因此,職能治療師若能在重建服務前端即時發揮專業,並視職業災害勞工需求與其他專業合作,滿足勞工的多元需求,便能使職業災害勞工接受完整且有效的照護。本研究之目的為探討職能治療師對職業災害勞工提供醫療復健所需專業知能的重要性與具備程度,以及了解專業知能發展需求。
    研究者以目前或曾經有對職業災害勞工提供醫療復健的職能治療師為研究對象,利用自編之「職能治療師對職業災害勞工醫療復健之專業知能調查問卷」為研究工具,採用李克特式五點量表形式作答,得分越高表示填答者認為該題目的重要程度及具備程度越高,利用網路問卷調查方式,共收集272份問卷,扣除無效問卷後,共得203份有效問卷。所得資料以描述性統計、獨立樣本t檢定、單因子變異數分析等方法進行分析。

    分析結果如下:
    一、 職能治療師對職業災害勞工醫療復健之專業知能重要程度自評部分,在知識、評估及治療技術三個面向皆達到「重要」程度以上。
    二、 在職能治療師對於職業災害勞工醫療復健之專業知能重要程度的自評上,不因最高學歷、總執業年資、生理職能治療執業年資、執業場域類型、教學與否及提供職業災害勞工醫療復健情形等不同背景而在專業知能的重要程度上有所差異。
    三、 職能治療師對職業災害勞工醫療復健之專業知能具備程度自評部分,在知識、評估及治療技術三個面向,具備程度皆落在部分具備到大致具備之間,其中平均分數以評估面向為最高,其次為治療技術,知識面向為最低分。
    四、 在職能治療師對於職業災害勞工醫療復健之專業知能具備程度的自評上,因總執業年資和執業場域的不同而有差異存在,不因最高學歷、生理職能治療執業年資、教學與否及提供職業災害勞工醫療復健情形等不同背景而有所差異。
    根據研究結果加以討論,發現在了解職災相關政策、使用實證職能治療、資源尋求與整合能力、評估職災勞工心理社會功能、提供工作環境改造建議等部分為職能治療師對職業災害勞工醫療復健之專業知能發展需求所在。最後,提出實務上及對未來研究之相關建議,以供參考。

    The medical rehabilitation provided by occupational therapists is a part of occupational accidents labor reconstruction services. Therefore, if occupational therapists can perform their professions at the beginning of reconstruction services immediately, cooperate with other professions according to the needs of workers and satisfy the diverse needs of workers, then occupational accidents workers can receive complete and effective care. The purpose of this study is to explore the professional competencies of occupational therapists in medical rehabilitation for workers with occupational accidents., and to understand the development needs of professional competency.

    The researcher invited occupational therapists, who provided medical rehabilitation for occupational accidents workers, to rate the questionnaire developed by the researcher ”Professional Competency of Occupational Therapists in Medical Rehabilitation for Workers with Occupational Accidents”. The questionnaire was answered in the form of a Likert-style five-point scale. The higher the score, the more important and mastered the question is considered by the respondent. A total of 272 questionnaires were collected using online questionnaire surveys. After deducting invalid questionnaires, a total of 203 valid questionnaires were collected. The data were statistically analyzed by descriptive statistics, independent sample t-test, and one-way ANOVA.

    The main findings of the research are as follows:
    1. Occupational therapists rated the importance of professional competency in medical rehabilitation for workers with occupational accidents as above the "important" level in terms of knowledge, assessment, and treatment techniques.
    2. There were no differences in rating the importance of professional competencies in medical rehabilitation for workers with occupational accidents among different backgrounds, such as the highest degree of education, years of work experience, years of experience in physiological occupational therapy, type of workplace, teaching or not.
    3. Occupational therapist rated their mastership of professional competency in medical rehabilitation for workers with occupational accidents from “partial” to “approximately” level in terms of knowledge, assessment, and treatment techniques, and the average score in assessment scope is the highest, followed by treatment techniques, and knowledge scope is the lowest score.
    4. There were differences in rating the mastership of the professional competency in medical rehabilitation for workers with occupational accidents among years of work experience and workplace; there were no differences in rating the mastership of professional competencies in medical rehabilitation for workers with occupational accidents among different backgrounds such as the highest degree of education, years of experience in physiology occupational therapy, teaching or not.

    Based on the results, it was found that understanding occupational accident-related policies, using occupational therapy evidence-based intervention, resource seeking, and integration capabilities, assessing the psychosocial functions of workers in occupational accidents, and providing suggestions for working environment are the needs for improving professional competencies of occupational therapists in medical rehabilitation for workers with occupational accidents. Finally, the researcher provides suggestions for practical application and subsequent researches.

    第一章 緒論1 第一節 研究背景與動機1 第二節 研究目的與待答問題5 第三節 名詞釋義6 第二章 文獻探討9 第一節 臺灣職能治療之現況9 第二節 職業災害勞工之重建16 第三節 職能治療師對職業災害勞工的醫療復健24 第三章 研究方法37 第一節 研究設計37 第二節 研究對象39 第三節 研究工具40 第四節 研究步驟46 第五節 資料處理與分析48 第四章 研究結果與討論49 第一節 基本資料分布狀況49 第二節 職能治療師對職業災害勞工醫療復健之專業知能重要程度分析52 第三節 職能治療師對職業災害勞工醫療復健之專業知能具備程度分析60 第四節 職能治療師對職業災害勞工醫療復健之專業知能發展需求分析68 第五章 研究結論與建議77 第一節 結論77 第二節 建議80 第三節 研究限制及未來研究建議82 參考文獻84 中文文獻84 英文文獻87 附錄一 職能治療師對職業災害勞工醫療復健之專業知能問卷(初稿)92 附錄二 專家審查意見彙整表97 附錄三 職能治療師對職業災害勞工醫療復健之專業知能預試問卷105 附錄四 職能治療師對職業災害勞工醫療復健之專業知能正式問卷109

    中文文獻
    王子娟、李淑貞(2013):高職災勞工的輔具需求評估研究-以製造業與營造業職災致肢體障礙為例 台北:行政院。

    朱金龍(2014):赴日韓考察職業災害危害預防及職災勞工重建,行政院所屬各機關出國報告 台北:勞動部。

    吳菁宜(2014):臺灣職能治療養成教育畢業後繼續教育之概況。醫療品質雜誌, 8(2),頁 8-11。

    吳菁宜、陳怡安(2013):生理疾病職能治療學: 介入理論與技巧. II。臺北:禾楓書局。

    林克忠、黃曼聰、吳菁宜、張自強、蔡佩倫(2009):臺灣職能治療人員對實證職能治療觀點的調查研究。臺灣職能治療研究與實務雜誌, 5(2),頁 102-115。

    林克忠、黃曼聰、吳菁宜、張自強、蔡佩倫、劉榮森等人(2010):臺灣職能治療人員對實證職能治療的觀感與相關因素分析。臺灣職能治療研究與實務雜誌, 6(1),頁 1-12。

    社團法人臺灣職能治療學會(2018):職能治療的定義。取自 http://www.ot-roc.org.tw/dw/others

    社團法人臺灣職能治療學會(2019a):2019年版職能治療師養成教育課程審核標準及作業辦法。取自 http://www.ot-roc.org.tw/dw/wfot_review

    社團法人臺灣職能治療學會(2019b):職能治療核心能力。取自 http://www.ot-roc.org.tw/core_competence

    邱滿艷、陳由娣(2016):從多元觀點探討職業災害勞工之福利服務需求。社區發展季刊,153,頁 440-453。

    范詩辰、賴冠吟(2011):臺灣生理疾病職能治療之歷史。載於薛漪平主編,生理疾病職能治療學: 評估理論與技巧. I。臺北:禾楓書局。

    秦唯珊、林冠含、郭育良、蕭淑銖(2013):勞工發生職業傷害後 12 個月復工狀況之探討。台灣公共衛生雜誌,32(6),頁 576-585。

    秦唯珊、謝月慈、吳雪菁、郭育良、蕭淑銖(2014):影響勞工職業傷害後心理健康的原因。勞工安全衛生研究季刊,22(2),頁 179-190。

    張哲豪、汪宗燁、吳明宜、郭立杰、蔡佩倫(2008):預防職場傷害之人因健康管理課程。臺灣職能治療研究與實務雜誌, 4(1),頁 62-68。

    張彧(2012):從職能治療看ICF。從職能治療看ICF,冊2012,頁251-257。

    張彧(2017):職能治療與職業重建。臺北:禾楓書局。

    張彧、曾美惠、林洺秀、陳秋蓉(2007):各國推動職災勞工重返職場之成效及檢討。勞工安全衛生研究季刊, 15(3),頁 262-279。

    張雁晴、劉亦修、潘璦琬、鍾麗英、陳詞章、江愛華(2002):大學職能治療教育與臨床工作需求的符合度。醫學教育,6(1),頁 13-25。

    許雅雯(2017):健康促進概論。新北市:新文京。

    陳淑敏、宋明娟、甄曉蘭(2010):大學生專業能力指標之發展── 以國立臺灣師範大學為例。高等教育,5(2),頁61-100。

    陳曉瑩(2006):中途致殘者就業支持服務理念。工業安全衛生(210),頁 14-16。

    勞工職業災害保險及保護法(2021):中華民國一百十年四月三十日總統華總一義字第11000040931 號令制定公布全文109條;施行日期,由行政院定之。

    勞動部(2019)。 108年職業災害勞工保障權益手冊。取自 https://www.mol.gov.tw/service/2186/26417/26433/

    勞動部(2021):職災勞工職業重建提供職能復健服務單位聯絡資訊。取自 https://www.osha.gov.tw/media/7185644/11001%E8%81%B7%E8%83%BD%E5%BE%A9%E5%81%A5%E6%9C%8D%E5%8B%99%E5%96%AE%E4%BD%8D%E8%81%AF%E7%B5%A1%E8%B3%87%E8%A8%8A.pdf

    勞動部勞工保險局(2020):108年勞動統計年報。取自 https://www.mol.gov.tw/statistics/2452/2455/45910/

    勞動部勞工保險局(2021a):109年統計提要。取自 https://www.1955.gov.tw/0104097.html

    勞動部勞工保險局(2021b):109年職業災害統計資料。取自 https://www.1955.gov.tw/0019152.html

    勞動部職業安全衛生署(2020a):108年勞動檢查統計年報。取自 https://www.osha.gov.tw/1106/1164/1165/1168/29804/

    勞動部職業安全衛生署(2020b):職業病認定參考指引。取自 https://www.osha.gov.tw/1106/1176/1185/1190/

    潘璦琬、李致瑩、陳詞章、陳韻玲(2010):職能治療專業角色與功能之探討:職能治療師觀點。臺灣職能治療研究與實務雜誌, 6(2),頁 76-89。

    蔡宜蓉、張玲慧、周映君、毛慧芬(2017):我國職能治療專業發展的困境與願景-職能治療領袖之焦點團體。職能治療學會雜誌,35(2),頁 146-168。

    蔡念祖(2014):上下肢職業傷害勞工復工因子探討(未出版)。中山醫學大學醫學檢驗暨生物技術學系碩士論文,臺中。

    謝清麟(2011):生理疾病職能治療之時代趨勢。載於薛漪平(主編),生理疾病職能治療學: 評估理論與技巧. I。臺北:禾楓書局。

    職能治療師法(2020):中華民國一百零九年一月十五日總統華總一義字第 10900003841 號令修正公布。

    顏紹伊、李淑貞、王子娟、蔡美文、羅鴻基(2016):、職業災害致肢體障礙勞工之健康狀況和輔具需求與使用之初探:以製造業與營造業為例。物理治療, 41(2),頁 151-152。

    職業災害勞工職業重建補助辦法(2014):中華民國一百零三年七月十四日勞動部勞職授字第 10302008401 號令修正公布。

    羅鈞令、褚增輝、施杏如、林清良、毛慧芬、黃曼聰等人(2001):我國職能治療人力現況與分析。職能治療學會雜誌,19,頁 9-23。

    羅鈞令、蕭小菁、黃俐貞、陳美香 (2017):探討 [以職能為基礎] 在職能治療師養成教育課程與教學之落實。職能治療學會雜誌,35(2),頁 126-145。

    蘇桂瑢、林克忠、盧時雨、吳菁宜(2010):現代任務導向中風復健途徑之文獻回顧。臺灣職能治療研究與實務雜誌,6(1),頁 50-65。

    英文文獻
    Aiken, F. E., Fourt, A. M., Cheng, I. K., & Polatajko, H. J. (2011). The meaning gap in occupational therapy: Finding meaning in our own occupation. Canadian Journal of Occupational Therapy, 78(5), 294-302.

    American College of Occupational and Enviromental Medicine. (2006). Preventing needless work disability by helping people stay employed. Journal of Occupational and Environmental Medicine, 48(9), 972-987.

    American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process.

    American Occupational Therpay Association. (2020). Work Rehabilitation. Retrieved from https://www.aota.org/About-Occupational-Therapy/Professionals/WI/Work-Rehab.aspx

    Amini, D. (2011). Occupational therapy interventions for work-related injuries and conditions of the forearm, wrist, and hand: A systematic review. American Journal of Occupational Therapy, 65(1), 29-36.

    Amini, D. A., Kannenberg, K., Bodison, S., Chang, P., Colaianni, D., Goodrich, B., & Lieberman, D. (2014). Occupational therapy practice framework: Domain & process 3rd edition. American Journal of Occupational Therapy, 68, S1-S48.

    Bade, S., & Eckert, J. (2008). Occupational therapists' critical value in work rehabilitation and ergonomics. Work, 31(1), 101-111.

    Bennett, S., & Bennett, J. W. (2000). The process of evidence‐based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal, 47(4), 171-180.

    Che Daud, A. Z., Yau, M. K., & Barnett, F. (2015). A consensus definition of occupation-based intervention from a Malaysian perspective: A Delphi study. British Journal of Occupational Therapy, 78(11), 697-705.

    Che Daud, A. Z., Yau, M. K., Barnett, F., & Judd, J. (2016). Occupation-based intervention in hand injury rehabilitation: Experiences of occupational therapists in Malaysia. Scandinavian Journal of Occupational Therapy, 23(1), 57-66.

    Colaianni, D., & Provident, I. (2010). The benefits of and challenges to the use of occupation in hand therapy. Occupational Therapy in Health Care, 24(2), 130-146.

    Colaianni, D. J., Provident, I., DiBartola, L. M., & Wheeler, S. (2015). A phenomenology of occupation‐based hand therapy. Australian Occupational Therapy Journal, 62(3), 177-186.

    Désiron, H. A., de Rijk, A., Van Hoof, E., & Donceel, P. (2011). Occupational therapy and return to work: a systematic literature review. BMC Public Health, 11(1), 615.

    Dorsey, J., Ehrenfried, H., Finch, D., Jaegers, L., Kaskutas, V., & Kannenberg, K. (2017). Occupational Therapy Services in Facilitating Work Participation and
    Performance. American Journal of Occupational Therapy, 71.

    Dunstan, D. A., & Covic, T. (2006). Compensable work disability management: A literature review of biopsychosocial perspectives. Australian Occupational Therapy Journal, 53(2), 67-77.

    Earley, D., & Shannon, M. (2006). The use of occupation-based treatment with a person who has shoulder adhesive capsulitis: a case report. American Journal of Occupational Therapy, 60(4), 397-403.

    Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137(5), 535-544.

    Fisher, A. G. (2013). Occupation-centred, occupation-based, occupation-focused: Same, same or different? Scandinavian Journal of Occupational Therapy, 20(3), 162-173.

    Fitzpatrick, N., & Presnell, S. (2004). Can occupational therapists be hand therapists? British Journal of Occupational Therapy, 67(11), 508-510.

    Grice, K. O. (2015). The use of occupation-based assessments and intervention in the hand therapy setting–A survey. Journal of Hand Therapy, 28(3), 300-306.

    Guzelkucuk, U., Duman, I., Taskaynatan, M. A., & Dincer, K. (2007). Comparison of therapeutic activities with therapeutic exercises in the rehabilitation of young adult patients with hand injuries. The Journal of Hand Surgery, 32(9), 1429-1435.

    Hansen, A. Ø., Kristensen, H. K., Cederlund, R., Möller, S., & Tromborg, H. (2020). An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale—A randomized controlled trial. Journal of Hand Therapy.

    Hardison, M. E., & Roll, S. C. (2017). Factors associated with success in an occupational rehabilitation program for work-related musculoskeletal disorders. American Journal of Occupational Therapy, 71(1), 7101190040.

    Higgins, A., O’Halloran, P., & Porter, S. (2012). Management of long term sickness absence: A systematic realist review. Journal of Occupational Rehabilitation, 22(3), 322-332.

    International Labour Organizaton. (2020). Retrieved from https://www.ilo.org/global/about-the-ilo/lang--en/index.htm

    Jack, J., & Estes, R. I. (2010). Documenting progress: Hand therapy treatment shift from biomechanical to occupational adaptation. American Journal of Occupational Therapy, 64(1), 82-87.

    Marom, B. S., Ratzon, N. Z., Carel, R. S., & Sharabi, M. (2019). Return-to-work barriers among manual workers after hand injuries: 1-year follow-up cohort study. Archives of Physical Medicine and Rehabilitation, 100(3), 422-432.

    Matheson, L. N., Ogden, L. D., Violette, K., & Schultz, K. (1985). Work hardening: Occupational therapy in industrial rehabilitation. American Journal of Occupational Therapy, 39(5), 314-321.

    McDougall, A., & Nowrouzi-Kia, B. (2017). Work Disability Prevention: A Primer for Occupational Therapists. American Journal of Occupational Therapy, 71(6), 7106360010.

    Mosey, A. C. (1986). Psychosocial Components of Occupational Therapy: Lippincott Williams & Wilkins.

    Nunnally, J. C. (1978). Psychometric Theory 2nd ed. In: Mcgraw hill book company.

    Nunnally, J. C., & Bernstein, I. (1994). Validity. Psychometric Theory, 3, 99-132.

    Radomski, M. V., & Latham, C. A. T. (2008). Occupational Therapy for Physical Dysfunction: Lippincott Williams & Wilkins.

    Roll, S. C. (2017). Current evidence and opportunities for expanding the role of occupational therapy for adults with musculoskeletal conditions. American Journal of Occupational Therapy, 71(1), 7101170010p7101170011-7101170010p7101170015.

    Rudman, D. L., & Dennhardt, S. (2008). Shaping knowledge regarding occupation: Examining the cultural underpinnings of the evolving concept of occupational identity. Australian Occupational Therapy Journal, 55(3), 153-162.

    Scaffa, M. (2001). Community-based practice: Occupation in context. Occupational therapy in community-based settings. Philadelphia: Davis Company, 3-18.

    Schell, B. A. B., Gillen, G., Scaffa, M. E., & Cohn, E. S. (2013). Willard and Spackman's occupational therapy: Lippincott Williams & Wilkins.

    Shah, H. M., & Chung, K. C. (2009). Archie Cochrane and his vision for evidence-based medicine. Plastic and Reconstructive Surgery, 124(3), 982.

    Tan, H. S. K., Yeo, D. S. C., Giam, J. Y. T., Cheong, F. W. F., & Chan, K. F. (2016). A randomized controlled trial of a Return-to-Work Coordinator model of care in a general hospital to facilitate return to work of injured workers. Work, 54(1), 209-222.

    Thibault, P., Loisel, P., Durand, M.-J., Catchlove, R., & Sullivan, M. J. (2008). Psychological predictors of pain expression and activity intolerance in chronic pain patients. Pain, 139(1), 47-54.

    Trombly, C. A. (1995). Occupation: Purposefulness and meaningfulness as therapeutic mechanisms. American Journal of Occupational Therapy, 49(10), 960-972.

    Unsworth, C. A. (2001). The clinical reasoning of novice and expert occupational therapists. Scandinavian Journal of Occupational Therapy, 8(4), 163-173.

    Weinstock-Zlotnick, G., & Mehta, S. P. (2019). A systematic review of the benefits of occupation-based intervention for patients with upper extremity musculoskeletal disorders. Journal of Hand Therapy, 32(2), 141-152.

    World Federation of Occupational Therapists. (2011). Definitions of occupational therapy from member organisations. Retrieved from https://www.wfot.org/resources/definitions-of-occupational-therapy-from-member-organisations

    World Health Organization. (2001). International classification of functioning, disability and health: ICF: World Health Organization.

    World Health Organization. (2002). Occupational health: a manual for primary health care workers. Retrieved from https://www.who.int/occupational_health/publications/emhealthcarework/en/

    Young, A. E., Roessler, R. T., Wasiak, R., McPherson, K. M., Van Poppel, M. N., & Anema, J. (2005). A developmental conceptualization of return to work. Journal of Occupational Rehabilitation, 15(4), 557-568.

    下載圖示
    QR CODE