社會心理危害、不安定僱用模式與受僱者之健康

Psychosocial Risk Factors, Precarious Employment and their Associations with Health Outcomes among Employees in Taiwan

王佳雯(Chia-Wen Wang)

指導教授 ： 鄭雅文

國立臺灣大學/公共衛生學院/衛生政策與管理研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.00543

摘要

最近幾年隨著勞動市場的改變，職場的社會心理危害越來越受到重視，尤其是一些新興的社會心理危害如不安定僱用與工作的不安定感，對工作者的健康造成負面的影響，先進國家在職場社會心理危害與不安定僱用和健康等方面的研究已經有所成果，但是國內在此方面的研究卻不多見，盼望本研究能為此領域做出一些貢獻，並且提供政府單位與學界做參考。
本研究主要以三大主軸進行，第一部份是職場社會心理危害之調查監測制度，比較國際與台灣監測的項目與內容，希望可以從國際經驗當中，提出對於台灣社會心理危害監測內容與項目之政策建議；第二部份以我們聚焦於社會心理危害中的不安定僱用模式，去瞭解國外不安定僱用的趨勢、致病機制與流行病學文獻回顧等部分；第三部分我們研究台灣目前不安定僱用的盛行狀況以及不安定受僱者之健康狀況，最後再針對不安定僱用提出政策建議。
研究結果顯示各國職場社會心理危害調查之監測指標主要包括：僱用契約、薪資狀態、工作保障性、升遷機會與訓練、工作控制、工作負荷、工時、輪班、夜班工作、組織正義、家庭與工作衝突等；台灣納入監測指標則較為有限。國外的不安定僱用普遍顯示出上升的趨勢，流行病學的證據顯示不安定僱用對工作者健康所造成的致病機制包括不安定僱用族群是社會經濟的弱勢、非自願選擇此類的工作、處在較差的工作環境、工作是不穩定的以及較少的社會保護。我國的量性資料分析結果顯示，台灣受僱者中有 21%屬不安定僱用，不論男、女性，不安定僱用盛行於較高年齡層、低教育程度、低職等、小公司、工時短之受僱者族群。且相較於長期受僱者，我們發現不安定受僱者與較差的自評健康 、工作不滿意度、生病缺勤以及身體各部份痠痛有正相關，此外統計結果也顯示，不安定受僱者有較高的個人以及工作疲勞。
本研究建議台灣職場社會心理危害調查監測之範圍可充實以下面向：在就業狀態方面，應納入契約類型、薪資狀態、就業保障等指標並予以精確化；在工作內容與特質方面，可考慮擴充工作負荷之測量內容，另外超時工作之類型與是否額外給薪，亦可納入考量；在職場社會與組織特質方面，除了組織正義之外，亦可考慮國際上普遍被監測的家庭與工作衝突、職場暴力、騷擾、霸凌等題項；不安定僱用的政策因應包括必須限制與減少非自願性的不安定僱用、對縮編、轉包與外包進行管理控制、擴大職業安全衛生的保護與職災補償；量性的結果顯示我國不安定僱用的受僱者比起長期受僱者有較差的健康，在勞動市場改變之下，未來在台灣，不安定的受僱者可能會越來越多，因此這方面的議題需要更多人的關注。

關鍵字

職場社會心理危害 ； 國際比較 ； 不安定僱用模式 ； 受僱者健康 ； 政策因應

並列摘要

Due to dramatic labor market changes, psychosocial hazards at work have become increasingly important in recent years. Especially, the health impacts of some newly emerging psychosocial hazards such as precarious employment and job insecurity have been studied in depth in developed countries. However, few studied have been conducted on these issues in Taiwan.
There were three objectives in this study. First, we reviewed national surveys of psychosocial work hazards conducted in some selected developed countries (including the European Union, Canada, UK, Denmark and Finland) and Taiwan, with regard to their designs, survey methods and questionnaire items. Based on international comparisons, this study aimed to provide some suggestions to the Council of Labor Affairs for improvement in future surveys. Secondly, we reviewed and synthesized existing epidemiologic literature concerning the health impacts of precarious employment.This review aimed to provide a better understanding on the prevalence and changing trends of precarious employment in developed countries, as well as its causal mechanisms and associations linking to poor health. Thirdly, we studied the prevalence of precarious employment and their associations with health outcomes among Taiwanese employees, using data from a national survey conducted in 2007 in Taiwan.
Our results showed that major psychosocial work hazards being monitored in national surveys of the selected countries included:type and nature of employment contract, salary status, employment security, career prospects and opportunity for future development, job control, job demands, working hours, shift work, night work, organizational justice, and family-work conflict. In contrast, limited dimensions were assessed in Taiwan’s national surveys. Our review revealed that the prevalence of precarious employment has been on the rise in most developed countries. Precarious employment was associated with adverse health outcomes, which were caused through by a number of mechanisms, including being with lower socio-economic status, being involuntarily transferred to unfavorable work positions, being exposed to poor working conditions, having less social protection and welfare. Results from our data analyses showed that 21% of Taiwanese employees were on precarious employment. It was also found that in both men and women, precarious employment was more prevalent among employees who were older, with lower education level, lower employment grade, employed in smaller enterprises, and with shorter working hours. When compared with those with permanent employment, precarious employees were found to have poor self-rated health, higher risk of sickness absenteeism and higher risk of bodily pain, higher level of job dissatisfaction, and higher levels of work-related burnout status.
For the future surveys, we suggested that Taiwan's surveys could be further improved by adopting validated measures for work contract, salary status and employment security, expanding the scope of the job demand measures to include measures for overtime work with or without pay, family-work conflict, violence, harassment and bullying. With regard to labor policy, we suggested that precarious employment should be limited, and intervention policies should be designed to minimize the health effects of involuntary precarious employment, downsizing, subcontracting and outsourcing. While precarious employment has become more prevalent in Taiwan, we suggest that more attention should be paid to its adverse health impacts.

並列關鍵字

psychosocial hazards at work ； international comparison ； precarious employment ； policy implications ； employees' health

參考文獻

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