護理之家護理人員心理社會因子與肌肉骨骼傷害相關性之追蹤研究

A Follow-Up Study of Psychosocial Risk Factors for Musculoskeletal Disorders among Nursing Personnel in a Nursing Home

10.6288/TJPH2006-25-03-07

馮兆康(Chao-Kang Feng)；毛義方(I-Fang Mao)

肌肉骨骼傷害 ； 心理社會 ； 護理人員 ； 前瞻性研究 ； musculoskeletal disorders ； psychosocial ； nursing personnel ； follow-up study

台灣公共衛生雜誌

25卷3期（2006 / 06 / 01）

231 - 241

繁體中文

目標：許多國家的研究顯示，在護理之家工作的護理人員有很高的肌肉骨骼傷害率。本追蹤研究的主要目的在於評估位於彰化某護理之家女性護理人員之頸、肩與下背部之肌肉骨骼傷害發生率，以及探討與上述三部位肌肉骨骼傷害有關之職場心理社會因子。方法：本研究是一個為期1年的追蹤研究，基線資料共有80位女性護理人員受訪，其中75位經過1年追蹤後完成第2次受訪。兩次調查都以人員面訪之方式收集問卷中的資料，問卷主要變項包括自覺身體部位之肌肉骨骼傷害、個人特徵、自覺身體負荷情形以及心理社會因子（如工作控制、病人之情緒負荷、時間壓力、工作滿意及社會支持）。結果：此75位受訪者，頸部、肩部及下背部傷害之年發生率分別為38.2%、54.8%及55.9%。單變項分析顯示，時間壓力及自覺身體負荷與頸部傷害有關；時間壓力及病患情緒負荷與肩部傷害有關；下背傷害則僅與現職年資有關。經過邏輯斯複迴歸分析，自覺身體負荷大及時間壓力大者有較高發生頸部傷害之機會；時間壓力大者有發生較高肩部傷害機會；現職年資越短則有較高發生下背部傷害機會。結論：護理人員之肌肉骨骼傷害是多因性的，而時間壓力是發生肌肉骨骼傷害最有關之心理社會因子，建議在成本控制許可下，院方多聘護理人員以減輕工作負擔，進而降低時間壓力對肌肉骨骼傷害之影響。

Objectives: Nursing personnel working in nursing homes have quite a high musculoskeletal disorders (MSDs) rate in many countries. The aims of this follow-up study were to access the incidences and to explore the work-related psychosocial factors for neck, shoulder and low back disorder among female nursing personnel at a nursing home located in Chunghua. Methods: In this one year follow-up study, the baseline data comprised 80 female nursing personnel to complete a questionnaire by face-to-face interview. Of these, 75 (93.8%) completed a second questionnaire 1-year later. The variables of this questionnaire including self-reported MSDs in different body regions, personal characteristics, perceived physical exertion and psychosocial factors such as job control, emotional demand of clients, time pressure, job satisfaction and social support. Results: Of the 75 subjects, the 1-year incidence rate of neck, shoulder and low back disorder were 38.2%, 54.8% and 55.9%, respectively. Univariate analysis showed that time pressure and perceived physical exertion were related to neck disorders; time pressure and emotional demand of clients were related to shoulder disorders; and current work-years were related to low back disorders. Multiple logistic regression analysis revealed that the higher the perceived physical exertion and the higher the time pressure, the greater the risk of neck disorders; the higher time pressure, the greater the risk of shoulder disorders; while the less the current work-years, the more the risk of low back disorders. Conclusions: This study indicated that factors related with incident MSDs were multiple. In particular, time pressure was the most important psychosocial factor. For lowering time pressure and physical loading and also decreasing MSDs occurrence among nursing personnel, this study suggests that the employer should hire more staff under cost controls.

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