衛生行政機關人員的職場暴力經驗與其身心健康影響：COVID-19疫情期間的調查

Workplace violence and associations with health outcomes in public health administration agencies in Taiwan: a survey during the COVID-19 pandemic

10.6288/TJPH.202302_42(1).111102

王怡婷(Yi-Ting Wang)；鄭雅文(Yawen Cheng)

衛生行政機關 ； 職場暴力 ； 職場社會心理特質 ； 職業健康 ； 新冠肺炎 ； public health administration agencies ； workplace violence ； psychosocial work characteristics ； occupational health ； COVID-19

台灣公共衛生雜誌

42卷1期（2023 / 02 / 24）

42 - 61

繁體中文;英文

目標：探討衛生行政機關人員於疫情期間的職場暴力經驗與身心健康影響。方法：於2022年3月間，針對衛生福利部、所屬衛生行政機關及各縣市衛生局所任職一年以上之工作人員進行網路問卷調查，以結構式問卷且以不記名方式蒐集資料，有效樣本492份。結果：過去一年曾遭遇肢體、言語、心理或性騷擾任一形式職場暴力之盛行率為48.17%；以言語暴力最普遍（43.50%），心理暴力次之（31.71%）。言語與心理暴力的最主要來源為上司，其次為服務對象，再其次為同事。調查結果並顯示，衛生行政機關人員之工時、工作心理負荷、工作體力負荷偏高，而自評健康不佳盛行率為22.97%，個人疲勞分數高於50分為60.57%，心理健康不佳為63.41%。迴歸分析顯示，職場正義低落是工作者遭遇組織內部言語及心理暴力之主要相關因素；例行工作與民眾直接互動，則是遭遇組織外部言語暴力之主要相關因素；過去一年曾遭遇職場暴力，與自評健康不佳、心理健康不佳及個人疲勞有相關，尤以來自組織內部的職場暴力對健康影響較為顯著。結論：本調查以網路無記名方式進行，因此樣本代表性有其限制，然而衛生行政機關人員在疫情期間的工作負荷與職場暴力問題仍是需關注的議題。

Objectives: To investigate the prevalence of workplace violence in public health administration agencies and its effects on health outcomes. Methods: A survey was conducted in March 2022. Staff who had been working for at least one year in the Ministry of Health and Welfare or its subordinate agencies, the Department of Health, or in public health centers were recruited. Data were collected anonymously with a structured, online questionnaire. A total of 492 valid questionnaires were collected. Results: A total of 48.17% participants reported having experienced workplace violence (physical, psychological, verbal, or sexual). The most common type of violence was verbal (43.50%), followed by psychological (31.71%). Supervisors were the primary perpetrators of verbal and psychological violence, followed by clients and colleagues. Staff reported long working hours and high levels of psychological and physical stress. Furthermore, 22.97% of workers reported poor self-rated health, 60.57% had personal burnout levels higher than 50, and 63.41% reported poor mental health. Regression analyses showed that low workplace justice was most strongly associated with internal verbal and psychological violence, whereas routine work requiring interaction with the public was most strongly associated with external verbal violence. Staff who had experienced workplace violence in the past year had significantly higher risks of poor self-rated health, mental health, and personal burnout, and poor health was more strongly associated with workplace violence that originated inside the organization than with workplace violence that originated from outside the organization. Conclusions: This survey was conducted on-line anonymously, so the representativeness of our findings might be limited. However, heavy workloads and workplace violence in public health administration agencies during the COVID-19 pandemic are important issues deserving urgent attention.

1. 王佳雯, CW,鄭雅文, YW,李論昇, YS,徐儆暉, JH(2010)。職場社會心理危害調查監測制度之國際概況。台灣衛誌，29，551-560。
   連結：
2. 陳敦源, DY,吳舜文, SW,陳揚中, YC,王光旭, GX(2019)。從工作要求資源模式檢視公共衛生護理人員職業倦怠因素：以公共服務動機為調節變數。台灣衛誌，38，478-497。
   連結：
3. 葉婉榆, WY,鄭雅文, YW,陳美如, MJ,邱文祥, WH(2008)。職場疲勞量表的編製與信效度分析。台灣衛誌，27，349-364。
   連結：
4. 盧瑞芬, YJ,曾旭民, HM,蔡益堅, YJ(2003)。國人生活品質評量（I）：SF-36台灣版的發展及心理計量特質分析。台灣衛誌，22，501-511。
   連結：
5. 邊立中, LC,鄭雅文, YW,陳怡欣, IS,陳秋蓉, CJ(2014)。職場暴力盛行率與受僱者健康狀況之相關。台灣衛誌，33，36-50。
   連結：
6. 中華民國統計資訊網：行政組織與人力。https://winsta.dgbas.gov.tw/DgbasWeb/ZWeb/StateFile_ZWeb.aspx。引用2022/09/22。 National Statistics, R.O.C. (Taiwan). Administrative organization and manpower. Available at: https://winsta.dgbas.gov.tw/DgbasWeb/ZWeb/StateFile_ZWeb.aspx. Accessed September 22, 2022. [In Chinese]
7. Balducci, C,Fraccaroli, F,Schaufeli, WB(2011).Workplace bullying and its relation with work characteristics, personality, and post-traumatic stress symptoms: an integrated model.Anxiety Stress Coping,24,499-513.
8. Bonde, JP,Gullander, M,Hansen, AM(2016).Health correlates of workplace bullying: a 3-wave prospective follow-up study.Scand J Work Environ Health,42,17-25.
9. Bryant-Genevier, J,Rao, CY,Lopes-Cardozo, B(2021).Symptoms of depression, anxiety, post-traumatic stress disorder, and suicidal ideation among state, tribal, local, and territorial public health workers during the COVID-19 pandemic - United States, March-April 2021.MMWR Morb Mortal Wkly Rep,70,947-952.
10. Canadian Centre for Occupational Health and Safety (CCOHS). OSH answers fact sheets -- violence and harassment in the workplace. Available at: https://www.ccohs.ca/oshanswers/psychosocial/violence.html. Accessed July 25, 2022.
11. Cheng, Y,Huang, HY,Li, PR,Hsu, JH(2011).Employment insecurity, workplace justice and employees’ burnout in Taiwanese employees: a validation study.Int J Behav Med,18,391-401.
12. Cheng, Y,Pien, LC(2016).Prevalence, distribution, and trends of workplace violence and its associated health problems: findings from national surveys of Taiwan.Psychosocial Factors at Work in the Asia Pacific,Cham, Switzerland:
13. Cheng, YW,Luh, WN,Guo, YL(2003).Reliability and validity of the Chinese version of the Job Content Questionnaire in Taiwanese workers.Int J Behav Med,10,15-30.
14. Einarsen, S,Nielsen, MB(2015).Workplace bullying as an antecedent of mental health problems: a five-year prospective and representative study.Int Arch Occup Environ Health,88,131-142.
15. ElGhaziri, M,Simons, S,Lipscomb, J(2020).Understanding the impact of bullying in a unionized US public sector workforce.Workplace Health Saf,68,139-153.
16. Giorgi, G,Ando, M,Arenas, A,Shoss, MK,LeonPerez, JM(2013).Exploring personal and organizational determinants of workplace bullying and its prevalence in a Japanese sample.Psychol Violence,3,185-197.
17. Hansen, AM,Hogh, A,Garde, AH,Persson, R(2014).Workplace bullying and sleep difficulties: a 2-year follow-up study.Int Arch Occup Environ Health,8,285-294.
18. ILO. Code of practice on workplace violence in services sectors and measures to combat this phenomenon. Available at: https://international.vlex.com/source/code-practice-workplaceviolence-services-sectors-measures-combatphenomenon-11314. Accessed July 25, 2022
19. ILO.Safe and healthy working environments free from violence and harassment.
20. International Labour Office (ILO). C190 - Violence and Harassment Convention 2019 (No. 190). Available at: https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C190. Accessed July 25, 2022.
21. Jang, Y,You, M,Lee, H(2021).Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic.Bmc Public Health,21,2075.
22. Kind, N,Eckert, A,Steinlin, C,Fegert, JM,Schmid, M(2018).Verbal and physical client aggression - a longitudinal analysis of professional caregivers’psychophysiological stress response and burnout.Psychoneuroendocrinology,94,11-16.
23. Lahelma, E,Lallukka, T,Laaksonen, M,Saastamoinen, P,Rahkonen, O(2012).Workplace bullying and common mental disorders: a follow-up study.J Epidemiol Community Health,66,e3.
24. LeBlanc, MM,Kelloway, EK(2002).Predictors and outcomes of workplace violence and aggression.J Appl Psychol,87,444-453.
25. Li, JH,Xu, J,Zhou, H(2021).Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study.BMC Public Health,21,106.
26. Martino, VD,Hoel, H,Cooper, CL.Preventing violence and harassment in the workplace.
27. Moorman, R(1991).Relationship between organizational justice and organizational citizenship behaviors: do fairness perceptions influence employee citizenship?.J Appl Psychol,76,845-855.
28. Niedhammer, I,David, S,Degioanni, S(2009).Workplace bullying and sleep disturbances: findings from a large scale cross-sectional survey in the French working population.Sleep,32,1211-1219.
29. Nielsen, MB,Indregard, AM,Overland, S(2016).Workplace bullying and sickness absence: a systematic review and meta analysis of the research literature.Scand J Work Environ Health,42,359-370.
30. Nyberg, A,Kecklund, G,Hanson, LM,Rajaleid, K(2021).Workplace violence and health in human service industries: a systematic review of prospective and longitudinal studies.Occup Environ Med,78,69-81.
31. Occupational Safety and Health Administration (OSHA). Enforcement procedures for investigating or inspecting workplace violence incidents, 2011. Available at: https://www.health.state.mn.us/facilities/patientsafety/preventionofviolence/docs/oshaenforceprocinvestorinspectwrkplcviol.pdf. Accessed July 25, 2022.
32. Peng, X,Pu, Y,Jiang, X(2021).Analysis of factors that influenced the mental health status of public health workers during the COVID-19 epidemic based on bayesian networks: a cross-sectional study.Front Psychol,12,755347.
33. Rodriguez-Munoz, A,Moreno-Jimenez, B,Sanz-Vergel, AI(2015).Reciprocal relations between workplace bullying, anxiety, and vigor: a two-wave longitudinal study.Anxiety Stress Coping,28,514-530.
34. Rudkjoebing, LA,Hansen, AM,Rugulies, R,Kolstad, H,Bonde, JP(2021).Exposure to workplace violence and threats and risk of depression: a prospective study.Scand J Work Environ Health,47,582-590.
35. Rugulies, R,Madsen, IE,Hjarsbech, PU(2012).Bullying at work and onset of a major depressive episode among Danish female eldercare workers.Scand J Work Environ Health,38,218-227.
36. Scales, SE,Patrick, E,Stone, KW,Kintziger, KW,Jagger, MA,Horney, JA(2021).A qualitative study of the COVID-19 response experiences of public health workers in the United States.Health Secur,19,573-581.
37. Sheppard, DM,Newnam, S,Lious, RM,Perret, M(2022).Factors contributing to work-related violence: a systematic review and systems perspective.Safety Science,154,105859.
38. Stone, KW,Kintziger, KW,Jagger, MA,Horney, JA(2021).Public health workforce burnout in the COVID-19 response in the US.Int J Environ Res Public Health,18,4369.
39. Wiesman, J,Baker, EL(2022).The public health worker mental health crisis: a major leadership challenge.J Public Health Manag Pract,28,95-98.
40. 台灣衛生所專業人員協會：線上調查。https://www.facebook.com/PublicHealthNote/。引用2022/07/25。 Taiwan Health Center Professionals Assocstion (THCPA). Online survey. Available at: https://www.facebook.com/PublicHealthNote/. Accessed July 25, 2022. [In Chinese]
41. 行政院人事行政總處：110年直轄市、各縣市統計要覽─依學歷統計。https://www.dgpa.gov.tw/information?uid=331&pid=10942。 Directorate-General of Personnel Administration, Executive Yuan, R.O.C. (Taiwan). Summary of statistics of special municipalities, counties, and cities in 2021 -- by education level. Available at: https://www.dgpa.gov.tw/information?uid=331&pid=10942. Accessed September 22, 2022. [In Chinese]
42. 李雅惠, YH(2012)。高雄=Kaohsiung，國立高雄師範大學人力與知識管理研究所=Graduate Institute of Human Resource and Knowledge Management, National Kaohsiung Normal University。
43. 梁文敏, WM(2017)。,台北=Taipei:衛生福利部國民健康署=Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan)。
44. 陳淑靜, SC(2021)。台北=Taipei，國立台灣師範大學健康促進與衛生教育學系健康促進與衛生教育學系=Department of Health Promotion and Health Education, National Taiwan Normal University。
45. 監察院, R.O.C. (Taiwan)(2020)。監察院：衛生所之公衛功能之確保及人力與業務均衡案。台北：監察院，2020。 The Control Yuan, R.O.C. (Taiwan). Corrective Measures Targeting Public Health Centers to Ensure Effective Public Health Functions, Sufficient Staffing, and Fair Workload Allocation. Taipei: The Control Yuan, R.O.C. (Taiwan), 2020. [In Chinese]。
46. 銓敘部：中華民國110年銓敘部統計年報─提要分析。台北：銓敘部，2022。 Ministry of Civil Service, R.O.C. (Taiwan). Statistical Yearbook of Civil Service, 2021: Summary Analysis. Taipei: Ministry of Civil Service, R.O.C. (Taiwan). [In Chinese: English abstract]
47. 銓敘部：中華民國110年銓敘統計年報－行政機關公務人員概況。台北：銓敘部，2021。 Ministry of Civil Service, R.O.C. (Taiwan). Statistical Yearbook of Civil Service, 2021: Civil Servants of Administration Agency. Taipei: Ministry of Civil Service, R.O.C. (Taiwan). [In Chinese: English abstract]
48. 劉廷揚, TY,李昭蓉, CJ,蘇政宏, CH,吳佩璉, PL(2016)。公共衛生人員情緒勞務、情緒智力與工作倦怠關聯性研究。政策與人力管理，7，89-114。
49. 衛生福利部國民健康署：2021年台灣各縣市衛生所統計年報。台北：衛生福利部國民健康署，2022。 Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). 2021 Health Promotion Administration Annual Report. Taipei: Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), 2022. [In Chinese: English abstract]
50. 衛生福利部統計處：公立衛生行政機關人員數。台北：衛生福利部統計處，2022。 Department of Statistics, Ministry of Health and Welfare, R.O.C. (Taiwan). Number of Workers at Public Health Administrative Agencies. Taipei: Department of Statistics, Ministry of Health and Welfare, R.O.C. (Taiwan), 2022. [In Chinese]
51. 謝曼麗, ML,許修鴻, HH(2018).勞動環境安全衛生狀況認知調查—2016年.台北=Taipei:勞動部勞動與職業安全衛生研究所=Institute of Labor, Occupational Safety And Health, Ministry of Labor, R.O.C. (Taiwan).