醫院勞工對作業環境之感受度調查研究：邁向健康促進醫院

Employee Perception on Environment of Work Setting: An Evolving Study of Health Promotion Hospital

10.30027/CJOM.200904.0002

錢才瑋(Tsair-Wei Chien)；黃建元(Chien-Yuan Huang)；羅培德(Roberto Vasquez Castillo)；許森彥(Sen-Yen Hsu)；蘇世斌(Shih-Bin Su)

Rasch分析 ； 單向度 ； 工作抗壓 ； 等級量尺模式 ； 健康促進 ； Rasch analysis ； unidimensionality ； compression resistant ； rating scale model ； health promotion

中華職業醫學雜誌

16卷2期（2009 / 04 / 01）

93 - 108

繁體中文

醫院評鑑及健康促進醫院皆要求對員工身心健康做調查與分析。本研究探討(1)是否有個勞工抗壓的評估工作環境量表，可協助僱主具體改善勞工的工作環境；(2)如何分析量表，以挑出最是優先到入身心輔導的族群；(3)發展一套電腦輔助自我評估工作環境的篩選作業，以協助員工心理診斷分析報表的建置。 本研究利用Rasch(1960)測量客觀等距的特性，分析某健康促進醫院2008年員工工作抗壓度調查。利用WINSTEPS等軟體進行等級量尺模式的檢測，當問項的outfit或infit均方誤超出0.5及1.5之外者，即予刪列而期以符合其單向度反局部獨立性的試題反應理論假設。經由統計檢定分析進行(1)最優先輔導族群的篩選；及(2)受試者電腦問卷的診斷報表之提供。 結果顯示40個問項中僅一題不符合其單向度的Rasch模式預期，39題可將抗壓能力區分台4個等級，閾值界點分別為原始總分的85、104及120分。籍此作為我們衡量「工作壓力感受度」能力的高、中、低及弱之等級。年輕主管是我們篩選出來最需優先輔導的族群。個人自我評估之電腦報表可以提供醫師輔導勞工增進工作抗壓的診斷判讀之參考。

For hospital accreditation and health promotion's reasons, we probed into 1) whether an appropriate scale for evaluating job environment of employees resisting compression and pressure; 2) how to analyze survey data to screen out the targeted people most likely to meet a consultation with medical doctors; 3) developing a set of computer-aid evaluation system generating printing diagnostic report and screening employees out for a talk with mental consultants. In this study we adopted the objective and interval characteristics of Rasch model to analyze the data of 1,644 hospital employees who were recruited in 2008 for a job compression resistant survey. The WINSTEPS software was performed to examine data fitting to the Rasch model's requirements with Infit and Outfit MNSQ at range of 0.5 and 1.5 and forming a single construct in order to 1) know who are the most urged to be arranged a mental consultation; and 2) produce a performance report for diagnosis and analysis. The results revealed that the 40 but one item fitted the model's expectation fairly well. The examinees could be separated into 4 strata with cut-off thresholds of 85, 104 and 120 of global raw scores, i.e., severity of symptoms, classified as healthy, mild, moderate and severe. The youngest and rookie section chiefs should be drawn attention and concentration on problems of compression and pressure. Self-evaluation report on computer could be developed in detecting aberrant responses endorsed by employees and diagnosing reference symptoms for an advance following-up and treatment at early stage.