影響勞工職業傷害後心理健康的原因

Factors Affecting Mental Health among Occupational Injured Workers

秦唯珊(Wei-Shan Chin)；謝月慈(Yueh-Tzu Hsieh)；吳雪菁(Hsueh-Ching Wu)；郭育良(Yue-Leon Guo)；蕭淑銖(Judith Shu-Chu Shiao)

職業傷害 ； 勞工 ； 心理社會健康 ； Occupational injury ； Worker ； Psycho-social health

勞工安全衛生研究季刊

22卷2期（2014 / 06 / 01）

179 - 190

繁體中文

背景：勞工發生職業傷害後，有一定比例會罹患精神疾病，精神症狀也是職傷勞工未能順利復工的重要因子，然而目前國內仍缺乏關於影響職業傷害勞工精神狀況之質性研究。目的：瞭解影響勞工職傷後精神狀況的相關因子，做為對政府照顧職災勞工之建議。方法：以民國98年02月至08月因職業傷害住院超過3天以上，且有申請勞保職業傷害給付的勞工為研究對象，其職業傷害發生後第3個月，使用簡式精神症狀自陳量表（Brief Symptom Rating Scale, BSRS-50）調查其精神狀況，以及使用中文版簡式創傷後壓力疾患量表（an acronym for four items: Startle, Physiological arousal, Anger, and Numbness, SPAN-C），篩選出精神症狀嚴重之個案，尋求願意參與質性訪談者；在所有符合條件的357位職傷個案中，共有7位同意接受深度訪談。結果：影響職傷勞工精神症狀之因素共有六項：1.生理疼痛與復原狀況不盡理想，2.申請職業傷害補償與相關資源不易，3.執業場所缺乏職場正義，4.就業缺乏保障，5.缺乏雇主的社會支持，6.提早復工導致受傷地方傷害加劇。結論：勞工若於災害發生到順利復工的過程中，未受到合理與妥善的照護，相當容易產生心理與精神上的問題。建議政府應整合現有社區資源，將職災勞工照護普及到各鄉鎮，使其能夠合理地在社區中生存。

Background: Research findings from previous studies suggest that there are certain proportion of workers may develop psychiatric symptoms after experiencing major occupational injuries and such events quite often become an obstacle to their 〞return to work〞 at later stages. Up to the present time, there is no qualitative study investigating the risk factors influencing occupationally injured workers' psycho-social health and their adjustment to the life after occupational injury. Purpose: Identifying the risk factors affecting injured workers' psycho-social health and assistances needed in the process of recovery from occupational injury. Methods: Injured workers who were hospitalized for 3 days or longer and received Inpatient Hospitalization Benefit of Occupational Accident Medical Benefits from Labor Insurance between February 1 and August 31, 2009 were recruited at 3 months after injury, as the stage one study. The psychological symptoms were measured using a self-reported questionnaire Brief Symptom Rating Scale (BSRS-50) and an acronym (SPAN-C) for four items: Startle, Physiological arousal, Anger, and Numbness. The participants with high score of psychological symptoms would be invited to participate in face to face interview. At stage 2, a total of 7 injured workers participated in an in-depth interview within 1year after the occupational injury. Results: Six themes were identified from the interviews: 1. the physical suffering, 2. unattainable workers' compensation, 3. workplace injustice, 4. employment insecurity, 5. lack of employers' social support, and 6. exacerbating pre-existing injury after a premature return to work. Conclusions: Workers did not receive reasonable and proper assistances from the government tended to develop psychological and mental disorders. With the findings of this study, the authors suggest that relevant government agencies may re-organize/re-integrate community resources and establish 〞single window services〞 for occupationally injured workers, to lead a more reasonable life in the community.

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