運用職場周全性健康促進模式改善老人福利機構工作者健康促進行為及健康之成效研究

Abstract

臺灣已成為高齡社會，社會及家庭正負擔沉重的照顧責任，亦加重老人福利機構員工工作負荷與健康影響，職場應營造健康的工作環境，以促進工作者健康。本研究將評估運用世界衛生組織職場周全性健康促進模式對於老人福利機構工作者的健康促進行為及健康介入成效。採準實驗研究設計，母群體為臺北市及新北市3家市立老人福利機構工作者，立意分派實驗組為某家機構87位工作者，進行6個月職場周全性健康促進模式介入；對照組為另2家機構63位工作者，無任何介入措施。以結構式問卷進行前、後測評量，包含基本資料、健康情形、生活型態。統計分析以卡方檢定、McNemar檢定、成對樣本t檢定、獨立樣本t檢定及廣義估計方程式。時間與組別交互作用結果，實驗組於每週量體重1次以上及腰圍肥胖之前、後測改變量，比對照組明顯。控制其他變項，45歲以上比23至44歲，較可能每週量血壓、每週運動150分鐘以上及每週走路天數較佳。大學以上比高中（職）以下，工作疲勞分數顯著較高。工作年資愈高，愈可能攝取2份以上水果。平均每週工時愈長，每週走路總時間愈高。照顧服務員比行政、社工、輔導員及其他人員，每天睡眠時間顯著較少、每週走路總時間顯著較多。輪班比固定班別，每週走路天數較少、個人疲勞及工作疲勞分數顯著較高。本研究結果證實職場周全性健康促進模式介入能有效改善老人福利機構工作者腰圍肥胖，並建立每週量體重的健康促進行為。建議老人福利機構未來推動職場健康促進，需再強化機構政策執行、工作環境調整及勞工健康服務護理人員的角色。As Taiwan has become an aging society, both the society and individual households face heavy care burdens. Considering that population aging has increased the workload and affected the health of workers of senior welfare institutions, employers must endeavor to create a healthy work environment to promote workers’ health. This study evaluated the effectiveness of Workplace Comprehensive Health Promotion Model developed by World Health Organization, as an intervention for the health promoting behavior and health of senior welfare institution workers. A quasi-experimental design was adopted, and workers of three public senior welfare institutions in Taipei and New Taipei City were recruited as the population. The workers of one institution, 87 in total, were assigned purposively as the experimental group, whereas the workers of the other two institutions, 63 in total, were assigned as the control group. The experimental group were subjected to the Workplace Comprehensive Health Promotion Model for 6 months as an intervention, whereas the control group were subjected to no intervention. A pretest–posttest analysis was performed using a structured questionnaire that collected information on the participants’ demographic information, health status, and lifestyle, which was subsequently assessed using chi-squared test, McNemar’s test, paired sample t test, independent samples t test, and generalized estimating equation. Group-by-time interaction was observed, as the experimental group exhibited greater changes than the control group in self-weighing at least once weekly and in pretest–posttest waist circumference measurements. When other variables were controlled for, the participants who were 45 years old or above surpassed those 23-44 years old in taking weekly measurement of blood pressure, at least 150 min/week of physical activity and days of walking per week; those with a bachelor’s degree or above had significantly higher work fatigue scores than those with a high school degree or below. Additionally, participants who were greater in the length of service were found to be more likely to consume more than two portions of fruits, and those with longer work hours per week were more likely to spend more time walking each week. The participants who served as nurse assistants slept significantly less and spent significantly more time walking each week than did those serving as administrative staff, social workers, counselors, and others. The participants who worked in shifts had significantly less days of walking but significantly higher personal burnout and work-related burnout scores than that for those on fixed shifts. The findings of this study confirmed that the Workplace Comprehensive Health Promotion Model can effectively improve the waist circumference of workers of senior welfare institutions and help them develop the health promoting behaviors, including exercising regularly and self-weighing at least once weekly. Senior welfare institutions implementing the Workplace Comprehensive Health Promotion Model are advised to enhance institutional policy implementation, improve work environment, and orientate the roles of the occupational health service nurse.