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

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.