居家照顧服務員肌肉骨骼不適的相關因子之探討

Factors Associated with Musculoskeletal Discomforts in Home Helpers

臺灣由於人口老化和失能人口增加使得長期照護需求殷切，服務體系也隨之發展和成長，以居家服務量能的提升最為明顯；不過，人力不足問題隨之浮現，留住現有人力成為當務之急，留任的措施有多項，減少肌肉骨骼不適是留任的重要措施之一；只是目前相關的研究甚少，本研究的目的是探討居家照顧服務員肌肉骨骼不適的情形和相關因子，採量化橫斷性設計，從北部和東部多個居家服務機構進行方便取樣，在機構團體督導場合以標準化結構問卷對341位居家照顧服務員進行集體施測。結果顯示居家服務員主要是中年的女性（93.0%），在過去一年至少有一個肌肉骨骼部位不適的比率高達（88.0%），以肩膀（67.4%）、下背或腰（64.2%）、手腕或手（56.6%）比率三者最高。以九個身體不適部位分別進行羅吉斯迴歸分析，結果顯示相關因子因不適部位不同而有所不同，整體疲憊感受是不同部位不適的最強預測因子，照護過程動作類型次之，其他顯著因子包括工作投入、工作天數、每天休息時數滿意度。

A rapid growth of aging and disabled population has driven up the needs for long-term care services in this country. The past decade has seen a rapid development of service systems, particularly home helper services. This research aimed at exploring factors associated with musculoskeletal discomforts in each one of the nine body areas in home helpers. Employing a cross-sectional design, this study used structured and standard questionnaires to collect data from a group of 341 home care workers drawn from home care agencies. The results showed that home helpers were made of predominantly middle-aged female (93.0%). A majority of the respondents (88.0%) reported at least one area of musculoskeletal discomforts. Among the nine body areas, shoulder discomforts pertained to be the most prevalent (67.4%). Lower back or lumbar came on the second (64.2%) followed by wrists or hands (56.6%). The findings from nine logistic regression analyses indicated that predictors varied by body areas. Feelings of total burnout marked the most robust predictor, followed by motions during care process. Other factors which turned out significant included the extent of commitment to work, average working days per week, satisfactions with work breaks, and work related gestures and movements.