新冠肺炎疫情期間公衛人員的職場暴力經驗與心理健康影響：訪談研究

Experiences of Workplace Violence and their Mental Health Impacts among Public Health Workers: An Interview Study

研究目的：即使在平常時期，公衛人員在執行強制性措施過程可能遭遇民眾負面情緒甚至暴力相向，身處於科層體制也可能承受管理壓力。在新冠肺炎疫情期間進行的調查研究指出，公衛人員遭遇職場暴力與情緒困擾的比例偏高，本研究進一步探討公衛人員遭遇職場暴力的經驗。研究方法：於2022年11月至2023年1月間針對19位（17位女性、2位男性）曾在新冠肺炎疫情期間遭遇職場暴力的公衛人員進行深度訪談。研究結果：疫情期間由於防疫工作複雜繁重且政策變動快速，公衛人員的工作負荷加重且伴隨職場暴力風險。外部職場暴力來自民眾，原因包括違反規定受罰、自覺需求未被滿足、對政府政策不滿等，大多以言語辱罵、威脅、恐嚇、騷擾等形式出現。內部職場暴力主要來自主管與資深同事，以霸凌形式出現。衛生機關主管未積極防治職場暴力問題，造成內外部暴力持續存在，嚴重影響公衛人員身心理健康。研究結論：公衛行政部門的職場暴力問題普遍，對公衛人員的工作士氣與身心健康帶來負面影響，是衛生主管機關亟需關注的議題。對於如何因應職場暴力問題，本文對主管機關提出建議。

Purpose: Even in ordinary times, public health workers are susceptible to negative emotions and violence from the public, and working within hierarchical, bureaucratic systems can impose additional psychological stress. A survey conducted during the COVID-19 pandemic revealed that public health workers were at high risk of being the target of workplace violence and having poor mental health. In this study, we explored public health workers’ experiences of the origins and forms of workplace violence. Methods: We conducted in-depth interviews between November 2022 and January 2023 with 19 public health workers (17 women and 2 men) who experienced workplace violence during the COVID-19 pandemic. Results: Our findings indicated that the complex and demanding epidemic control measures, coupled with rapid policy changes, led to heavy workloads during the pandemic. Public health workers also encountered various types of workplace violence. External workplace violence primarily came from the general public, mainly in the form of verbal abuse, threats, intimidation, and harassment. Common reasons for targeting public health workers included citizens being punished for regulatory violations, having unmet needs, and being dissatisfied with government policies. Internal workplace violence mainly came from supervisors and senior colleagues, mostly in the form of power harassment. Employers failed to take active measures, resulting in persistent violence and tremendous physical and mental health impacts on public health workers. Conclusion: Workplace violence, occurring not just during the pandemic but also in ordinary times, undermines the morale of public health workers and infringes on their health rights. This pressing issue demands urgent attention and action. We provide recommendations for health authorities to address the problem.