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題名：多元職場健康促進方案改善職場高齡工作者代謝異常之成效
作者：陳美滿
作者(外文)：Meei-Maan Chen
校院名稱：亞洲大學
系所名稱：健康產業管理學系健康管理組
指導教授：蔡仲弘
學位類別：博士
出版日期：2013
主題關鍵詞：高齡員工；職場健康促進；代謝異常；aging worker；worksite health promotion；metabolic disorders
原始連結：連回原系統網址new window
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目的--人口高齡化衍生高齡工作者議題，而高齡工作伴隨較多不容忽視的健康問題。本研究旨在於探討以多元化職場健康促進介入策略，改善高齡工作者代謝異常之成效。
方法--以「類實驗」進行24週的介入研究，以立意取樣選擇雲嘉地區三中小型職場為研究場域。在1,245位員工中，438位50歲以上、全職、以參與場域為主要工作地點、無行動失能或限制者為徵募對象。其中264位同意簽署參與研究同意書接受初步篩檢，108位願意繼續參與介入研究。可參與活動的58人分派為介入組；不能者50人為參考組。本研究的多元介入包括增加身體活動、改善飲食、改進生活作息時間安排及壓力調適等。介入期的前4週以各種課程增進介入組個案保健知識並輔導其執行自我健康管理；後20週則加入小組及團體層次的活動策略，強化良好健康習慣之養成。參考組維持原職場之健康照護服務。兩組個案於基準點及結束點均接受體重、腰圍、血壓、血脂及糖化血色素(HbA1C)檢測，及以問卷評估個案生活方式、時間分配及生活壓力等。資料分析採線性混合模式(linear mixed model)探討介入成效。
結果--多元化職場健康促進介入活動顯著降低體重 (介入組 vs. 參考組 = -1.22kg vs. -0.30kg, p=0.026)、BMI (-0.46 vs.-0.02kg/m2, p=0.006)、及腰圍 (-2.68cm vs. +0.79cm, p<0.001)，但對血壓及血液生化指標則無顯著成效。該介入活動亦對於增進運動頻率 (+0.77次/週 vs. +0.04次/週，p=0.001)具有顯著意義。但對工作壓力、睡眠時數、坐態時數及蔬菜攝取量則未有顯著差異。
結論--本研究所試行多元職場健康促進介入策略可有效增進高齡員工的運動頻率，並改善代謝異常指標--體重及肥胖指標。此介入模式應可作為某些職場未來推動高齡工作者健康促進活動之模式。但各職場主、客觀條件迥異，如何依各職場之特性發展適合各職場的介入模式，可能是職場健康促進成效之關鍵。
Abstract
Objectives: Taiwan's general population and workers are aging rapidly, and older workers usually have a higher prevalence of aging-related metabolic disorders. Thus, we conducted this study to examine the effectiveness of a multidimensional health promotional program to reduce the risk of metabolic disorders in older Taiwanese workers.
Methods: We conducted a 24-wk quasi-experiment in three selected worksites in southern Taiwan. Among 1,245 total employees, 438 were ≥50 years old, full-time on-site workers, and without physical disability. Among them, 264 participated in the primary questionnaire screening for qualification, and 108 were willing to sign the study consent and participate in the study. They were assigned to either the intervention (IG, n=58) or the reference group (RG, n=50), according to their availability to participate in the study activities. The multidimensional intervention program focused on increasing lifestyle, especially physical activity, and improving diet, time-use, and stress management to minimize metabolic risk. The intervention included two stages. The first stage (4 weeks) emphasized improving participants' self-care knowledge and awareness of the importance of self-management, whereas the second stage (weeks 5-24) was aimed to improve lifestyle by meaning of motivational lectures, group activities, and team competitions. Subjects in the reference group received no active interventions. All subjects were measured for lifestyle, anthropometric and biochemical indicators at baseline and end-point. Linear mixed model was used to determine the intervention effects.
Results: The intervention resulted in lower body weight (IG vs. RG=-1.22kg vs. -0.30kg, p=0.026), BMI (-0.46 vs. -0.02kg/m2, p=0.006) and waist circumference (-2.68cm vs. +0.79cm, p<0.001). The program also found significant differences in the change of exercise frequency (p=0.001). Effects on other biochemical parameters, sedentary time, sleeping hours, work stress and vegetable consumption were not significant.
Conclusions: Results suggest that worksite-based multidimensional health promotion program was effective in reducing body fatness and waist circumference, the major risk factor of metabolic syndrome in older workers in Taiwan. The model may serve as a simple and practical example for worksite health promotion. However, due to the diversity nature of worksites, the success may be dependent on the development of a culturally suitable program for each specific worksite.
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