2014-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/650573摘要：心理韌性與職場正義是否影響受傷勞工之心理健康與復工：五年追蹤研究 工作場所中的職業傷害是無法避免的。在台灣，有超過五萬名勞工發生職業傷害，且其中有 68%因此住院。我們過去研究發現 7.5%職傷勞工在受傷後三個月有創傷後壓力症候群或重度憂鬱症，5.1%在受傷後 12 個月有創傷後壓力症候群或重度憂鬱症。這些發現指出有部分職傷勞工會發展成慢性精神疾病。此外，我們也發現精神症狀嚴重的勞工也比較難復工。 從過去的文獻中，我們發現較差的壓力因應方式(coping skills)，與不好的生活品質，都與創傷後發生創傷壓力症候群有高度相關。受傷後的復工過去亦曾被發現與自我效能(self-efficacy)有關。目前壓力因應方式(coping skills)或自我效能(self-efficacy)對於職傷勞工復工的影響尚不清楚。其他預測勞工精神疾病的重要因子，如職場正義過去也曾被發表過，在台灣，職場正義已經被發現是預測心臟病發病後復工的重要因子。然而，職場正義是否能夠預測職傷勞工精神健康與復工狀況，目前仍屬未知。我們希望能夠進行長期追蹤研究，調查是否壓力因應方式，自我效能，與職場正義會影響職傷勞工精神症狀與復工狀況。 過去我們在 2009 年追蹤 4,403 位發生職業傷害的勞工。我們過去已經調查其在職業傷害發生後三個月與 12 個月的精神症狀與復工情形。在目前的計畫書中，我們希望在經過這些職傷勞工的同意後，繼續追蹤他們受傷後第 60 個月的狀況。我們會使用心理韌性量表、職場正義、簡式健康表、創傷後症候群檢查表、世衛組織生活品質問卷作為測量工具。對於精神症狀得分嚴重的個案，我們會使用中文版迷你國際神經精神會談工具為其進行精神疾病之診斷與篩檢。由於個案數眾多，因此我們希望在第一年時先追蹤 2,203 位職傷勞工，第二年繼續追蹤 2,200 位職傷勞工。我們所欲測試的假說如下： 1. 心理韌性得分較高的職傷勞工是否有較低的風險發生精神症狀，與精神疾病。 2. 心理韌性得分較高的職傷勞工是否有較高的復工機會。 3. 職場正義較高的職傷勞工是否有較低的風險發生精神症狀，與精神疾病。 4. 職場正義較高的職傷勞工是否有較高的復工機會。 5. 心理韌性，職場正義，與復工是否可以預測生活品質。 6. 在預測精神健康與生活品質時，心理韌性與職場正義彼此之間是否有交互作用。 我們希望能夠找出在職傷發生後，那些個人與職場因子是可以被改善的。當這些因子被發現後，我們可以使用策略去優化個人因子或職場環境，進而使受傷勞工之精神與身體達到最理想的安適狀態。<br> Abstract: Occupational injuries (OI) are unavoidable in workplaces. In Taiwan, >50,000 workers suffer from OI yearly, and 68% of them are hospitalized. Our previous study found 7.5% workers with OI had either post-traumatic stress disorders (PTSD) or major depression at 3 months after injury, and 5.1% had either PTSD or major depression at 12 months after injury. These findings indicated that those sustaining OI had high risk of mental ailments as a result. In addition, those with more psychological symptoms had more difficulty in return-to-work. From the literature, poor life quality and risk of developing PTSD after traumatic events have been highly related to poor coping skills. Return-to-work after injury has been related to self-efficacy. Whether coping skills and self-efficacy predicts return-to-work after OI in workers is unknown. Another important factor predicting worker’s developing mental diseases has been lacking of workplace justice. Workplace justice has been found to predict return-to-work after heart attacks in Taiwan. Whether workplace justice predicts return-to-work and mental health after OI is unknown. We propose to conduct a cohort study to investigate whether coping skills, self-efficacy, and workplace justice affects psychological health and return-to-work in a group of workers sustaining OI. We have followed up 4403 workers who suffered from OI in 2009. Psychological symptoms and return-to-work were studied at three months and twelve months after the injury event. In this current project, we propose to follow these workers at 60 months after injury event after their informed consent. The resiliance scale and workplace justice of the injured workers will be studied, as well as Brief Symptom Rating Scale (BSRS), Post-traumatic Symptom Checklist (PTSC), and World Health Organization Quality of Life questionnaire. Among those with abnormal scores in BSRS or PTSC, the Chinese version of the Mini-international Neuropsychiatric Interview (MINI) will be administered. Due to the large number of injured workers to be followed, we propose following up 2203 workers in the first year of study, and 2200 workers in the second year of study. We will test the following hypotheses: 1. Those workers with high resilience scores will have lower risk of developing psychological symptoms, and lower risk of psychiatric diseases. 2. Those workers with high resilience scores will have high probability of return-to-work. 3. The workers from workplace with high justice will have lower risk of developing psychological symptoms, and lower risk of psychiatric diseases. 4. The workers from workplace with high justice will have high probability of return-to-work. 5. Resilience, workplace justice, and return-to-work predict quality of life. 6. There are interactions between resilience and workplace justice in predicitng psychological health and quality of life. We expect to identify important personal and workplace factors which can be intervened after OI. When these factors are identified, strategies to optimize personal factors and workplace environment can potentially optimize the mental and physical well-being of the injured workers.