王榮德臺灣大學：職業醫學與工業衛生研究所賴靜芬Lai, Chin-FenChin-FenLai2007-11-282018-06-292007-11-282018-06-292004http://ntur.lib.ntu.edu.tw//handle/246246/59830一、影響職業災害上肢骨折勞工復工相關因素之探討 本研究利用追蹤的方式，以了解哪些因素會影響到職業災害上肢骨折勞工的復工及其復工天數，希能利用研究結果幫助勞工順利復工。研究對象是由勞保局92年8月1日至10月3日職災住院資料中篩選出在92年7月15日至9月20日發生上肢骨折職業災害的勞工。利用電話訪問的方式，在其受傷後45天左右訪問第一次，90天左右訪問第二次，受傷六個月後訪問第三次，以了解職業災害上肢骨折勞工的基本資料、醫療情形、社會支持、生理及工作狀況。並以Multiple logistic regression及Cox regression分析何因子會影響到上肢骨折勞工的復工及其復工天數。結果共得110份問卷，初訪成必v為54%，將此110人收納為研究對象追蹤六個月，至第三次追蹤成左怓1.Factors Affecting Return to Work of Upper Limb Fracture Workers This is a prospective study, and we tried to understand what factors will affect returning to work (RTW) of upper limb fracture workers. We collected data from Bureau of Labor Insurance of those with occupational injury causing upper limb fracture and being hospitalized (from July 15, 2003 to September 20, 2003). Questionnaires concerning RTW were applied and filled up by researcher through telephone interview. We have followed up each case at 45days, 90 days and 180 days from their injury respectively. Multiple logistic regression and Cox regression to analyse factors affecting RTW and duration required for RTW were executed. There were 110 workers recruited by the first interview (response rate 54 %) and 102 workers (93 %) were successfully followed up throughout three times of interview. The results show the significant factors (p<0.05) affecting RTW are fracture site, with fixed employer and self- perceived workability. The factors affecting duration required for RTW are gender, age, major income source of family, fracture site, self-perceived handicap, whether paid after injury, work as blue or white collar, days of hospitalization. We concluded that when occupational injury occurred, workers should be sent to hospital as soon as possible, and proper compensation and functional capacity evaluation should be provided, which would be helpful for protecting these victimized workers. We also have to pay attention to the workers without fixed employer because of poor occupational support. 2.Factors Affecting Quality of Life of Upper Limb Fracture Workers This is a prospective study, and we tried to understand what factors will affect Quality of life (QOL) of upper limb fracture workers. We collected data from Bureau of Labor insurance of those with occupational injury causing upper limb fracture and being hospitalized (from July 15, 2003 to September 20, 2003). Questionnaires concerning RTW and QOL were applied and filled up by researcher through telephone interview. We have followed up each case at 45days, 90 days and 180 days from their injury respectively. paired t-test and multiple liner regression model to analyse the change between two QOL and what factors will affect their QOL were executed. There were 110 workers recruited by the first interview (response rate 54 %) and 90 workers (82 %) were successfully followed up throughout two times of interview. The results show that there are significant changes between the two QOL tests in each domain and facet excepting social support, sexual activity, freedom, physical safety and security, home environment, opportunities for acquiring new information and skills, physical environment (pollution / noise / traffic / climate), and changes in pain and discomfort, negative feelings, dependence on medicinal substances and medical aids are negative. The duration required of RTW is the most important factor affecting QOL, and the type of work is a important predictor for QOL.目 次 第一篇 影響職業災害上肢骨折勞工復工相關因素之探討 中文摘要 2 英文摘要 3 前言 4 材料與方法 5 結果 7 討論 9 結論 14 參考資料 15 表目錄 表1 職業災害上肢骨折成戊X問者之個人基本資料及其與1999年母群體、未能成戊X問者之比較 18 表2 職業災害上肢骨折受試者之復工與未復工影響因子之比較(t-test) 21 表3 職業災害上肢骨折受試者之復工與未復工影響因子之比較(X2-test) 22 表4 影響職業災害上肢骨折勞工三個月時是否復工之因子分析。(Multiple logistic regression) 24 表5 影響上肢骨折職業災害發生至恢復工作的天數之因子分析。(Cox regression model) 24 圖目錄 圖1 職業災害上肢骨折勞工未復工曲線(追蹤180天) 25 第二篇 影響職業災害上肢骨折勞工生活品質相關因素之探討 中文摘要 27 英文摘要 28 前言 29 材料與方法 30 結果 33 討論 35 結論 40 參考資料 41 表目錄 表1 職業災害上肢骨折成戊X問者之個人基本資料及其與1999年母群體、未能成戊X問者之比較 44 表2 職災上肢骨折勞工兩次生活品質各範疇之比較　(n=90人，Paired t-test) 46 表3 職災上肢骨折勞工兩次生活品質各層面之比較　(n=90人，Paired t-test) 47 表4 影響兩次職災上肢骨折勞工生理範疇分數差值的因子分析(multiple liner regression model) 48 表5 影響兩次職災上肢骨折勞工心理範疇分數差值的因子分析(multiple liner regression model) 49 表6 影響兩次職災上肢骨折勞工社會關係範疇分數差值的因子分析(multiple liner regression model) 50 表7 影響兩次職災上肢骨折勞工環境範疇分數差值的因子分析(multiple liner regression model) 51 附錄 附錄1 上肢骨折勞工復工情形問卷編制前之一對一訪談結構式問卷 52 附錄2 上肢骨折勞工復工情形問卷編制前之一對一訪談名單 55 附錄3 上肢骨折勞工復工情形問卷編制前之一對一訪談結果 57 附錄4 上肢骨折勞工生活及復工情形問卷 58 附錄5 世界衛生組織生活品質問卷(台灣簡明版) 61 附錄6 影響復工相關因子資料整理 68 附錄7 影響生活品質相關因子資料整理 76 附錄8 1999年健保職業災害住院個案之傷害類型與年齡人次分佈表n(%) 81 附錄9 職業災害上肢骨折受試者之個人基本資料(人數=110人) 82 附錄10 職業災害上肢骨折成戊X問者(n=110)與1999年母群體(n=2399)之比較 83 附錄11 職業災害上肢骨折成戊X問者(n=110人)與未能成戊X問者(n=94人)之比較 84 附錄12 上肢骨折勞工復工至第三次追蹤，成弘l蹤者與未能成弘l蹤者之比較 85 附錄13 上肢骨折勞工生活品質至第二次追蹤，成弘l蹤者與未能成弘l蹤者之比較 85674711 bytesapplication/pdfen-US上肢骨折復工職業災害生活品質追蹤型研究Upper limbProspective studyOccupational injury[SDGs]SDG3[SDGs]SDG11thesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/59830/1/ntu-93-R91841004-1.pdf