工作场所健康促进赋权增能模式研究

发布时间：2018-03-08 02:03

本文选题：赋权　切入点：增能　出处：《中国疾病预防控制中心》2013年博士论文　论文类型：学位论文

【摘要】：目的健康促进中的赋权增能是指“使人们获得控制影响其生活和健康影响因素的能力的过程”,这已成为健康促进领域公认的核心策略。从促进和加强我国职业人群健康的角度来说,引进赋权增能理论和实践模式是非常必要的,但在我国应用需要考虑其跨文化的普适性和本土化的问题。本研究旨在探索和解读基于我国社会、经济、文化背景的工作场所健康促进领域中的赋权增能内涵、要素和作用机制,构建适合我国国情的工作场所健康促进赋权增能模式,为进一步推进和发展我国工作场所健康促进工作提供理论指导。方法本研究首先采用文献法,在国内、外相关文献数据库和网站查询资料,对收集到的信息进行查阅、鉴别、整理与分析,研究赋权增能理论的内涵、要素和已有模式的优缺点。然后采用质性研究方法,将工作场所健康促进领域拥有相关信息最丰富的人群作为抽样目标人群,通过目的抽样、滚雪球抽样选取20名人员进行深度访谈,将访谈录音转换成文稿,提取要点并与受访者确认,而后进行访谈资料的分析和提炼,形成赋权增能模式框架。最后,在2家不同规模、不同性质的企业中开展实证研究,采用“全国工作场所健康促进试点企业”项目统一制订的基本情况调查表、McLean's职业紧张调查表、Goldberg普通健康调查表、心理赋权量表和以身作则问卷,结合访谈法和观察法,对赋权增能干预各层面结果进行测量。通过理论构建和实践发展,最终形成基于我国国情现状的工作场所健康促进赋权-参与-增能模式。结果第一部分：解释了将empowerment翻译为“赋权增能”的理由,批判式分析了现有的赋权增能模式的优缺点,深度探讨了该理论在目前中国社会经济转轨时期应用的意义和可行性,并综合理论研究和我国国情,提出了建立自上而下外力赋权和自下而上主动增能相结合的我国工作场所健康促进赋权增能模式总体思路。第二部分：探索和解释了那些影响到工作场所健康促进的经济、政治、社会和文化的因素,理解相关群体如何自我解读工作场所健康促进赋权增能的要素、优先领域和职业人群应具备的基本职业健康素养,并结合理论研究结果,提炼出制度、文化、心理和技术作为自上而下赋权的4个领域：健康意识、知识、技能、自我效能、自我决定、拓展社会支持网络以及通过个人或集体行动来对他人、决策或环境产生影响的能力等,作为增能的内容。初步提出了以对员工和组织进行赋权为前提、以员工和组织增能为目标、以员工参与为增能主要手段的工作场所健康促进赋权-参与-增能模式。第三部分：两家企业在组织领导、健康相关部门和人员设置、经费场所保障、沟通协调机制、民主管理方式、监督管控、信息／教育／医疗资源的提供等方面进行制度赋权；将健康安全的理念植入企业文化,积极倡导并融入各项活动,进行文化赋权；在内、外部专业人员的引导、协调、参与和服务下,借助技术工具,进行技术赋权；在制度、文化、技术赋权中,重视员工对赋权措施的心理体验,使其达到一定水平的心理赋权。通过赋权和有效参与,员工掌控影响其生活和健康影响因素的能力得到了不同程度的提高。问卷调查结果显示,两家企业分别有98.9%和93.2%的员工能够利用所学的健康知识应用于生活和工作中；77.8%和59.8%的员工认为自己获取健康知识的能力得到了提高；56.2%和32.5%的员工在健康相关问题的处理上具备了一定的批判式思维。两家企业员工心理赋权平均得分率分别为68.71%和65.60%,自我效能维度的平均得分率均大于74%;专业人员心理赋权平均得分率分别为77.50%和72.14%,在工作意义和自我效能两个维度的得分率均在80%以上。干预后员工体检异常指标也有部分改善。企业内部的安健环部门和医务室,藉由整个项目过程的参与,转变了服务意识、提升了服务能力,能够主动发掘员工的健康需求,采用了更加入性化和个体化的方式为员工提供健康服务和发展工作场所健康促进项目。通过实证研究,认识到社会、政治、经济、文化和环境的大背景对健康促进乃至企业发展的影响,将其补充到质性研究中提出的模式框架,提出最终的工作场所健康促进赋权-参与-增能模式。第四部分：对所提出的模式进行解析和说明。结论工作场所健康促进赋权-参与-增能模式赋予了赋权增能理论的中国特色内涵,丰富了工作场所健康促进理论,为我国工作场所健康促进工作的发展和全面推进提供了有效的理论模式和实践范例。
[Abstract]:objective
Health promotion in empowerment refers to "make people obtain the control effect of process factors of the ability of life and health effects, which has become the core of health promotion strategy from recognized. To promote and strengthen the view of health in our country occupation population, the introduction of empowerment theory and practice mode is very necessary in our country, but need to consider the application of cross-cultural applicability and localization problems. The purpose of this study is to explore and interpret the society of our country, based on the economy, the cultural background of the workplace health promotion in the field of empowerment connotation, elements and mechanism, building suitable for China's workplace health promotion and empowerment empowerment mode, the development of China's workplace health promotion work to provide theoretical guidance for the further promotion.
Method
This paper adopts the method of literature, in the domestic and foreign literature database and web site information, the information collected for inspection, identification, collation and analysis of the connotation of empowerment by the theory, the advantages and disadvantages of existing elements and patterns. Then by using qualitative research method, the workplace health promotion areas have the most abundant information related to the sampling population as the target population, through purposive sampling, snowball sampling to select 20 staff in-depth interviews, interviews will be converted into the presentation, extraction points and with the respondents confirmed that after the interview and data analysis and extraction, the formation of empowerment framework. Finally, in 2 different scale to carry out empirical research, the different nature of the enterprise, the "unified national workplace health promotion pilot enterprises formulate the basic situation questionnaire of occupational stress questionnaire, McLean's, Goldbe RG general health questionnaire, psychological empowerment scale and by questionnaire, interviews and observation, the empowerment intervention at all levels were measured. Results through theoretical construction and practice development, and ultimately the formation of current situations of our country workplace health promotion empowerment participation empowerment based on mode.
Result
The first part: explain the empowerment translated as "empowerment" reasons, critical analysis of the existing advantages and disadvantages of empowerment model, discusses the depth of theory in the current application of social economic transition Chinese significance and feasibility, and comprehensive theoretical research and actual situation in China, put forward the establishment of top-down external empowerment and the combination of bottom-up initiative to increase to our workplace health promotion and empowerment mode of general idea.
The second part: the exploration and interpretation of the influence to economy, workplace health promotion, political, social and cultural factors, to understand how groups of self interpretation of workplace health promotion can increase the weighting factor, priority areas and occupation groups should have the basic occupation health literacy, and combined with the result of theoretical research, refine the system. 4 areas of culture, psychology and technology as top-down empowerment: health awareness, knowledge, skills, self-efficacy, self decision, expand social support network and through individual or collective action of others, or the environment influence decision-making ability, as can increase the content. Initially proposed to employees and organizations empowerment as the premise, with employees and organizations can increase as the goal, to increase the staff involved in the main means of workplace health promotion empowerment participation empowerment mode.
The third part: the two companies in the leadership of the organization, the relevant departments and personnel to set up health funds, places of security, communication and coordination mechanism, democratic management, supervision and control, to provide such information / education / medical resources system empowerment; health and safety will be implanted into the concept of corporate culture, and actively promote the integration of cultural activities. Empowerment;, external professional staff guidance, coordination, participation and service, with the tools of technology, technological empowerment; in the system, culture, technological empowerment, employee empowerment measures of psychological experience, to achieve a certain level of psychological empowerment. Through empowerment and effective participation of employees, control ability to influence factors the life and health effects is improved in different degrees. The survey results show that the two companies were 98.9% and 93.2% of the employees can use the knowledge of health Used in life and work; 77.8% and 59.8% of employees believe that their ability to gain health knowledge has been improved; 56.2% and 32.5% of the employees have a certain critical thinking in dealing with health related problems. Two employees psychological empowerment average scoring rate were 68.71% and 65.60%, the average score of self-efficacy rate are more than 74% professional personnel; psychological empowerment average scoring rate were 77.50% and 72.14%, in the two dimensions of meaning and self-efficacy scores were all above 80%. The intervention of employee medical examination indicators are also part of the modification. The internal HSE department and Clinic, through the whole project process in transition the service awareness, improve service ability, can take the initiative to explore the health needs of employees, with a more user-friendly and individualized way for employees to provide health services and development. Workplace health promotion project. Through empirical research, to realize the social, political, economic, cultural background and environmental impact on health promotion and development of the enterprise, be added to the framework proposed in qualitative research, finally put forward the workplace health promotion empowerment participation empowerment mode.
The fourth part: the analysis and explanation of the proposed model.
conclusion
The workplace health promotion empowerment participation growth mode gives the connotation of the Chinese characteristics of the empowerment growth theory, enriches the theory of workplace health promotion, and provides effective theoretical models and practical examples for the development and promotion of workplace health promotion in China.

【学位授予单位】：中国疾病预防控制中心
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R13

【参考文献】