北京市某出版企业员工健康危险因素及其干预效果评价

发布时间：2018-03-27 12:14

本文选题：健康危险因素　切入点：健康相关　出处：《北京协和医学院》2012年硕士论文

【摘要】：背景国外己有大量研究表明健康危险因素与健康相关工作效率低下存在关联,但是由于国内外企业组织形式、医疗保障体制以及文化上的差异,这些研究结果还未能引起国内企业的足够重视。目前,我国中小企业依然缺乏健康促进的指南性文件,对于在中小企业实施健康促进能否改变企业员工的健康状况,以及哪种健康促进方式能改变企业员工的健康状况依然没有确切的证据。本研究选择北京市某出版企业为现场,探讨该企业员工健康危险因素与健康相关工作效率低下的关联,并评价在该企业开展的健康促进项目对健康危险因素干预的效果。目的 1.描述北京市某出版企业员工中健康危险因素的现况。 2.探索北京市某出版企业员工健康危险因素与工作效率低下是否存在关联。 3.探索北京市某出版企业健康促进项目能否降低员工健康危险因素水平。方法本研究采用自身前后对照的类实验方法。通过文献查阅和专家咨询,参考美国密歇根大学的健康危险评估(HRA)问卷,美国网络医疗服务集团健康危险评估问卷和美国梅奥诊所健康危险评估问卷,制定本研究的健康危险评估问卷；参考世界卫生组织《健康和绩效调查问卷》(HPQ)、美国《工作能力快速调查问卷》(WPSI)问卷,制定本研究的生产力调查问卷,将二者合并为《健康与生产力调查》问卷。选取北京市某出版企业员工为调查对象,对其进行基线调查,通过1年零3个月的工作场所健康促进对员工健康危险因素进行干预,在干预后对员工进行随访调查,分析健康危险因素与健康相关工作效率低下之间的关联,并探讨健康促进对健康危险因素水平的变化是否有影响,以及哪些健康促进方式对健康危险因素水平的变化有影响。结果 1.基线调查时,北京市某出版企业233名员工的生活方式和生物学健康危险因素中,不合理膳食的比例最大(47.21%),其余依次为身体活动少(28.33%)、血压偏高(26.18%)、超重/肥胖(25.75%)、吸烟(17.60%)、饮酒(18.88%)、使用放松药物(3.86%)。在心理健康危险因素方面,80.69%的员工自报存在压力大,工作满意度低和生活满意低者均占16.74%,总体健康感差者占9.44%。具备2个和3个健康危险因素的员工分别占26.92%和20.19%。低健康危险的员工占69.23%,高健康危险者占30.77%。 2.男性员工吸烟(χ2=36.922,P0.001)、饮酒(χ2=20.119,P0.001)、超重/肥胖(χ2=23.695,P0.001)、血压偏高(χ2=20.235,P0.001)的比例均高于女性,男性员工工作满意度低的比例高于女性(Z=-2.175,P=0.030)。 45岁以下员工身体活动少(χ2=5.926,P=0.015)、自报压力大(Z=-2.875,P=0.004)的比例高于45岁以上者；45岁以上的员工吸烟(χ2=6.676,P=0.010)和超重或肥胖(χ2=11.500,P=0.001)的比例高于45岁以下者。未婚及其他婚姻状况者饮酒的比例高于已婚者(χ2=4.219,P=0.040)。具有硕士及以上学位者身体活动少(χ2=5.084,P=0.024)、自报存在工作压力大(Z=3.121,P=0.002)的比例高于大学本科及以下学历者。已婚者生活满意度低的比例低于未婚及其他婚姻状况者(Z=3.812,P0.001)。男性员工具有的健康危险因素个数多于女性(Z=4.794,P.001),45岁以上者多于45岁以下者(Z=-2.287,P=0.022)。男性员工处于高健康危险的比例高于女性(χ2=11.379,P=0.001)。 3.40.77%的员工出现工作效率低下。未婚及其他婚姻状况者较已婚者出现工作效率低下的比例更高(χ2=8.979,P=0.003)。硕士及以上学历者较大学本科及以下学历者的工作效率低下更严重(Z=2.074,P=0.038),未婚及其他婚姻状况的员工较已婚者的工作效率低下更严重(Z=3.070,P=0.002)。 4.婚姻状况(OR=5.116,95%CI：1.000～26.185)、学历(OR=3.564,95%CI：1.260～10.087)及生活满意度(OR=3.981,95%CI：0.970～16.342)与工作效率低下有关联,未婚及其他婚姻状况者较已婚者更易出现工作效率低下,具有硕士及以上学位者较大学本科及以下学历者更易出现工作效率低下,生活满意度低者较生活满意者更易出现工作效率低下。员工具有的健康危险因素数与其工作效率低下级别之间存在相关性(rs=0.199,P=0.050)。处于高健康危险的员工工作效率低下程度高于低健康危险者(Z=2.553,P=0.011)。 5.经过1年零3个月的干预,143名员工自报膳食不合理的比例由47.55%降至29.37%(χ2=9.941,P=0.002)。其中,参加健康讲座的员工不合理膳食比例由基线时的52.54%降至25.42%(χ2=9.846,P=0.002)；读过电子邮件的员工不合理膳食比例由48.33%降至21.67%(χ2=9.143,P=0.003)。员工出现绝对工作效率低下的比例由基线时的36.36%增至48.48%(χ2=5.333,P=0.021),但干预前后相对工作效率低下的差别没有统计学意义(χ2=-156,P=0.265)。结论 1.北京市某出版企业员工存在的生活方式及生物学健康危险因素的比例从大至小依次为不合理膳食、身体活动少、血压偏高、超重/肥胖、吸烟、饮酒、使用放松药物。大部分员工至少存在一些生活或工作方面的压力,对工作和生活不满意的员工及总体健康感差的员工所占的比例均较小。 2.基线调查时40.77%的员工出现工作效率低下。未婚及其他婚姻状况者较已婚者存在工作效率低下的比例更大,且工作效率低下的程度更高。具有硕士及以上学位者较大学本科及以下学历者工作效率低下的比例更大,工作效率低下程度更严重。存在生活满意度低者较不存在者更易出现工作效率低下。员工具有的健康危险因素个数与工作效率低下级别存在关联。处于高健康危险的员工工作效率低下程度较低危险者严重。 3.经过1年零3个月的干预显示,健康讲座和健康知识邮件发送这两种健康促进方式对员工健康危险因素的干预均有效,二者均能使不合理膳食的员工比例下降。
[Abstract]:background
Abroad has been a large number of studies show that association between health risk factors and health related work efficiency is low, but because of the domestic and foreign enterprise organization form, medical security system and cultural differences, these results also failed to pay enough attention to domestic enterprises. At present, China's small and medium-sized enterprises still lack of guidelines of health promotion, to promote can change the employee's health status of health in the small and medium-sized enterprises, and what kind of health promotion can improve enterprise staff's health status is still not conclusive evidence. This study selected a publishing enterprise in Beijing as the site, to explore the relationship between health risk factors and health related employees of the enterprise, low working efficiency, and to promote the project evaluation the risk factors of health intervention in the enterprises to carry out health.
objective
1. describes the current status of health risk factors among the employees of a publishing company in Beijing.
2. to explore whether there is a relationship between health risk factors and inefficient work efficiency in a publishing enterprise in Beijing.
3. to explore whether the health promotion project of a publishing enterprise in Beijing can reduce the level of health risk factors for employees.
Method
This research adopts the self controlled experimental method. Through literature review and expert consultation, health risk assessment reference of the University of Michigan (HRA) questionnaire, the network medical service group health risk assessment questionnaire and the Mayo Clinic Health Risk Assessment Questionnaire, the study of health risk assessment questionnaire; reference "health and performance investigation of WHO the questionnaire (HPQ), the < > > fast working ability questionnaire (WPSI) questionnaire, the study of productivity questionnaire, the two merged into the" questionnaire of health and productivity survey. We selected staff of a publishing enterprise "in Beijing city as the research object, carries on the baseline survey, through 1 years and 3 months workplace health promotion intervention on health risk factors, were followed up for employees in the post intervention analysis of health risk factors and health related work efficiency The relationship between low and the influence of health promotion on the level of health risk factors is also discussed. And what health promotion ways have an impact on the level of health risk factors.
Result
1. baseline, lifestyle and biological health risk factors in Beijing, a publishing enterprise of 233 employees, unreasonable diet the largest proportion (47.21%), followed by less physical activity (28.33%), high blood pressure (26.18%), overweight / obesity (25.75%), smoking (17.60%), alcohol (18.88%), (3.86%) the use of drugs to relax. In the aspect of mental health risk factors, 80.69% of the employees are self-reported stress, low job satisfaction and life satisfaction low were accounted for 16.74%, poor sense of overall health accounted for 9.44%. with 2 and 3 health risk factors of employees accounted for 26.92% and 20.19%. low health the risk of employees accounted for 69.23%, high health risk accounted for 30.77%.
2. male employees smoke (x 2=36.922, P0.001), drinking (2=20.119, P0.001), overweight / obesity (2=23.695, P0.001), high blood pressure (x 2=20.235, P0.001) ratio is higher than that of women, male workers low job satisfaction ratio is higher than that of women (Z=-2.175, P= 0.030).
Employees under 45 years old have less physical activity (2=5.926, P=0.015), and the ratio of self reported pressure (Z=-2.875, P=0.004) is higher than that of people over 45 years old. Employees over 45 years old have a higher proportion of smoking (2=6.676, P=0.010) and overweight or obesity (x 2=11.500, P=0.001) than those under 45 years old.
Unmarried and other marital status, drinking a higher proportion of married persons (2=4.219, P=0.040). And with master degree have less physical activity (x 2=5.084, P=0.024), there are self-reported work pressure (Z=3.121, P=0.002) is higher than the proportion of undergraduate degree and below. The married proportion is lower than the low life satisfaction unmarried and other marriage status (Z=3.812, P0.001).
Male workers had more health risk factors than women (Z=4.794, P.001). Those over 45 years old were more than 45 years old (Z=-2.287, P=0.022). The proportion of male workers in high health risk was higher than that of women (2=11.379, P=0.001).
The 3.40.77% staff work efficiency. Unmarried and other marital status than married people appear low work efficiency a higher proportion (x 2=8.979, P=0.003). The low efficiency of master degree or above bachelor degree is more serious and the following qualifications (Z=2.074, P= 0.038), low working efficiency and other unmarried marriage the status of employees than married people more serious (Z=3.070, P=0.002).
4. marital status (OR=5.116,95%CI:1.000 ~ 26.185), education (OR=3.564,95%CI:1.260 ~ 10.087) and life satisfaction (OR=3.981,95%CI:0.970 ~ 16.342) are associated with low working efficiency, unmarried and other marital status were married were more prone to low work efficiency, and with master degree with bachelor degree and below were more prone to work efficiency low, low life satisfaction with life satisfaction are more likely to have low efficiency. There is a correlation between the number of employees with health risk factors and the work efficiency is low level (rs=0.199, P=0.050). In the high health risks to lower the efficiency of the staff is higher than the low health risk (Z=2.553, P=0.011).
5. after 1 years and 3 months after intervention, 143 employees from the daily dietary unreasonable proportion from 47.55% to 29.37% (2=9.941, P=0.002). Among them, the staff in health lectures unreasonable diet ratio from 52.54% to 25.42% at baseline (2=9.846, P=0.002); read electronic mail staff a reasonable diet increased from 48.33% to 21.67% (2=9.143, P=0.003). Employees absolute low working efficiency ratio from 36.36% to 48.48% at baseline (2=5.333, P=0.021), but relatively low working efficiency before and after the intervention, the difference was not statistically significance (2=-156, P=0.265).
conclusion
Lifestyle and health risk factors are biological employees of a publishing enterprise of Beijing city in 1. the proportion from large to small were unreasonable diet, physical inactivity, high blood pressure, overweight / obesity, smoking, drinking, drug use to relax. Most of the staff there are at least some live or work pressure, not satisfied with the work and the staff of life and overall health of poor staff proportion are small.
40.77% of the staff work efficiency of 2. at baseline. Unmarried and other marital status than married has low working efficiency and a greater proportion of the work efficiency of higher degree. And with master degree with bachelor degree and the following qualifications work efficiency of a greater proportion of low efficiency degree more serious. The existence of low life satisfaction is not being more prone to inefficiency. Association between health risk factors and the number of employees with low work efficiency at high level. The health risk of employees work efficiency is low under low level of serious danger.
3., after 1 years, 3 months' intervention, two health promotion methods such as health lectures and health knowledge mail were effective in intervention of employees' health risk factors, and two could reduce the proportion of employees who had unreasonable meals.

【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R131

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