關鍵字：
經痛(Dysmenorrhea)、職場女性(Women Workers) 、員工協助方案(Employee Assistance Program)
英文關鍵字
：
Dysmenorrhea、Women Workers 、Employee Assistance Program
摘要
：
<div>產業快速轉變、生活水準不斷提昇，擴大女性就業機會，近年來政府亦積極推展性別工作平等，促進女性就業，依<span>行政院主計處「人力資源調查」顯示，我國性別工作平等法於</span>91年3月8日立法通過，臺灣女性參與勞動市場比率逐年遞增，由91年46.6%上升至99年49.9%，9年間提升3.3個百分點[1]，顯見女性在職場角色的重要性，職場女性由於傳統刻板社會性別影響，身兼數職，除需要在職場與家庭間找到平衡，進入職場亦面臨新的健康威脅，尤其是女性與男性不同生理構造，女性健康由於受到荷爾蒙的影響，在育齡期女性容易出現與月經相關的疾病，及懷孕與生產的問題，所以，職場女性的健康危害問題不容忽視。</div>
<div>過去研究已指出環境壓力如生活或工作壓力都可能影響內分泌及出現經期疾病，經期疾病可能降低女性生活品質，及因工作缺席及生產力降低導致嚴重的經濟損失，很多危險因子包含體重、種族、生活事件、壓力，及工作環境如輪班、噪音、振動、有機溶劑暴露等都會改變經期功能[2,3]。國內研究發現女性勞工由於不同的工作狀況、輪班及工作姿勢等均會影響女性的生理、生育及經期健康[4,5,6]。</div>
<div>婦女在經期間或經期前後，明顯出現的下腹墜痛、腰酸或腰痛，以致影響生活、學習和工作稱為「經痛」，根據統計90%以上的婦女在一生中曾有過經痛的經驗，經痛依其特性可分為原發性經痛與續發性經痛二大類，「原發性痛經」又稱功能性經痛，大多屬於排卵性的週期，通常並無組織或構造上的異常，其疼痛的程度和 體內所含的前列腺素量有關，主要原因是因子宮為了要排出較 大量的月經血或較大片剝落下來的子宮內膜，過度強烈收縮所造成。「續發性經痛」是指有組織或構造上的異常，疼痛隨週期而加劇，嚴重時可合併腹瀉、嘔吐、冒冷汗、昏厥，進而影響生活及工作，此需找醫師診治。 育齡期女性之經痛反映內分泌失調，嚴重經痛者甚至會有不孕的問題，衍生更長期、更複雜的求醫歷程，甚至中輟工作。已屆停經階段的經痛通常與疾病有關，若能早期就醫處理則對勞動生產力影響減至最小。</div>
<div>原發性經痛是年輕婦女在職場週期性缺席常見的婦科疾病，過去研究指出沒有骨盆腔之疾病之原發性經痛的盛行率佔43-90％，嚴重經痛致無法上學、工作之續發性經痛盛行率約佔10-15％ <span>[7,8]</span>。一項針對台灣一家醫學中心之護理人員進行經期功能與生活型態及工作狀況調查研究指出，70％的護理人員有偶爾及經常發生經痛的情形，經常發生經痛佔30％[3 ]；經痛與年齡、抽菸、生活事件及婚姻等有關，較少規律運動及工作較費力者有較高的經期不適[9]；另一項研究指出高壓力婦女比低壓力有高出2倍發生經痛的風險，有高壓力且曾有經痛史的婦女亦較低壓力且不曾有經痛史有高出10倍發生經痛風險[10]。國內研究亦發現護理人員及空服員輪班在兩個月內累積到15天以上者，較6天以內者發生經痛的機率高出1.58倍，非典型工時且輪大夜班者在生理期發生疼痛的危險比為典型工時的1.47倍[4]。夜間工作者有較高比率月經不規則及經痛的現象[5]。女性空服員、百貨公司服務員與醫務人員有70％生理期有不適感。護理人員服務病房單位的不同及不同的工作職階與經痛率有相關，百貨公司員工不同的工作類型與經痛率有關，焦點團體分析上，發現大多數女性都有經期不適經驗，建議公司應重視工作環境對於女性經期健康的問題[11]。政府為維護職場上性別工作平等，亦積極推動性別工作平等法之各項措施，營造友善職場環境，依本會「性別僱用管理調查」顯示，事業單位對於各項措施如生理假、流產假、陪產假、家庭照顧假等實施比率也較91年成長許多，99年間事業單位有提供「生理假」比率由91年17.3％上升至99年45.4％[12]，顯見掌握國內職場女性經痛與工作危險因子及營造友善工作環境是項重要議題。</div>
<div>經痛會影響女性員工的出缺席及與工作績效，造成個人經濟損失，女性員工生理假天數高，影響職場產能，產生間接成本問題，造成雇主經濟損失，為能讓職場女性的工作健康保護更加周延，有效改善工作條件促進經期健康，讓雇主及女性勞工達雙贏，掌握職場女性勞工經痛與工作危險因子，及有效改善經痛方法，並輔導提昇事業單位進行經期健康管理能力，都是需要政府與企業共同合作努力，鑑此特規劃本研究案。</div>;There are two purposes of this research. First, explore the relativity of different industry, work category, equipment environment, working ways (standing posture, sitting posture) and shift duty system with female menstrual cramp by questionnaire, and when menstruation took place, the supported project content provided by the employer and occupation nurses. Furthermore, put forth the menstrual health management and menstruation friendly workplace meaures etc. concretely suggestions. Besides, establish a menstruation information website as health guidelines. The subjects of this study are emprise nursing personnel and the content of questionnaire includes personal attributes (nursing seniority, experiences of gynecology specialty and menstrual cramp, and the serving quantity of dealing dysmenorrheal), service unit data (industry category, enterprise scale, employee’s sex comparison), attribution of menstruation and work (work condition harm, work harm, organization cultural environment harm), the goodwill measures of career menstruation (supporting environment, health service, strengthen personal technical ability) and the offering of occupation nurses’ menstrual caring. Respectively hold two curriculum classes of occupation nursing credit certification in Taipei and Kaohsiung and member communication network. The former with paper pen questionnaire method, the latter adopts the network method to fill a questionnaire, and add up to recall 302. Based on the respondents’ answering contents, proceed the logically debugging and examine the consistency between ask and answer, delete the questionnaire with doubt, the effective questionnaire is 280.According to the responses, the occupation nurses seniority even distributes below 5 years, between 5-10 years, and above 10 years; 21.1% contains gynecology specialty experience, 73.9 % comes from a manufacturing industry, mostly from electronics manufacturing industry; enterprise scale also even distributes from less than 500 people to more than 2000 people; 25.4% occupation nurses’ personnel usually has menstrual cramp, 37.1% never/rarely, 37.1% occasionally, 63.2% chooses to take a medicine in severe painful condition, 47.9 % thinks to use a medicine to effectively smooth a menstrual cramp.Relatively related work factors from occupation nurses’ subjectivity perception to menstrual cramp, one after another is big pressure from operation load (65.4%), shift duty (51.4%), standing posture for a long time (50.4%), night shift (47.1%), unemployed big pressure (44.3%), often carry heavy objects (40.7%), excessively strict management system (38.9%), often go to abroad on business (36.8%), cannot give attention to both work and family (32.9%), work overtime (32.5%), low temperature working place (32.5%), quickly work/ take a stroll in the company/ factory (31.4%). Among them, the work condition endangers a factor (7) to have at most, secondly is work harm factor (3), the organization cultural environment harm factor (2) less. Usually/always experienced menstrual cramp has higher ratio of work attribution factor than never/rarely/occasionally, ex-5 one after another is big pressure from operation load (71.8%), long time standing posture (60.6%), shift duty (56.3%), unemployed big pressure (54.9%), and night shift (53.5%). The nurses’ specialty experience and seniority do not influence the ratio of menstrual cramp attribution to work factor. Career menstruation goodwill measures on creating healthy supporting environment, includes a fountain machine to provide tepid water (88.5%), physiology leave (77.4%), rest room (74.6%), declare the concepts of sexual equality (61.8%), selling warm beverages (50.4%); the actions of health service include to provide the fomentation measures (75.3%), pap smear (54.1%); enterprise seldom provides to strengthen the personal coping skills. The ratio of offering of menstruation goodwill measures in electronics manufacturing industry and the emprise scale above 1000 people is higher than non-electronics manufacturing industry and non-manufacturing industry. The care of menstrual cramp provided by occupation nurses is not related to the industry category.The webpage of menstruation health information is named”Empower Menstruation”, The slogans of webpage are “More knowledge, less menstrual cramp”, “Learn the perception of menstrual cramp, and defend the labor’s health”. The configuration contents of menstrual cramp knowledge net include to know mentrual leave, menstrual cramp DIY, menses diary, menses reinforcement, related resource link and occupation nurse working group. The occupation nurse working group includes assistance project, menstrual cramp assessment, and health education resource download and discussion area.The results of survey found that menstrual health literacy shortage of occupation nurses, personal menstrual cramp experience have an influence upon work factor and menstrual cramp relativity viewpoint. Consequently suggest the work point for next year is the occupation nurses’ training of menstrual health literacy, collocate already configured empowerment menstruation website, promote the performance ability of employee’s menstrual cramp assistance project, and precede the evaluation test. Menstruation friendly workplace measures will initiate the enterprise concern and examine work condition, physical environment and work posture to turn worse a phenomenon of menstrual cramp by guiding. In addition, suggest to inlet employee’s health questionnaire inspection into the menstrual cramp assessment, normally place the menstruation health topic into human resource education training curriculum.
計畫摘要
：
<div>產業快速轉變、生活水準不斷提昇，擴大女性就業機會，近年來政府亦積極推展性別工作平等，促進女性就業，依<span>行政院主計處「人力資源調查」顯示，我國性別工作平等法於</span>91年3月8日立法通過，臺灣女性參與勞動市場比率逐年遞增，由91年46.6%上升至99年49.9%，9年間提升3.3個百分點[1]，顯見女性在職場角色的重要性，職場女性由於傳統刻板社會性別影響，身兼數職，除需要在職場與家庭間找到平衡，進入職場亦面臨新的健康威脅，尤其是女性與男性不同生理構造，女性健康由於受到荷爾蒙的影響，在育齡期女性容易出現與月經相關的疾病，及懷孕與生產的問題，所以，職場女性的健康危害問題不容忽視。</div>
<div>過去研究已指出環境壓力如生活或工作壓力都可能影響內分泌及出現經期疾病，經期疾病可能降低女性生活品質，及因工作缺席及生產力降低導致嚴重的經濟損失，很多危險因子包含體重、種族、生活事件、壓力，及工作環境如輪班、噪音、振動、有機溶劑暴露等都會改變經期功能[2,3]。國內研究發現女性勞工由於不同的工作狀況、輪班及工作姿勢等均會影響女性的生理、生育及經期健康[4,5,6]。</div>
<div>婦女在經期間或經期前後，明顯出現的下腹墜痛、腰酸或腰痛，以致影響生活、學習和工作稱為「經痛」，根據統計90%以上的婦女在一生中曾有過經痛的經驗，經痛依其特性可分為原發性經痛與續發性經痛二大類，「原發性痛經」又稱功能性經痛，大多屬於排卵性的週期，通常並無組織或構造上的異常，其疼痛的程度和 體內所含的前列腺素量有關，主要原因是因子宮為了要排出較 大量的月經血或較大片剝落下來的子宮內膜，過度強烈收縮所造成。「續發性經痛」是指有組織或構造上的異常，疼痛隨週期而加劇，嚴重時可合併腹瀉、嘔吐、冒冷汗、昏厥，進而影響生活及工作，此需找醫師診治。 育齡期女性之經痛反映內分泌失調，嚴重經痛者甚至會有不孕的問題，衍生更長期、更複雜的求醫歷程，甚至中輟工作。已屆停經階段的經痛通常與疾病有關，若能早期就醫處理則對勞動生產力影響減至最小。</div>
<div>原發性經痛是年輕婦女在職場週期性缺席常見的婦科疾病，過去研究指出沒有骨盆腔之疾病之原發性經痛的盛行率佔43-90％，嚴重經痛致無法上學、工作之續發性經痛盛行率約佔10-15％ <span>[7,8]</span>。一項針對台灣一家醫學中心之護理人員進行經期功能與生活型態及工作狀況調查研究指出，70％的護理人員有偶爾及經常發生經痛的情形，經常發生經痛佔30％[3 ]；經痛與年齡、抽菸、生活事件及婚姻等有關，較少規律運動及工作較費力者有較高的經期不適[9]；另一項研究指出高壓力婦女比低壓力有高出2倍發生經痛的風險，有高壓力且曾有經痛史的婦女亦較低壓力且不曾有經痛史有高出10倍發生經痛風險[10]。國內研究亦發現護理人員及空服員輪班在兩個月內累積到15天以上者，較6天以內者發生經痛的機率高出1.58倍，非典型工時且輪大夜班者在生理期發生疼痛的危險比為典型工時的1.47倍[4]。夜間工作者有較高比率月經不規則及經痛的現象[5]。女性空服員、百貨公司服務員與醫務人員有70％生理期有不適感。護理人員服務病房單位的不同及不同的工作職階與經痛率有相關，百貨公司員工不同的工作類型與經痛率有關，焦點團體分析上，發現大多數女性都有經期不適經驗，建議公司應重視工作環境對於女性經期健康的問題[11]。政府為維護職場上性別工作平等，亦積極推動性別工作平等法之各項措施，營造友善職場環境，依本會「性別僱用管理調查」顯示，事業單位對於各項措施如生理假、流產假、陪產假、家庭照顧假等實施比率也較91年成長許多，99年間事業單位有提供「生理假」比率由91年17.3％上升至99年45.4％[12]，顯見掌握國內職場女性經痛與工作危險因子及營造友善工作環境是項重要議題。</div>
<div>經痛會影響女性員工的出缺席及與工作績效，造成個人經濟損失，女性員工生理假天數高，影響職場產能，產生間接成本問題，造成雇主經濟損失，為能讓職場女性的工作健康保護更加周延，有效改善工作條件促進經期健康，讓雇主及女性勞工達雙贏，掌握職場女性勞工經痛與工作危險因子，及有效改善經痛方法，並輔導提昇事業單位進行經期健康管理能力，都是需要政府與企業共同合作努力，鑑此特規劃本研究案。</div>;There are two purposes of this research. First, explore the relativity of different industry, work category, equipment environment, working ways (standing posture, sitting posture) and shift duty system with female menstrual cramp by questionnaire, and when menstruation took place, the supported project content provided by the employer and occupation nurses. Furthermore, put forth the menstrual health management and menstruation friendly workplace meaures etc. concretely suggestions. Besides, establish a menstruation information website as health guidelines. The subjects of this study are emprise nursing personnel and the content of questionnaire includes personal attributes (nursing seniority, experiences of gynecology specialty and menstrual cramp, and the serving quantity of dealing dysmenorrheal), service unit data (industry category, enterprise scale, employee’s sex comparison), attribution of menstruation and work (work condition harm, work harm, organization cultural environment harm), the goodwill measures of career menstruation (supporting environment, health service, strengthen personal technical ability) and the offering of occupation nurses’ menstrual caring. Respectively hold two curriculum classes of occupation nursing credit certification in Taipei and Kaohsiung and member communication network. The former with paper pen questionnaire method, the latter adopts the network method to fill a questionnaire, and add up to recall 302. Based on the respondents’ answering contents, proceed the logically debugging and examine the consistency between ask and answer, delete the questionnaire with doubt, the effective questionnaire is 280.According to the responses, the occupation nurses seniority even distributes below 5 years, between 5-10 years, and above 10 years; 21.1% contains gynecology specialty experience, 73.9 % comes from a manufacturing industry, mostly from electronics manufacturing industry; enterprise scale also even distributes from less than 500 people to more than 2000 people; 25.4% occupation nurses’ personnel usually has menstrual cramp, 37.1% never/rarely, 37.1% occasionally, 63.2% chooses to take a medicine in severe painful condition, 47.9 % thinks to use a medicine to effectively smooth a menstrual cramp.Relatively related work factors from occupation nurses’ subjectivity perception to menstrual cramp, one after another is big pressure from operation load (65.4%), shift duty (51.4%), standing posture for a long time (50.4%), night shift (47.1%), unemployed big pressure (44.3%), often carry heavy objects (40.7%), excessively strict management system (38.9%), often go to abroad on business (36.8%), cannot give attention to both work and family (32.9%), work overtime (32.5%), low temperature working place (32.5%), quickly work/ take a stroll in the company/ factory (31.4%). Among them, the work condition endangers a factor (7) to have at most, secondly is work harm factor (3), the organization cultural environment harm factor (2) less. Usually/always experienced menstrual cramp has higher ratio of work attribution factor than never/rarely/occasionally, ex-5 one after another is big pressure from operation load (71.8%), long time standing posture (60.6%), shift duty (56.3%), unemployed big pressure (54.9%), and night shift (53.5%). The nurses’ specialty experience and seniority do not influence the ratio of menstrual cramp attribution to work factor. Career menstruation goodwill measures on creating healthy supporting environment, includes a fountain machine to provide tepid water (88.5%), physiology leave (77.4%), rest room (74.6%), declare the concepts of sexual equality (61.8%), selling warm beverages (50.4%); the actions of health service include to provide the fomentation measures (75.3%), pap smear (54.1%); enterprise seldom provides to strengthen the personal coping skills. The ratio of offering of menstruation goodwill measures in electronics manufacturing industry and the emprise scale above 1000 people is higher than non-electronics manufacturing industry and non-manufacturing industry. The care of menstrual cramp provided by occupation nurses is not related to the industry category.The webpage of menstruation health information is named”Empower Menstruation”, The slogans of webpage are “More knowledge, less menstrual cramp”, “Learn the perception of menstrual cramp, and defend the labor’s health”. The configuration contents of menstrual cramp knowledge net include to know mentrual leave, menstrual cramp DIY, menses diary, menses reinforcement, related resource link and occupation nurse working group. The occupation nurse working group includes assistance project, menstrual cramp assessment, and health education resource download and discussion area.The results of survey found that menstrual health literacy shortage of occupation nurses, personal menstrual cramp experience have an influence upon work factor and menstrual cramp relativity viewpoint. Consequently suggest the work point for next year is the occupation nurses’ training of menstrual health literacy, collocate already configured empowerment menstruation website, promote the performance ability of employee’s menstrual cramp assistance project, and precede the evaluation test. Menstruation friendly workplace measures will initiate the enterprise concern and examine work condition, physical environment and work posture to turn worse a phenomenon of menstrual cramp by guiding. In addition, suggest to inlet employee’s health questionnaire inspection into the menstrual cramp assessment, normally place the menstruation health topic into human resource education training curriculum.