零抬舉照護：對於臺灣照服員長期照護之影響

研究目的NO-Lift Policy （不徒手搬運）已在先進國家中為主要照護模式。而在台灣，雖有倡議該照護模式，但普遍度接受度低，照顧服務員長期仰賴雙手、腰部、背部等肌肉協助「搬運」被照顧者，高重複性的動作導致照服人員普遍患有肌肉骨骼的疼痛，積累成年下來的身體不適造成的職業傷害，進而影響照服員無法續任工作，成為照服人員人力缺口因素之一。輔具的運用，可有效降低照服員的工作負荷，減少肌肉骨骼不適的發生。本研究探討影響照服員使用移位輔具相關因素，進一步了解零抬舉照護對於台灣照服員長期照護的影響。研究方法利用PRECEDE-PROCEED Model探討照服員對於移位輔具的認知、使用經驗及工作壓力，並使用敘述性統計、卡方分析及羅吉斯回歸，進一步分析在有移位輔具資源下，影響移位輔具使用之相關因素。以自擬問卷進行線上發放，問卷內容包含傾向因素、使能因素、增強因素及移位輔具使用之情形，針對台中市在線照服員，於111年02月至111年04月，進行網路問卷發放，共回收49份問卷。研究結果發現工作時間中有使用移位輔具狀況，僅38.8%的照服員有使用移位輔具，大多數照服員還是有使用徒手搬運（89.8%），其次是使用非移位類型的工具（如：床單）有44.9%，協助被照顧者移轉位，其他類型的移位輔具則是比較少人使用。 討論年齡與從事照服員經歷，是影響傾向因素的相關因素，同時年齡也是影響移位輔具使用之相關因素。工作中使用移位輔具的狀況，是影響使能因素的相關因素。工作中移轉位次數並非影響照服員因移轉位造成的工作壓力，影響增強因素的相關因素是照服員從事的單位。

Objective“NO-Lift Policy” has become the dominant mode of care in advanced countries. In Taiwan, although this care model has been advocated, it is not widely accepted. Caregivers have long relied on muscles such as hands, waist, and back to use human power to move the patients. The highly repetitive movements cause caregivers to suffer from musculoskeletal pain and occupational injuries caused by the accumulation of physical discomfort in adulthood, which in turn affect the inability of caregivers to continue working, become one of the factors for the manpower shortage of caregivers. The use of assistive devices can effectively reduce the workload of the caregivers and reduce the occurrence of musculoskeletal discomfort. The main purpose of this study is to explore the factors that affect the use of assistive devices for nursing aide, and further to understand＂NO-Lift Policy＂the effect of nursing aide long-term care in Taiwan.Research methodsIn this study, the PRECEDE-PROCEED Model was used to explore the related factors that affect the use of assistive devices for caregivers in Taiwan. Using descriptive statistics, Chi-square test and Logis regression to analyze the relevant factors affecting the use of assistive devices. Self-designed structured questionnaire was used which included predisposing factors, enabling factors, enhancing factors, and the use of assistive devices. The online questionnaire was filled out by caregivers in Taichung City. From Feb 2022 to April 2022, a total of 49 effective questionnaires were received. ResultsOnly 38.8% of the caregivers used assistive devices during working time, and most of the caregiver still used human power by hand (89.8%) to transfer patients. Types of tools (such as bed sheets) are used by 44.9% of the people to assist the patient in shifting.ConclusionAge and the experience of working as an attendant are related factors affecting the tendencies, and age is also a related factor affecting the use of assistive devices. The use of assistive devices at work is a relevant factor affecting enabling factors. The number of shifts at work does not affect the work pressure of the attendant due to the shift, and the related factor that affects the enhancement factor is the unit that the attendant is engaged in.