心臟科醫師工作壓力與身心健康之關係

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2001; Moller et al., 1996; Kaplan et al., 1996; Miilunpalo et al., 1997; Liukkonen et al., 2004)  !"#$%&'()%*+ ,-    ! ! !   !"# !   !  ! ! !"   !"#$ !"#$%&'()  !"#$%   1     2-4    5  !"  !"#$%&'()*+,-./01(    1    !    2-4    5 !"  !"# !" 95%   !"#$%&'()*+,-./012

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17.3% (131/756 = 17.3) !"#$%&'(  !"#$%&'()*+,-."/$0  !"#$%&'()*+,-./!"0  !"#$%&'()*+,-./0 SPSS 12.0 !"#$%&'()*+,-./0  !"#$%&'( )*+,-./01  !"#$%&'()*+,-./! 5   !"# 20%  !"#$%&'()*  !"#$%&'() (linear regressions)  !" (logistic regressions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ronbach’s alpha !"#$%&'( 0.58  !

 !"#$%&'( (Cheng et al., 2000)  !"#$!%&'()*+,'(-36  ! 47  36.43%  !"#$%  !"#$%&'()*+,$$- 32  86  ! " # $ 65.27   ! " 9.46   Cronbach’s alpha 0.61  !"#$%&#  !"#$%&!"'62  ! 48  38.1%  !"#$%&'()*+ -   !"#$%&'()*+,-./01  !"#$ !"#$% 16   !"#$ (12.3%) 3  !"#$  !"#$%&'()*+,)*-./,0  !"#$%&'()*+,-. ()  !"#$%&

 !"#$%& Cronbach’s alpha  0.85 !" 62.3%  !"#$%&'(  !"#$%&'()&*+,-./01  !"# 59.2%  !"#$%&'()  !"#$%&'()*+,-./,01$ 54.6% !"#$%&'(%)*+,- !"#$% Cronbach’s alpha !"#$%&'(%)*+,- 0.8 !"#$%&'(%)*+,-  64.6%  !"#$%&#'()*#+,  !"#$%"&'()*+'(,-./  Cronbach’s alpha  0.80  56.9%   !"#$%&'()*+,-.+/012  50.7%  !"#$%&'()*+,-  ! !"#$%&'()*+,- " # $ % & ' ( ) # $ * + , - " Cronbach’s alpha 0.85  !"#$%&

()  !"#$%&'!"()  !"#$%&'()*+,-./01  !"#$%& 1.34  (range  1-10)  2.07  !"#$%&'()*+,- !"#$%&'()*+,-./012  !"#$%&'()*+,-./01 31  23.7%  ! "# 52  39.7% 

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() model 1 !"#$ (CHQ)  !"#$%&'()*+,-.%/0- !"#$%!"#$%&'()*+,-.%/0-&'()*+, - !"#$%&'()*+,-.%/0- !  !"#$%&'()*+,'-./012  !"#$%&'()*+,-./012  !"#$%&'($)*+,-.$/0  !"#$%&'()*+,-. -  !  !"#$%&'()*+,- -  !"  !"#$%&'()*+, -./01  !"#$%&'()*+,-./01  ! (p < 0.01) !"#$ -  !"  !"#$%&'()*+,-./#$%  !"#$%&'()*+,-./ (p < 0.05) !"#$%&'()*+,-./0 () model 2 !"  !"#$%&'()*+,-.%/0- !"#$%&'() - !"#$%&'()*+,-.%/0- !"#$%&  !"#$%&'()*+,-.'/01  !"#$%&'()*+ (p < 0.05)  !"#$%&'!()*+,-.-/0  -  !"#$%&'()*+, -  !  !"#$%&'()*+,-./  !"#$%&'()*+,-./0  15%  !"#$%&'()*+,  !"#$%&'()*+,

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 !"#$%&'()*+,-./01  !  !  95% CI for OR 95% CI for OR B(S.E.) OR B (S.E) O R Lower Upper Lower Upper  !  !"#$% 200  /  -1.98 (1.63) 0.14 0.01 3.32  200  /  -1.44 (1.94) 0.24 0.01 10.59  !"#$ 8  12  / 0  8  2.16 (1.53) 8.65 0.44 172.09  12  / 0  8  2.96 (2.55) 19.36 0.13 2864.63  !"  /  3.26 (1.72) 26.10 0.91 753.09  !  300  / 300  -1.49 (1.57) 0.23 0.01 4.85  !"#$  /  !" 2.52 (2.35) 12.42 0.12 1242.28  !"#$% /  !" 1.22 (1.86) 3.39 0.09 129.50  !"#$ 6  10  / 0  5  -0.18 (1.58) 0.84 0.04 18.63 11  15  / 0  5  -0.36 (2.02) 0.70 0.01 36.30  15  / 0  5  -2.14 (2.19) 0.12 0.01 8.67  !"#  /  0.95 (1.26) 2.59 0.22 30.36  !  !"  /  -2.45 (1.70) 0.09 0.01 2.42  !"  ! /  !" 0.09 (1.06) 1.10 0.14 8.71  !"  !" -0.24 (0.31) 0.78 0.43 1.43  !" -0.08 (0.23) 0.93 0.59 1.46  !" 0.48 (0.35) 1.62 0.81 3.23  !" -0.47 (0.35) 0.63 0.31 1.26  !" -0.23 (0.56) 0.80 0.27 2.37    /  -2.63 (1.43) 0.07 0.01 1.19 -1.35 (0.77) 0.26 0.06 1.18   /  -2.67 (1.87) 0.07 0.01 2.69 JCQ  !  /  -3.75 (1.60) 0.02* 0.01 0.54 -1.89 (0.77) 0.15* 0.03 0.69

Model Chi-square Improvement

χ 2 = 21.1 P = 0.52 χ 2 = 8.42 P = 0.02 *P < 0.05

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 !"#$%&'()*+ 62.8%  !"  !"#$%&'()* (23.2%)  !  200  !"#$%&'()* 10.17  65.9% !"#$ 8  ! 8  12  !"  10.9%  !"#$%& 12  !"  !"#$%&'()*#+,- !#./  !"#$ %&'()*+,&- ./#  !"#$#%&'($)*+,-./01  !"#$%&'()*+,#-.&/01  !  !"#$%&'()*+,"-./0  !"#$% (64.6%) !"#$%&' (62.3%)  !"#$%&'( (59.2%)  !"#$!% (54.6%) !"#$%&  !"#$%&'($)*+,-./01  !"#$%&'()&*+,-./01  !"#$%&'()*+,-./01%  !"#$%&'()*+ ,-./01  !"#$%&'()*+,-./012  !"#$%&'()*+,-./012  !"#$%!&'()*+,-./01  !"#$%&'()*+,-"#  !"#$%&"'()*+, !"  !"#$%&'()*+,(-./01!  !"#$%&'()*+,-./012  !"#$%&'()*+,-./012$  !"#$%&'()*+,-./012 

!"#$%&'()*+,- Karasek and Theorell !"#$%&'()*+,- !"#$%  !"#$"%& !'()*+,- !"#$%&'()*+,-./012  !"#$%&'()*+ (high strain)   !"#$%&'()*+,-. !/0  !"#$%&'()*+,-./012  !"#$%&'(  !"#$%&'()*+,$-./0  !"#$%&!"#'()*+,-./0  !"#$ %&'()*+,&-(./0  !"#$%&'()*'+,-"./ 0  !"#$%&'()*+,-./0123  !" 3D  !"#$%&'()*+  !"#$%&'()*+,-.$/01  !"#$%&'()*+,-./012  !"#$%&'()*+,-./0"12%  !"#$%&'()*+ ,-./012  !"#$%&'()*+,-./  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01#  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01#  !"#$%&' ! (cohort study)   !"#$%&'()*+,-./01  !"#$ Johnson  !"#$ Karasek  !"#$%&'()*+ (Johnson & Hall,

1988) !"#$%&'&()*+,-.  !"#$%&'()*+,-./01  !"#$%&'()* +,-./01  !"#$% Johnson  !"#$%&'  !"#$%&'()*+",-./01  !"#$%&'

 !

 (1994) !"#$%&'()*+,   ! 21(3) 153-165   !"#$ (2001) -  -    -  !" !"#$%&'(  !"#$%&'()*+,-./01  ! 21  6411-6419   !"#$!%&'!() (1997)  !"#$%&'()*+,-.-/0  !"#$ !"!#$ 13  332-341

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Elucidating the Relationships between Physician Job

Strains and Health

Duan-Rung Chen Cheng-Ta Chung

Abstract

Physician health has been largely ignored. This study assessed the principal factors associated with physician health in a cardiologist sample group. Job Demand Control model was applied to assess the psychosocial environment in which physicians work. Mental health was measured using the Chinese Health Questionnaire. Self-reported health status was also examined. A total of 131 cardiologists responded to questionnaires. Multiple logistic regression results demonstrated that physician self-reported health status was associated to stressors related to hospital management and the health care environment. Job strain was significantly associated with minor psychiatric distress. Employment in a medical center and/or as managerial staff was a health risk factor for cardiovascular disease. Preliminary results indicate that more objective physiological indictors assessing health are needed.

Key words: Physicians, job strain, health status

1

Associate Professor, Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University.

2

Director, Chia-I Veterans Genera Hospital.

Received: Mar. 18, 2005 Revised: Aug. 30, 2005 Accepted: Oct. 12, 2005

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