Quality of Life Investigation: Application for Workers and Colorectal Cancer Survivors in Taiwan

Autor: Shang-YuYang, 楊尚育
Rok vydání: 2018
Druh dokumentu: 學位論文 ; thesis
Popis: 106
BACKGROUND: Quality of life (QoL) has been advocated by World Health Organization for many years to emphasize the well-being of ordinary people, workers, and patients. Through the investigation of QoL, we can look at changes in a person’s wellbeing during employment or over the course of treatment to reduce the negative impact of work stress and illness on personal health. Therefore, this dissertation includes two studies. We investigated the factors influencing the QoL of packaging workers in Study 1. In Study 2, we applied healthy lifestyle education for CRC survivors to examine their changes in QoL. Packaging workers, which comprise the greatest number of laborers in the Taiwan semiconductor industry, generally have low work positions, little work control, and experience stress related to completing tasks within a limited time period. Their high-demand tasks and low decision or task control could result in negative effects such as occupational burnout. All of the above factors could influence their QoL and are thus worthy of exploration. Through an understanding of these factors, we can determine the factors that affect health in a company or organization and then improve and manage their environment and equipment so as to enhance employee health and QoL. Colorectal cancer (CRC) is one of the world’s most common cancers. CRC survivors suffer from this disease and related treatments, which thus deteriorates their QoL and activities of daily living (ADL), as well as causing them emotional distress. By exploring the factors influencing QoL, we plan to develop an education handbook to facilitate a healthy lifestyle and improve the QoL in this population. Aim The present dissertation has the following aims: Study 1 explores the factors influencing the QoL of packaging workers in a semiconductor plant. Study 2 determines the potential effects of healthy lifestyle education provided by occupational therapist on QoL, ADL and healthy lifestyle behaviors in CRC survivors, and also to explore the association between the improvements in the QoL, ADL, emotional distress and the healthy lifestyle factors and the educational intervention. Methods In Study 1, 247 packaging workers (162 male and 85 female; Mean age: 35.6 years old) were recruited in 2015 and 2016 from a semiconductor plant in Taiwan using convenience sampling. The questionnaire comprised four parts: demographics, the World Health Organization QoL (WHOQOL-BREF), an occupational burnout inventory, and the Nordic Musculoskeletal Questionnaire. The four domains of the WHOQOL-BREF were defined as outcome variables. Predictive factors included gender (reference: male), age (reference: ≤ 35), BMI (reference: ≤ 23), educational level (reference: below university), marital/partner status (reference: married/cohabiting), years of work (reference: ≤ 5), work shift (reference: day shift), personal burnout, work-related burnout, over-commitment to work, and the number of body parts with discomfort (0-9). Study 2 designed a randomized clinical trial (RCT) to examine the effect of occupational therapists’ use of the healthy lifestyle education on QoL, ADL and the healthy lifestyle behavior in CRC survivors. We recruited 68 CRC survivors from the cancer center of National Cheng Kung University Hospital, Taiwan between August 2017 and February 2018 and randomly assigned them into an occupational therapy (OT) intervention group and non-intervention group. Participants in the OT intervention group were given an OT consultation based on a CRC education handbook at discharge preparation and on 1-month, 3-month follow-up clinic; participants of the non-intervention group were given the same CRC education handbook only at discharge preparation. The primary outcome was the QoL measured using WHOOQOL-BREF. Secondary outcomes were changes in ADL, emotional distress and healthy lifestyle behaviors. Outcomes were examined in baseline (discharge preparation), 1-month and 3-months follow-up clinic. Results The findings of Study 1 showed that physical QoL was negatively correlated with night-shift work, personal burnout, and number of body parts with discomfort (p〈0.05). Psychological QoL was negatively correlated with night-shift work and personal burnout. Environment QoL was negatively correlated with being male, night-shift work, and personal burnout (p〈0.05). In Study2: the RCT findings showed statistically significant improvement on scores on two items in the WHOQOL-BREF, including “overall quality of life” (p〈0.05) and “negative feelings” (p〈0.05) in the OT intervention group. The findings also indicated that at the 1-month follow-up, improvements in physical health QoL, psychological health QoL and emotional distress were found to be significantly associated with participation in activities (p〈0.05~0.01); in the 3-month follow-up, improvements in physical health QoL was found to be significantly associated with more exercise (p〈0.01). Conclusion In the future, we can try to improve the QoL among packaging workers by reducing musculoskeletal discomfort, personal burnout, and by improving work schedules. The findings of Study 2 showed that having occupational therapists work with CRC survivors can help these survivors have better QoL. It could be beneficial for CRC survivors to receive occupational therapist’s consultations based on healthy lifestyle for discharge preparation and in the first three months after discharge.
Databáze: Networked Digital Library of Theses & Dissertations
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