اثرات آموزش های ارگونومیک و سلامت در منافع کار،توانایی و سلامت عمومی کار سالمندان در رانندگان حمل و نقل شهری
|کد مقاله||سال انتشار||تعداد صفحات مقاله انگلیسی||ترجمه فارسی|
|6674||2000||9 صفحه PDF||سفارش دهید|
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Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : International Journal of Industrial Ergonomics, Volume 25, Issue 5, May 2000, Pages 503–511
Public urban transport drivers of the Munich Transportation Authority (n=122) with an average age of 50 years participated in 20 health days with full paid worktime over one year. The training consisted of physical exercise, professional skills training and self-experience in groups. The evaluation instruments were the work ability index (WAI) developed by the Finnish Institute of Occupational Health and the effect typology (ET) developed by the Austrian Institute of Occupational Health Promotion (IBG-Österreich). No changes were found in the WAI score. The ET evaluated for 50% of the participants the optimal effect “evolution”, i.e., psychobiological and noetic changes. A variance analysis of the WAI pre–post differences according to the effect classes of the ET showed significant differences, namely an increase in the WAI in the evolution group and a drop in the recovery group. The thoughts on early retirement decreased in the “evolution group”. The improvement of work ability and interest in work is essential for keeping elderly workers at work. The “individual” health training in Munich led to a rise of the WAI and indicated that, owing to its elements, this programme had an impact on ergonomics and relations at workplace
Researchers at the Finnish Institute of Occupational Health (FIOH) defined an “ergonomic triangle” of levels of health-promoting interventions to achieve an age-related work environment and sustainable improvement of work ability and health (Ilmarinen and Tuomi, 1993).This triangle is the ergonomic essence for evaluating successful interventions by using the work ability index (WAI) in the Finnish “Respect for the Ageing” programme. The WAI is an evaluation questionnaire which assesses the individual's ability to cope with work demands and assigns work ability to classes ranging from good to poor. The index bears a high predictive potential for early retirement (Tuomi et al., 1994) and death. In our evaluation research of occupational health promotion we have focussed on a second dimension which we consider important for keeping older workers healthy at work, namely interest in work. Staying in the work process must be founded on both work ability and interest in work. This hypothetical model is based upon a theory with a salutogenic paradigm: the “Existence Analysis” of Frankl (1987), an anthropological and psychotherapeutic method which is highly useful for “salutogenic” research in occupational health promotion and ergonomics.Based upon Frankl's work, we have developed the evaluation instrument called “Effect Typology (ET)” (Karazman et al., 1994) of occupational health promotion. The ET evaluates the salutogenic dynamics of a person. It was developed while evaluating the health promotion programme of 400 drivers who were employed by the Munich Public Transportation Authority. In 1995 and 1996 we made a co-evaluation of the programme both, by means of the WAI and by the ET to further validate the ET and to investigate the processes of occupational health promotion in general. 1.1. The effects of occupational health promotion The effects of occupational health promotion on health, well-being and workability (i.e. the quality of a health promotion programme) can be measured by evaluating the quality of its subjective effects on the workers and participants themselves. The subjective approach of the WAI has made it possible to examine working life, health promotion, and the influences on both. With our “Effect Typology” we have tried to define subjective effects of health promotion programmes on the basis of the bio–psycho–noetic model of human life of Frankl (1982), to measure the quality of occupational health promotion and to predict, whether its effects on somatic and psychic health are of short, medium, or long term (Karazman et al., 1994). These effects should be achieved by implementing specific elements in the programme like physical training, psychobiological training, stress management and social skills, and diet counselling. These elements are important for occupational functioning of transport drivers. Physical training was introduced to improve endurance and posture while psychological training was introduced and included general relaxation training, concentration training, visualisation, etc. to improve general relaxation. The stress management module and the social skill training should help the drivers in achieving new attitudes towards work-related stressors like responsibility for passengers, conflicts with passengers, lack of recognition, etc. Self-experience groups supported the social skill training. The diet counselling was used to address the specific demands of drivers working in shift work. As described above, we used the WAI and the ET to measure the quality of the health promotion programme and its effects on workability, health and work interest. With the ET we first defined the following qualitative hierarchy of the health effects of an occupational health promotion programme: recovery, relaxation, and evolution (Table 1).This typology is hierarchic, that is a “lower” health effect quality is automatically included in the next “higher” one, but no effect is inferior to the other because an optimal occupational health promotion strives to achieve all three effects (i.e., recovery, relaxation, and evolution). Moreover, involutional dynamics followed by a deterioration of health, work ability, and well-being or loss of interest in private and working life could be observed in each year of the programme. Even an occupational health promotion programme can have pathogenic “side-effects” and cause aversive emotions, stress, reluctance, social phobia, illness or accidents at the workplace. Therefore, a fourth class of effects, namely a category of deterioration, of “negative” effects, had to be defined. In Table 2 the theoretical impacts of this ET are presented.Based on the ET, we have developed and investigated methods for evaluating salutogenic effects of occupational health promotion programmes and intervention measures. The main part of this research work was done during the four subsequent one-year health promotion programmes carried out by the Munich Urban Transportation Authority for their elderly drivers. For details of this research we would like to refer to the paper “Effect-Typology and Work Ability Index – Evaluating the Success of Health Promotion in Elder Workforce” (Karazman et al., 1999), which will be published in the Journal of Experimental Aging Research.
نتیجه گیری انگلیسی
The Munich health promotion programme proved to bear a high salutogenic potential. Not only did the psychobiological parameters of health, well-being and work ability improve in the majority of participants, but so did work interest, personal development and noetic dynamics. This concurrence of psychobiological and noetic changes, evaluated by the ET in the majority of participants, was called “evolution” effect. Participants with such an “evolution” effect showed a significant increase in the WAI score and a decrease in thoughts on early retirement during the programme. In participants with only an improvement of the psychobiological parameters (“relaxation” or “recovery”) in our ET the WAI score dropped and thoughts on early retirement rose during the year of the programme. This coincidence of evolution effect, WAI increase, and decreasing thoughts on early retirement supports our hypothesis that the synergy of improved work ability and increased work interest, i.e., the synergy of psychobiological and noetic dynamics, is a prerequisite for keeping workers in the work process and work force. It is important to note that WAI scores in the “evolution” group rose and WAI scores in the other effect groups remained unchanged, as the Munich occupational health promotion programme was, at first sight, an “individual training programme” and a measure of behaviour prevention. An increase in the WAI score suggests a long-term improvement of health and work ability. And according to the FIOH such a long-term improvement can only be achieved via interventions in all three dimensions of the “triangle of occupational health promotion”. This premise and the increase of the WAI score indicate that the majority of drivers felt that the programme had an impact not only on their “individual” psychobiology, but also on ergonomics at work and relationships at the workplace. According to the structure of the programme, this three-dimensional effect of the programme in the “evolutionists” was induced by the following improvements: • improvement of psychological and somatic resources and abilities, • improvement of social relations among drivers due to and during group process, • improvement of the ergonomic fit between psychosocial work demands (communication, handling of troublesome passengers, coping time pressure, etc.) and the personal skills of the drivers. Our evaluation of this “individual” training showed, on average, unchanged WAI scores for all drivers, on the one hand, an increase in the WAI scores in the “evolution” group. An evolution effect is given when not only psychobiological but also noetic dynamics are induced. The noetic dynamics developed, as interests were renewed and work became effortless again because of improved psycho-biological and ergonomic fitness. The Munich health programme combined classical health training with professional skills training and self-experience in groups. Furthermore, thoughts on early retirement decreased in the evolution group. Previous studies have suggested that the frequency of thoughts on early retirement bear a significant predictive potential for early retirement. Thus on the basis of the two prognostic indicators, the WAI and frequency of thoughts on early retirement, we could expect drivers of the evolution group to stay longer in the work process, but this did not hold true for the other groups without induction of noetic dynamics. This result supports our hypothesis that, so as to keep the elder workforce in the work process, it is absolutely necessary to improve work ability and to increase interest in work by health promotion programmes.