臺灣博碩士論文加值系統

緣起： 2002年初，印尼雅加達因大雨而氾濫成災，由印尼慈濟人提出的遷建大愛村的計畫因此應運而生。在遷建之後，以探討大愛一村、二村居民，健康適應與環境品質為主要目標，經過多次與住入大愛村的社區居民訪談後，我們了解居民最關心的健康議題中，以結核病問題排行首位。

目的：利用健康促進方法，提升大愛一村社區居民及慈濟學校學生對結核病的知識，進而影響對結核病的態度及行為。

方法：本研究使用準實驗設計，基於現實情境的限制，分派實驗組及對照組。實驗組為：大愛一村的社區居民（N=650）及大愛一村的慈濟學校（N=817）；對照組為：大愛二村社區居民（N=541）及北雅加達的三所公立學校學生（N=825）。對社區居民進行之健康促進為慈濟學生家長的結核病講座、社區結核病防治教育、肺部X光篩檢及發放結核病的海報及月曆；而對慈濟學生則是媒體宣傳、活動宣傳及主題教育。使用問卷調查於健康促進推動前後，實驗組及對照組的社區居民及學生，他們在結核病知識、對結核病的態度及預防結核病的行為三大部分的分數。利用卡方檢定、ANOVA、F檢定及T-Test比較健康促進前後，社區居民及學生對於結核病的知識、態度及行為分數的差異。

結果：推對健康促進後， 整體上，大愛一村的社區居民在結核病的知識分數上，進步幅度顯著（P=0.046）高於大愛二村社區居民；女性比男性有較好的結核病知識（p=0.038）；教育程度較高者，結核病知識程度較高（p<0.001）。學生部份：慈濟學生在結核病的知識及態度上，分數都顯著（p<0.001）高於公立學校的學生分數；女學生的知識程度較男學生好（p=0.002）；學歷越好，知識程度也越好（p<0.001）。

結論：以社區結合學校做為多元密集結核病相關的健康促進推動，是有成效的，而學校亦可做為聯繫社區居民的一個管道。未來可按照此研究的健康促進模式，在其他較密集的村落或是有學校與社區居民連繫較強的地區，推廣結核病相關知識，進而達到預防結核病的效果。

Origin: In the early 2002, Jakarta, Indonesia was flooded by heavy rain. The Tzu-chi foundation in Indonesia brought up a relocation plan. After the relocation, our main goal of the study were health adaptation and quality of the environment for those who lived in Da-Ai villages I and II. Through repeatedly interviews with the residents in Da-Ai villages, we understood that the most concerned disease is Tuberculosis (TB).

Objective: To use health promotion to enhance knowledge, attitude and behavior toward tuberculosis of the residents in Da-Ai village I and Tzu-chi school students.

Method: This study used quasi-experimental design, based on the limitations of the real situation, to distribute participants into the case group and control group. The case group: Da-Ai village I (N=650) and Tzu-chi school in Da-Ai village I (N=817). The control group: Da-Ai village II (N=541) and three public schools in north Jakarta (N=825). The health promotion applied in Da-Ai village I included TB lectures for parents of students in Tzu-chi schools, education about TB control and prevention in community, chest X-ray screening and propaganda using TB posters and calendars. The health promotion applied in Tzu-chi school included media disseminating, activity disseminating and TB issue education. Pre and post- questionnaires were conducted to get the scores about TB knowledge, attitude and behavior of the case group and control group of community residents and students. Chi-square test, ANOVA, F test and T test were used to compare scores about TB knowledge, attitude and behavior before and after health promotion for community residents and Tzu-chi school students.

Result: After health promotion. The scores about TB knowledge of residents in Da-Ai village I was significantly higher than that in Da-Ai village II (p=0.046). Female had better TB knowledge than male (p=0.038). Those who had high level of education had better TB knowledge than those having low level of education (p<0.001). Tzu-chi school students’ TB knowledge and attitude scores were significantly higher than public school students’ scores (p<0.001). Female students had better knowledge scores than male students (p=0.002). Students with high level of education had higher scores of TB knowledge than those with low level of education.

Conclusion: The combination of school system and community as a multi-intensive health promotion unit for TB promotion was useful, and schools could be a pipeline to establish contact with community residents. In other dense communities where residents having strong relationship with schools could follow the health promotion model in this study to promote the knowledge of tuberculosis, then to achieve the effect of prevention from tuberculosis.

第一章 導論 1
第一節 背景介紹 1
第二節 研究目的 6
第三節 研究架構 7
第二章 文獻探討 8
第一節 結核病的流行概況 8
第二節 結核病的疾病描述、治療與預防 11
第三節 健康信念模式 13
第四節 影響結核病知識、態度、行為的因素 17
第三章 研究方法 24
第一節 樣本介紹及抽樣方法 24
第二節 統計分析方法 32
第三節 健康促進推動方法 34
第四章 結果 40
第一節 社區居民 40
第二節 學生 60
第五章 結論、討論與建議 74
第一節 重要結果摘要 74
第二節 討論 79
第三節 研究限制 83
第四節 建議 84
附錄一、參考文獻 85
附錄二、大愛一村後測問卷 88
附錄三、慈濟學校後測問卷 92

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