臺灣博碩士論文加值系統

鑒於家犬畜主對家犬健康及相關疾病醫療日漸重視，但危及家犬健康主要預防性疾病-犬心絲蟲病於國內家犬的盛行率卻未明顯降低，相較於歐美先進國家家犬的本病流行率逐年受到控制，可能的因素為國內畜主對此病預防、診斷及治療的意願相較於國外畜主較低。
本研究針對三組對象進行問卷調查：一、比較國立台灣大學附設動物醫院辦理輸入隔離檢疫犬隻（返國畜主）與臨床就診（台大畜主）家犬的畜主間對本病防治的相關醫療意願；二、比較於國立台灣大學附設動物醫院臨床就診（台大畜主）與桃園地區私人動物醫院臨床就診（桃園畜主）及飼養家犬的台大學生（學生畜主）的家犬畜主間對本病防治的相關醫療意願；三、比較國內經營犬隻（國內業者）及辦理國外進口犬隻（進口業者）的寵物業者對本病防治的相關醫療意願。第一組問卷調查結果顯示：台大畜主考量醫療費用的比例高於返國畜主二倍。比較曾聽過與未聽過畜主間曾聽過本病者皆佔90%以上。台大畜主以曾檢測（58%）、陽性曾治療（100%）及不曾預防（58%）為主；返國畜主以曾檢測（67%）、陽性曾治療（100%）及曾預防（62%）為主。返國畜主以預防為主，台大畜主以不曾預防為主。探討台大畜主不預防的理由，以養在室內不會被蚊子咬為主。比較對本病治療及付費意願，以輕微感染症狀的治療意願有顯著差異（p<0.05），且台大畜主治療意願較返國畜主低。影響畜主醫療意願的因素中，比較返國與台大畜主間的教育程度、年收入多寡、定期健檢等有顯著差異(p< 0.001)。返國畜主對本病的預防，以願意預防、進行預防前檢測及負擔預防費用為主，均有顯著差異 (p<0.00 1) ，且返國與台大畜主對本病感染的治療及付費意願都相當高 (80%以上)。第二組問卷調查結果顯示：桃園與學生畜主考量醫療費用的比例皆高於台大畜主二倍以上。學生及桃園畜主曾聽過本病各佔65%及79%。桃園畜主以不曾檢測（69%）、陽性曾治療（100%）及不曾預防（68%）為主；學生畜主以曾檢測（67%）、陽性曾治療（100%）及不曾預防（75%）為主。台大畜主曾預防及曾檢測的比例較其他二者為高，且有顯著差異（p<0.05; p< 0.001）。比較對本病治療及付費意願，以桃園畜主對本病無症狀、輕微感染症狀的治療意願低於台大與學生畜主。在桃園與台大、學生畜主間以個人年收入、飼養寵物年齡、曾聽說過犬心蟲病、定期健檢及飼養時間等因素有顯著差異 (p<0.001)。第三組問卷調查結果顯示：國內業者考量醫療費用的比例高於進口業者二倍以上。比較國內與進口業者曾聽過本病佔100%。進口業者以曾檢測（71.7%）及曾預防（58.3%）為主；國內業者以不曾檢測（56%）、陽性曾治療（63.6%）及不曾預防（67%）為主。探討國內與進口業者不預防的理由，皆以順其自然為主。比較國內與進口業者對本病治療及付費意願，以無症狀、輕微感染症狀及嚴重感染症狀的治療意願等有顯著差異（p<0.05）。國內業者對犬心絲蟲病感染的治療及付費意願較進口業者為低。
加強宣導國內畜主及業者的治療及預防意願，於犬隻隔離期間提醒輸入返國畜主及進口業者應進行本病之預防，將有助於降低國內家犬及犬隻犬心絲蟲病感染率。

In view of the willing of owners for dogs’ health and medical care is increasing. But in Taiwan, the canine heartworm disease (CHWD) is still an epidemic disease which is harmful and preventable. Compared with some countries-Europe and America, the CHWD epidemic rate is still high.
Probably the owners’ willing for the CHWD disease medical treatment in Taiwan is lower than other countries.
The research was designed to analysis three groups. First group, comparing with the willing to treat the CHWD in two groups of owners during quarantine period (quarantine subgroup) and the patient dogs treated in National Taiwan University Animal Hospital (NTU subgroup). Second group, comparing with the willing to treat the CHWD in three subgroups of owner who carried the dogs treated in National Taiwan University Animal Hospital (NTU subgroup) and the animal hospital of Tao-yuan county (Tao-yuan subgroup) as well as the students who raise dogs in National Taiwan University（student subgroup）. Third group, comparing with the willing to treat the CHWD in breeder’s importers (import subgroup) and native dogs’ brokers (native subgroup). In results of the first group, revealed that the ratio of considering the medical payment in NTU subgroup is two times than quarantine subgroup and over 90% owners have heard about the CHWD disease. The ratios of having the CHWD test, treating with positive result and never preventing are 58%, 100% and 58% respectively in NTU subgroup and 67%, 100% and 38% respectively in quarantine subgroup. The major reason why the NTU owners do not prevent with the CHWD is that they think indoor dogs will never be bit by mosquitoes. The willing to treat mild infection is lower in NTU owners and there are significant differences in owners’ education level, income per year and routine health examination (p<0.001) between two subgroups. The quarantine subgroup have tendency (p<0.001) to take prevention, test before prevention and pay preventive fees. Investigation revealed that both NTU and quarantine subgroups have high willing to treat and prevent the CHWD（> 80%）. In results of the second group, revealed that the ratios of considering the medical payment in Tao-yuan and student subgroups are two times than NTU subgroup. Only 65% and 79% owners have heard about the CHWD disease in student and Tao-yuan subgroups. The ratios of having the CHWD test, treating with positive result and never preventing are 69%, 100% and 68% respectively in student subgroup and 67%, 100% and 75% respectively in Tao-yuan subgroup. The ratios who had taken prevention and tests in NTU subgroup are more than in the other subgroups. The willing to treat sub-clinical and mild infection is lower in Tao-yuan owners and there are significant differences in owners’ income per year, dog’s age, the periods of owners to raise dogs, owners ever heard about the CHWD and routine health examination (p<0.001) between three subgroups. In results of the third group, revealed that the ratio of considering the medical payment in native subgroup is two times than import subgroup and 100% breeders in both subgroups have heard about the CHWD disease. The ratios of having the CHWD test, treating with positive result and never preventing are 71%, 50% and 41.7% respectively in native subgroup and 56%, 63.6% and 67% respectively in import subgroup. The major reason why the native and import subgroups do not prevent with the CHWD is that they consider do nothing is the best way. The willing to treat sub-clinical, mild and severe infection is lower in native subgroup. Investigation revealed that native subgroup have lower willing to treat and prevent the CHWD.
The result of this study revealed that the government needs to emphasis the importance of the CHWD prevention and propagate the owners and breeders to treat and prevent CHWD. During quarantine, propagating both quarantine owners and import breeders to take prevention of CHWD is also important.

目錄………………………………………………………………………...I
中文摘要………………………………………………………………….Ⅵ
英文摘要………………………………………………………………….Ⅷ
第一章 研究動機與研究目的………………………..…..……….….….1
第一節 研究動機與重要性…………………………………..….1
第二節 研究目的……………………………………………..….2
第二章 犬心絲蟲之生物及醫學相關特徵…………………..…….……4
第一節 心絲蟲之生物特徵…………………..……………...…..4
第二節 心絲蟲生活史……………………………..……..….…..6
第三節 流行病學………………………………..….…………....8
第四節 犬心絲蟲病之致病機制…………………….….…..….12
第五節 犬心絲蟲病之臨床醫療………………….……..…..…17
第三章 醫療意願及決策行為之探討……………...……...…………...25
第一節 病患醫療意願的初探………………………….………27
第二節 態度的概念………………………………………….…29
第三節 求醫行為的研究…………………………………….…30
第四節 病患醫療意願的理論模式………………………….....32
第五節 病患就醫選擇的考量層次…………………...………..34
第六節 獸醫、畜主與寵物關係的研究……………………….36
第七節 研究架構………………………………………..……...40
第八節 研究假設……………………..…………………..…….42
第四章 研究設計與資料分析………………...…………………..……44
第一節 研究設計…………………………………………..…...44
第二節 變項定義與測量…………………………….….…...…48
第三節 資料分析方法……………………………….……...….49
第五章 資料分析結果與討論…………………………..…….……..…51
第一節 問卷回收結果……………………………..….………..51
第二節 統計分析之摘要……………………………..…….…..53
第三節 資料分析結果表列（一）…………………………….…54
第四節 返國與國內台大畜主之統計結果分析及討論…...…..75
第五節 國內台大、桃園與學生畜主之統計結果分析及討論………………………………………..…….……...88
第六節 國內與進口業者之統計結果分析及討論…………...101
第六章 結論與建議事項…………………………..…….……..……..113
第一節 結論……………..………………………..…………...113
第二節 建議事項…………………..………………………..120
參考文獻……………………………………...…………………………122
附錄一 研究問卷及犬心絲蟲病宣導單…………………...…………132
附錄二 資料分析結果表列（二）………………...…………………142

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