臺灣博碩士論文加值系統

本研究主要針對澎湖離島地區居民十八歲以上成年人，瞭解其口腔保健知識及就醫行為的相關因素，並以澎湖本島與離島因地理環境之差異，探討其影響之因素。研究設計乃以抽樣調查方式，採分層多階段集束抽樣調查法（stratified multi-stage cluster sampling），抽樣機率以等比隨機抽樣（probability proportional to size，PPS design）方式。並以問卷方式探討島民之個人基本資料、檳榔菸酒盛行率、檳榔危害意識及態度、檳榔濫用、口腔健康行為及需求、一般飲食行為六部份。研究結果共回收417份問卷，問卷鍵入電腦後
以JMP4做簡單描述性及推論性統計邏輯式迴歸行資料之分析。
由研究結果得知，人口學特質與口腔保健行為方面年齡愈大，喝酒、嚼檳榔人數愈多，男性有抽菸（45.70%）喝酒（17.80%）嚼檳榔（10.90%）比率高於女性，在人口學特質與就醫行為方面，年齡愈大，定期看牙醫比人數愈少、年齡愈大，因工作忙找不時間、牙齒良好無牙痛之不看牙醫人數愈少；男性過去看牙醫次數（13.80%）、害怕看牙醫（4.50%）均低於女性；就離島與本島之不同來分析人口學變項探討與居民口腔保健行為及就醫行為之差異性，在人口學方面，本島之教育程度、高於離島、職業中之半技術性工人及自覺牙齒健康狀態離島均高於本島；在口腔保健行為方面，本島之刷牙次數、刷牙時間（62.80%）高於三分鐘、有漱口（87.80%）、有吃維他命（10.00%）及加強口腔衛生知識等均高於離島；在就醫行為方面，本島之定期看牙醫、過去看牙醫次數高於離島，牙齒好沒有牙痛離島高於本島。
進一步由邏輯式迴歸得知年齡愈高者定期看牙醫的機會愈低；非本省籍定期看牙醫比本省籍高；教育程度為國小者定期看牙醫的機率高於小學以下者；有漱口且有定期看牙醫之機率比無漱口者高；有吃維他命且有定期看牙醫之機率比無吃維他命者高。最後本研究建議離島應加強口腔衛生教育及進一步針對不同口腔保健行為對齲齒率等指標之影響作分析及比較。

The purposes of this study were to investigate the status and knowledge of oral health care and dental visit behavior among the adult populations aged over 18 in Penghu, and the differences between Makun and the islets around. The study samples were selected from the populations living in Penghu aged over 18 by the method of stratified multi-stage cluster sampling with selection probability proportional to size. The questionnaires contained personal data, behaviors of alcohol drinking, betel quid chewing and cigarette smoking, attitude of awareness of risk for betel quid chewing, behaviors of oral health care and dental needs, and daily diet habits. Descriptive statistics and inferential statistics using logistic models were performed by JMP4.
The results of oral health behaviors showed a high proportion of alcohol drinking and betel quid chewing in older age groups. The proportion of cigarette smoking, alcohol drinking and betel quid chewing in men were 45.70%, 17.80% and 10.90%, respectively, and were higer than in women. The results of seeking dental services showed low proportion of regular dental visits in older age groups. People with older age, busy for work and good dental conditions revealed less dental visits. We also found that frequencies of past dental services using and fear of dental treatment were low in men (13.80% and 4.50%, respectively). As regards the influences from geographical features, both status of oral health care and behaviors of seeking dental services were significantly different between Makun and islets around. For status of oral health care, frequencies of brushing, brushing time over 3 minutes (62.80%), mouth rinsing (87.80%), vitamin taking (10.00%) and knowledge of oral health were significant higher in Island than Islets. For behaviors of seeking dental services, regular dental visits and frequencies of past dental services using were higher in Island than Islets; nevertheless, good dental conditions was higher in Islets than Island.
Using logistic models, the data showed that the older the age groups the less the regular dental visits. People with primary educational level had the higher proportions in regular dental visits than those whom not graduated from the primary school. The behavior of regular dental visits was also had higher proportions in whom using mouth rinsing and vitamin than those whom did not.
From the results of our study, we suggested that the reinforcement of oral health care and further analysis of the associations of dental diseases and behaviors of seeking dental services of residents living in Islets is extremely urgent.

致謝 i
中文摘要 ii
英文摘要 iv
第一章 緒論
第一節 研究背景 1
第二節 研究目的 3
第二章 文獻探討
第一節 醫療可近性的概念與架構 4
第二節 醫療資源利用 7
第三節 知識、態度與行為之關係 11
第四節 影響就醫行為因素之探討 18
第三章 材料與方法
第一節 研究對象 27
第二節 研究設計與架構 28
第三節 研究工具與信校度檢測 32
第四節 研究便向與操作型定義 34
第五節 資料處理與統計分析 36
第四章 結果
第一節 基本人口學資料 37
第二節 澎湖本島與離島人口學、口腔保健行為
就醫行為 38
第三節 不同人口學對口腔保健行為與
就醫行為之差異 39
第四節 口腔保健行為與就醫行為之關係 42
第五節 影響就醫行為之因素 44
第五章 討論
第一節 研究樣本與母群體之檢定 45
第二節 澎湖地區民人口學、口腔保健行為、就醫行為
及彼此間之差異 46
第六章 結論與建議
第一節 結論 56
第二節 建議與限制 57
參考文獻 58
表格目錄 63
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