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研究生:陳素凰
研究生(外文):Su-Huang Chen
論文名稱:社區老人接種流感疫苗與否之相關影響因素的探討
論文名稱(外文):The Study of Exploring the Influence of Receiving Influenza Vaccination among Community Older Adults
指導教授:林佩芬林佩芬引用關係
指導教授(外文):Pay-Fan Lin
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:112
中文關鍵詞:老人流感疫苗社區
外文關鍵詞:older adultsinfluenza vaccinationcommunity
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本研究旨在了解社區老人有無接種流感疫苗之差異及影響因素。以橫斷面研究設計,方便取樣北市65歲以上老人,共230份訪視問卷。研究工具有流感接種結構式問卷、巴氏量表、自我效能量表。以SPSS12.0軟體作描述性統計、卡方、費氏精確檢定法、獨立樣本t檢定、對數複迴歸分析資料。
92年收案地區有接種疫苗的老人145位(63.0%),未接種者85位(37.0%);平均年齡74.4歲,男性88位(38.3%),女性142位(61.7%),多數老人教育程度在國中以下(93.0%),七成為非獨居者,九成老人巴氏量表得分為獨立狀態,自我效能得分為中等。在推論統計中以卡方、費氏精確檢定法、獨立樣本t檢定得出社區老人有無接種流感疫苗與獨立變項間之差異有八個獨立因子分別為,慢性病、生活不便、流感認知答對率、自覺流感侵襲的認知、醫生建議、親朋建議、接獲流感訊息加總計數、健康行為自我效能(P<.05)。其中影響社區老人有無接種流感疫苗的獨立解釋因子依序為自覺流感侵襲認知(有或無)、醫師建議(有或無)、流感認知答對率(每提升一題之答對率)、活動不便(有或無)。
依據上述結果本研究建議,社區衛生人員應與轄區內醫療院所建立網絡系統,針對在轄區內就醫的高危險群進行列管,可參照國外電腦化提醒系統進行催注,於流感宣傳期結合里內流感疫苗合約診所的醫師,針對主訴有行動不便、高危險群老人的自我辨識教育,著重罹患性與正向的流感認知,以促進老人的自我效能;並善用家庭評估技巧於社區,針對因活動不便或有家庭關係疏離者而無法接種疫苗的老人,結合社區資源(志工、慈善團體)以協助上述老人去接種流感疫苗。
The purposes of this study were to examine the (understand) the differences and the factors influenced the influenza vaccination receiving among community older adults. The study adopted an cross-sectional research design, convenience sampling of elderly in Wanhua county of Taipei, and the structure questionnaires included a self report vaccination scale、Bethel index(BI)、and a self rated abilities scale(SRAS)were used to collect the data total 230 validated questionnaires were obtained by face to face interviews. The data were analyzed by SPSS12.0 statistic software. The major statistic procedures included descriptive statistics andχ², Fisher’s exact test, independent t test, and Logistic regression. The results of this study were as following: 145(63.3%) out of 230 elderly were vaccinated, and 85(37.0%) were not, the average age was 74.45.97 years old, 88 male(38.3%), 142 female(61.7%), 70% of the subjects live family or friends with , 90% was independence in function status, the self efficacy score were moderate(69.1119.52) in 2003. The results showed the chronic condition, inactivity, knowledge of influenza, perceived susceptibility of influenza, physician’s advise, family’s advise, the numbers of influenza vaccinated information resources and self efficacy were significant factors which difference between vaccinated group and non-vaccinated group. The inactivity, knowledge of influenza, perceived susceptibility of influenza, and physician’s advise were significant influenced the vaccination behaviors(P<.05).
The study results suggested that the community health staff may build a network system by cooperating with physician, and a follow up system to monitor the high risk group as well as the application of computerized reminder system for vaccination. During vaccination promotion phase, staff may provide self-identify education for inactivity of elderly and high risk group, which focused on knowledge of influenza、perceived susceptibility and promote the self efficacy toward health behavior by applying the family assessment skill to integrate the community resources(eg, charity group) to help the inactivity elderly or the elderly with loosing family connections to improve the rate of influenza vaccination in community.
目 錄 頁數
誌謝……………………………………………………………………………… Ⅰ
中文摘要………………………………………………………………………… Ⅱ
英文摘要………………………………………………………………………… Ⅳ
圖表目次………………………………………………………………………… Ⅶ
第一章 緒論
第一節 研究背景與動機……………………………………………………… 1
第二節 研究目的……………………………………………………………… 4
第三節 研究問題……………………………………………………………… 5
第四節 研究假設……………………………………………………………… 6
第二章 文獻查證
第一節 流感的流行病學及相關學理………………………………………… 7
第二節 流感疫苗接種政策…………………………………………………… 13
第三節 健康行為相關理論…………………………………………………… 21
第四節 影響老人接種流感疫苗之相關研究………………………………… 23
第五節 名詞界定……………………………………………………………… 33
第六節 研究架構……………………………………………………………… 35
第三章 研究方法
第一節 研究設計……………………………………………………………… 36
第二節 研究對象及抽樣方法………………………………………………… 36
第三節 研究工具……………………………………………………………… 37
第四節 研究步驟……………………………………………………………… 41
第五節 資料處理與分析方法………………………………………………… 42
第六節 研究收案流程………………………………………………………… 44
第七節 研究倫理考量………………………………………………………… 44
第四章 研究結果……………………………………………………………… 45
第五章 討論…………………………………………………………………… 68
第六章 結論、建議與限制…………………………………………………… 76
中文文獻………………………………………………………………………… 81
英文文獻………………………………………………………………………… 85
附件(一)問卷專家評鑑表……………………………………………………… 99
附件(二)正式收案問卷內容…………………………………………………… 104
附件(三)台北市行政區關係位置圖
附件(四)台北市萬華區頂碩里鄰分佈圖
附件(五)萬華地區提供流感接種醫療院所與交通運輸系統之地理分佈圖
附件(六)研究相關公文
附件(七)問卷使用同意書
西文文獻
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