臺灣博碩士論文加值系統

　　台南市於2003年開始推動健康城市計畫。本研究為利用發表的健康社區評估量表，以社區環境、社區組織與活力、社區健康服務三個面相來測量台南市健康社區的發展程度，並探討健康社區的發展程度對社區居民的影響。研究方法是於健康社區之評估量表外，另設計一份電話訪問問卷，透過電話訪問瞭解社區居民對於健康社區的發展影響。第一份問卷對象為台南市的232個里長。實際施測於2004年9月起進行，計232份問卷回收。第二份電話訪問可用記錄計820份。

　　研究結果顯示，在健康社區的發展程度越高的社區，認為運動休閒設施足夠的比率越高。反而是健康社區的發展程度越低的社區，覺得大眾運輸方便的比率越高。認為台南市無障礙設施完善者，在健康社區的發展程度越高的社區，認為完善的比率越高。

　　進一步進行分量表與社區健康之關係的分析，利用因素分析所得到的五個分量表，本研究選取前面4個分量表：社區乾淨環境程度與「居民對社區整體環境的感受」及「居民參與」之關係、社區生活空間與「居民對社區整體環境的感受」之關係、社區休閒組織與活動和「居民參與」之關係及健康促進與社區照謢與「居民健康行為」之關係重新分類，重新加總。社區休閒組織與活動和「居民參與」之關係分析結果顯示，健康促進與社區照謢與「居民健康行為」之關係分析之後，只有在自覺健康狀態這一項有顯著的差異。在健康促進與社區照護得分比較高的社區，覺得自己的健康很好的比率反而低於健康促進與社區照護得分較低的社區。而覺得自己健康狀態不好的比率在健康促進與社區照護得分比較高的社區反而最高。

　　本研究是國內第一次以實證研究探討健康社區的推行對社區居民健康的影響，雖然有顯著差異的項目不多，但是仍然值得後續研究者參考。本研究同時也調查了市民的健康行，如自覺健康狀態，自殺傾向，接受疾病篩檢的行為，這些都可以作為公共衛生行政的參考。

　Tainan healthy city project started from 2003. The goal of this study was to investigate the degree of healthy community through evaluating the community environment, community organization and vigor, community services by using a scale for measuring healthy community, and to investigate the effect of degree of healthy community on residential people.
　
　In addition to the scale for measuring healthy community, another telephone interviewing questionnaire is also developed to retrieve the response of residential people. There are 232 local officer respond to the first self-administered questionnaire, and 820 valid telephone interview questionnaire completed in 2004 to 2005.
Results shows that the higher the degree of healthy community, the more residential people reply the sufficiency of leisure facilities hold in the community, and the more completeness of no-barrier environment. On the contrary, the lower the degree of healthy community, the more residential people respond that the public transportation system is convenient.
　
　Further analysis is done by using factor analysis. For groups of components is recalculated. Health promotion and community health care is significantly but negatively correlated with residential health behavior. Less people in the community with better healthy promotion and health care system feel of good health condition, at the same time, more people of those communities reply that they are of bad health condition.

　This study is the first study using evidence based data to prove the relationship between healthy city promotion and the effect on the health condition of residential. Although there are only few items showing significant differences, it can provide reference to the subsequent investigator. The health behaviors, such as self-evaluated goodness of health, tendency to suicide, likeness to participate disease screening are all important information to the field of public health.

目 錄
第一章　前言　　　　　　　　　　　　　　　　1
第一節　研究背景　　　　　　　　　　　　　　1
第二節　研究目的　　　　　　　　　　　　　　1

第二章　文獻探討　　　　　　　　　　　　　　2
第一節　公共衛生的發展　　　　　　　　　　　2
第二節　健康城市與健康社區　　　　　　　　　4
第三節　健康社區的發展對社區的影響　　　　　7

第三章　研究方法　　　　　　　　　　　　　　12
第一節　研究設計　　　　　　　　　　　　　　12
第二節　健康社區評估　　　　　　　　　　　　12
第三節　健康社區的發展程度對社區居民健康的影響
　　　　　　　　　　　　　　　　　　　　　　15

第四章　研究結果　　　　　　　　　　　　　　18
第一節　基本資料的描述　　　　　　　　　　　18
第二節　健康社區的發展與社區參與的關係　　　18
第三節 健康社區的發展與整體社區環境評價的關係
　　　　　　　　　　　　　　　　　　　　　　20
第四節　健康社區的發展與居民的健康行為　　　21

第五章　討論　　　　　　　　　　　　　　　　33
第一節　相關結果的討論　　　　　　　　　　　33
第二節　研究貢獻與限制　　　　　　　　　　　35
第三節　未來建議　　　　　　　　　　　　　　36

參考文獻　　　　　　　　　　　　　　　　　　37
附件一：健康社區評估量表(25題本)　　　　　　39
附件二：台南市健康城市評價問卷　　　　　　　43

表 目 錄
表 一：健康社區的發展程度的人口資料　　　　　23
表 二：健康社區的發展程度與居民的參與　　　　24
表 三：健康社區的發展程度與整體社區環境的評價25
表 四：健康社區的發展程度與居民的健康行為　　26
表 五：社區乾淨環境程度與「居民對社區整體環境感受」及「居民參與」之關係
　　　　　　　　　　　　　　　　　　　　　　　29
表 六：社區生活空間與「居民對社區整體環境的感受」之關係　　　　　　　　　　　　　　　　　　　　30
表 七：社區休閒組織與活動和「居民參與」之關係31
表 八：健康促進與社區照謢與「居民健康行為」之關係
　　　　　　　　　　　　　　　　　　　　　　　32

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