現代醫療體系分工日趨精細化，民眾在求醫過程中，常因本身之醫療相關知識缺乏等因素，以致無法適切遵從醫囑或正確使用藥品等有害健康之行為。過去之研究通常只探討不遵醫囑之行為，少有探討因個體之健康知能不足與不遵醫囑之行為的關聯者。本研究試圖探討健康知能在民眾之自我健康意識與服藥遵從行為之影響。本研究之樣本分別自北部、中部、南部、東部之醫學中心、區域醫院及地區醫院，隨機抽取進出醫院的一般成年民眾，共收集1079份問卷。問卷分別以台灣成人健康知能量表、自我健康意識量表、MARS檢測受訪者之健康知能、自我健康意識、服藥遵從行為。所收集之問卷，以SPSS 12.0中文版進行分析，包括項目分析、因素分析、t檢定、單因子變異數分析、Pearson相關等。資料顯示，超過半數民眾之健康知能為不足或為邊緣性程度；民眾常會「忘記」服藥。本研究之資料分析結果，包括健康知能程度高低會影響自我健康意識及服藥遵從行為；人口變項在健康知能、自我健康意識與服藥遵從行為上有統計之顯著差異；健康知能與自我健康意識呈正向相關；健康知能與服藥遵從行為呈正向相關。本研究之主要結論為健康知能高低對於自我健康意識以及服藥遵從行為上，具有顯著差異。健康知能程度較高者，明顯地比健康知能低者更重視自我健康意識，有更高度服藥遵從行為。

Along with the rapid development of science and associated technological application in modern health care industries, diversification of healthcare professional as well as related knowledge is growing simultaneously. Patients who are short of health literacy may fail to take medications following doctor’s directions, and may consequently, result in harms to their health. The literature on medication adherence tends to focus on identifying to what extent the patients adhere to medication the physician instructed in Taiwan, few if any explored the relationship between health literacy and medication adherence behavior of patients. This study attempts to analyze the effects of patients’ health literacy on the self-health consciousness as well as medication adherence behaviors. Adult samples are taken randomly from those visitors to those medical-center, district, and regional hospitals in the northern, central, southern parts of Taiwan. A structure questionnaire is used to collect respondents’ information on health literacy, self-health conscious, and medication adherence behavior. 1,079 valid questionnaires are collected and analyzed through item analysis, factor analysis, t-test, ANOVA, and Pearson correlation. Major results include indicating the levels health literacy is closely associated with self-health consciousness levels, and moderate medication behaviors. The levels of health literacy, self-health consciousness, and medication adherence behaviors varied along with demographic factors. The levels of health literacy and self-health consciousness are positively correlated, so as the levels of health literacy and medication adherence behaviors. This research concludes that the levels of health literacy paralleled with the levels of the self-health conscious and satisfactory level of medication adherence behaviors. Patients with a high health literacy level also show a high level of self-health consciousness, and a satisfactory medication adherence behavior.

摘要 i
Abstract ii
致謝 iv
目次 v
表目次 vii
圖目次 x
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 研究問題 6
第四節 研究範圍 7
第五節 名詞解釋 8
第二章 文獻探討 10
第一節 健康知能 10
第二節 自我健康意識 27
第三節 服藥遵從行為 30
第四節 健康知能、自我健康意識與服藥遵從行為 39
第五節 研究假設 41
第三章 研究方法 42
第一節 研究架構 42
第二節 研究工具 43
第三節 研究步驟 52
第四節 樣本與抽樣 53
第五節 資料分析 58
第四章 結果與討論 59
第一節 研究主要構念分析 59
第二節 樣本特性分析 68
第三節 健康知能程度與自我健康意識、服藥遵從行為 102
第四節 健康知能、自我健康意識與服藥遵從行為之相關性 104
第五節 構念與人口統計變項交叉分析 108
第五章 結論與建議 151
第一節 結論 152
第二節 建議 156
第三節 研究限制與未來研究方向 159
參考文獻 161
中文部份 161
英文部分 164
附錄 181
附錄一: 健康知能量表各構面之題項分佈 181
附錄二: 正式問卷 182

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