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研究生:田哲嘉
研究生(外文):Tien, Che-Chia
論文名稱:使用尿液尼古丁代謝物探討菸害防制問卷之信效度
論文名稱(外文):Urinary cotinine as a biomarker to explore the reliability and validity with questionnaire
指導教授:賴錦皇賴錦皇引用關係
指導教授(外文):Lai, Ching-Huang
口試委員:賴錦皇高森永簡戊鑑
口試委員(外文):Lai, Ching-HuangKao, Sen-YeongChien, Wu-Chien
口試日期:2014-05-06
學位類別:碩士
校院名稱:國防醫學院
系所名稱:公共衛生學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:88
中文關鍵詞:吸菸新訓人員尿液尼古丁代謝物
外文關鍵詞:SmokingRecruitsUrinaryCotinine
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前言:在菸害相關的研究中,經常使用問卷作為瞭解吸菸盛行率之調查工具,然而卻可能因為研究對象的回憶問題、錯誤分組與作答情境等原因而影響到問卷的信效度,透過尿液尼古丁代謝物偵測,可以避免上述問題,並提供客觀、準確反映研究對象吸菸情形之量化指標。
目的:使用尿液尼古丁代謝物(Cotinine)作為生物偵測指標,探討國軍新訓人員入伍期間吸菸行為的改變,並驗證問卷填答之信效度。
方法:以隨機抽樣方式選取國軍新訓單位某梯次的其中兩個連隊共計280員作為研究對象,研究設計採縱貫性研究,於新訓人員入伍第二天、休假前一天(入伍一周後)、休假三天後與休假六天後(結訓前一天)等四個時間點實施問卷調查並採集其50 mL尿液檢體,尿液檢體使用酵素免疫分析法檢測Cotinine濃度,問卷資料則使用SPSS 20.0版統計軟體進行分析。
結果:尿液Cotinine濃度分析的結果發現,新訓人員受訓期間吸菸量會降低,而休假期間吸菸量則會增多,另外在問卷信效度部份,除入伍第二天的每日暴露問卷外(AUC=0.903),菸害防制問卷與其餘三次的每日暴露問卷對於吸菸行為測量皆為不錯之診斷工具(AUC>0.95)。
結論:新訓人員休假期間吸菸情形較受訓期間更為嚴重,另外由於入伍第二天之問卷信效度較差,應避免於新訓人員剛入伍時實施問卷施測。
Background: Questionnaire is often used as the research tool of smoking prevalence. However, the reliability and validity of the questionnaire could be influenced by the recall problem of participants, misclassification, and the situation when answering the question. By detecting the urine nicotine metabolites, the problems can be ruled out and the smoking condition of participants can be reflected precisely.
Objectives: To study the smoking behavior change of the recruits during initial entry training, and to test the reliability and validity with the questionnaire by detecting the urinary cotinine concentration.
Methods: We chose two companies 280 people as research subjects from initial entry training recruits through random sampling. Longitudinal study design was used while we collect questionnaire and 50 mL urine sample from the recruits at four timing periods. The second day of training, before the vacation, after three-day vacation and after six-day vacation. ELISA was used to analyze cotinine concentration of the collected urine sample, and the data from questionnaire was used SPSS 20.0 version for statistical analysis.
Results: According to the result of Cotinine concentration, the recruits smoke less during training and more during holidays. Besides, the reliability and validity with the questionnaire, the health investigation questionnaire and the three other daily exposure questionnaires are all good tools for smoking behavior measurement (AUC>0.95) except the daily exposure questionnaire on the second day of initial entry training (AUC=0.903).
Conclusions: The smoking condition of recruits is more severe during holidays then during training. Besides, we should avoid doing the questionnaire at the beginning of the initial entry training due to the less reliability and validity of the questionnaire on the second day of the training.
第一章 緒論1
第二章 文獻探討5
第三章 研究材料與方法16
第四章 結果27
第五章 討論65
第六章 結論與建議74
第七章 參考文獻76
附錄79
中文參考文獻
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衛生福利部國民健康署(2013c)。菸害防制資訊網。

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