臺灣博碩士論文加值系統

　　健康危險評估是一項新的衛生教育工具，重點是生活方式的改善。用它可以估計一個人在某一時期（通常是10年）內可能因某一些原因而死亡的機率，評估出他的健康狀況（也就是健康年齡），利用它來增強人們實踐健康行為的動機，以減少危險因子，降低死亡機率，達成健康生活。
　　本研究的目的，旨在探討健康危險評估的原則與方法，進而利用臺灣地區生命統計資料，計算出健康危險評估的基本構成，即「單因遞減生命表」、「多因遞減生命表」、「健康年齡表」。另外，死亡原因的「危險因子指標」需多方面且長期的研究支持，本研究無法為之，故借用美國、印地安納州，衛里公會醫院在1979年發行的Geller-Gesner表中白人的危險因子指標，以利研究的進行。
　　為收集危險因子，並設計乙份適合我國大學生使用的「生活方式評估問卷」，該問卷的擬定是先參考文獻、草擬初稿、分類、刪改整理後，再經內容效度處理，修改後進行預測、處理表面效度，最後再次修正完成，內容分為健康幸福狀況測定及死亡危險因子測定兩部份。健康幸福狀況測定部份又分為運動、營養、自我照護、交通安全、藥物使用、社會環境、課業、情緒處理等八項，共有83題，施測後求得折半信度為0.95。死亡危險因子測定部份包括吸煙、喝酒、攜械習慣、曾患病歷，家人患病背景及憂鬱程度等，其中憂鬱程度測定是採用美國國立心理衛生研究所、流行病學研究中心的「憂鬱量表」（CES-D Scale），共有20題，施測後求得折半信度為0.87。
　　在民國七十一年十一月間，以系統抽樣法，抽取師大一年級學生123人為樣本，採個別填答方式來收集資料，經電腦處理，以百分率、相關矩陣、t考驗、變異分析、薛費氏法、複□歸及複相關來進行統計分析，所得重要結論如下：
　　1.師大新生健康幸福狀況測定結果約屬中上程度，其中八個項目得分與總分彼此間的關係，在男生都有顯著正相關；在女生「交通安全」與「自我照護」、「藥物使用」、「情緒處理」三項間關係不顯著外，其餘也都有顯著正相關。
　　2.健康幸福狀況八個項目得分對總分的淨解釋力，在男生都達顯著水準，但在測定女生時，「藥物使用」這項可以不必考慮，不管其有無則結果皆相同。
　　3.師大新生健康幸福狀況中「運動」、「交通安全」因性別不同而有顯著差異；「運動」、「情緒處理」及總分因居住地區不同有顯著差異。
　　4.師大新生憂鬱程度測定結果男女生都偏高。憂鬱程度與健康幸福狀況間的關係，在男生，除了與「營養」一項關係不顯著外，與其他各項及總分都有顯著負相關；在女生，除了與「營養」、「自我照護」、「交通安全」三項外，與其他各項及總分也都有顯著負相關存在。師大新生的憂鬱程度並不因性別、籍貫、居住地區、聯考組別不同而有顯著差異。
　　5.經健康危險評估計算出，師大新生十年總死亡機率，男生平均是1783.52/100,000、女生平均是767.74/100,000，男生比女生高出一倍以上。健康年齡，男生平均是18.59歲、女生平均是18.85歲。預期壽命，男生平均還能活55.21歲、女生平均還能活60.57歲。若目前學生的危險因子（與遺傳有關者除外）均能排除，則十年總死亡機率男生平均將減少21.52%、女生平均將減少10.73%。
　　6.「實足年齡與健康年齡之差」與健康幸福狀況之間，不論在男女生都有顯著正相關，由此２更可證明健康危險評估結果的可信度。
　　7.師大新生「十年總死亡機率」因性別及聯考組別不同而有顯著差異；「危機減少百分比」及「預期壽命」因性別不同而有顯著差異；「健康年齡」及「實足年齡與健康年齡之差」並不因性別、籍貫、居住地區、聯考組別之不同而有顯著差異。

　　The main purpose of the study was to explore the principles and methodology of Health Hazard Appraisal (HHA), then utilized the data from vital statistics of Taiwan area to caiculate the basic contents of HHA, as “Single-Decrement Life Tables”, “Multiple- Decrement Life Tables”,“Health Age Tables”by sex and age, but the risk factor indices for separate causes was adopted from the Geller-Gesner Table published in 1979 by the Mothodist Hospital of Indiana, Indianapolis.
　　The “Lifestyle Assessment Questionnaire” was developed to collect the college students'' risks. The final instrument was done including:1) wellness Laxentory, 83 items, diveded into eight content areas: exercise, Nutrition, self-care, traffic salety, drug abuse, social environment, work and emotional management; 2) Risk of Death, 36 items, diveded into six content areas: smoking, drinking wine, carrying weapons, patient records, family''s background of illness, and depression. The split-half reliability of Wellness Inventory was 95, while depression was. 87.
　　In November, 1982,123 freshmen of N.T.N.. were selected by systematic sampling method, the data was collected by individual. Analysis was made with computer by using percentage, correlation matrix, t-test, ANOVA, Scheffe'' test, mutiple-regression and mutiple-correlation. The important conclusions were made as follows:
　　1. Concerning the Wellness Inventory pretesting on freshmen of N.T.N.U., the results approximated to medium and upper levels. For male students, they showed significant correlation between the eight items-scores and the total ones; as regards female students, they also showed signigicant correlation each other, with the exception of relationship between “traffic safety”and “emo-tional management”, respectively.
　　2. The partial explanation for eight items-scores of wellness Inventory to the total ones reached a significant level, as pretesting male students. But, as pretesting female students, “drug abuse”might be omitted to consider, for its result made no influence.
　　3. In connection with the freshmen''s wellness, they showed significant differences in “exercise”and “traffic safty” due to separate sex; in “exercise”,“emotional management” and the total scores due to dwelling district.
　　4. The male and female students'' status of depressions was high. Their depressions degree did not show significant differences due to sexes, census, dwelling district, and sections of the College Entrance Examination.
　　5. By using HHA, the mean of the total probability of dying per 100,000 within the next 10 years for freshmen of N.T.N.U.was 1783.53 for male students and 767.74 for female students, the mean of the health age of male students was 18.59 and female students, 18.85. In case the students'' existing risk factors (except those relating to heredity) were overcome, such that the total probability of dying within 10 years concerning male students would reduce by 21.50%and concerning female students would reduce by 10.73%.
　　6.They showed significant correlation between “the differences of chronological age and health age ”and “wellness” in male and female students, respectively. In this situation, the HHA''s reliablity was approved.
　　7. The total probability of dying within 10 years of the freshmen of N.T.N.U. showed significant differences due to sexes and separate sections of the College Entrance Examination. The percentage of reducing risk showd signigicant differences due to separate sexes. Nevertheless, “healthage” and “the differences of chronoloical age and health age ”showed no significant differences due to sexes, census, dwelling districts, and sections of the College Entrance Examination.