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E88119
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花蓮縣秀林鄉與台北市北投區國三學生及老年人健康品質與其相關社會因子的研究
The Health-related Quality of Life and Its Relationship with Social Factors of Ninth-graders and the Elderly in Hsolin and Peitou Districts
1.譚延輝
1.Ian-huei Tan
1.國防醫學院藥學系
1.School of Pharmacy, National Defense Medical Center , National Defense University
001,002,003,004
1.國防醫學院藥學系
1.School of Pharmacy, National Defense Medical Center , National Defense University
002
1.行政院國家科學委員會
1.Naional Science Council
A.14 計畫執行期間(起):1998-08-01
A.14 計畫執行期間(訖):1999-07-31
1998-11-211999-04-10
A.16 收到日期:2000-01-27
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花蓮縣秀林鄉與台北市北投區之國三學生與65歲以上老人

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國三學生:502 65歲以上老人:590


590
001,004
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C.2 聯絡日期:2000-01-27
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1.國防醫學院藥學系
1.School of Pharmacy, National Defense Medical Center , National Defense University
1
C.7 資料公開日期:2001-08-01
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008
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1.RAND36題健康調查
2.生活品質
3.社會支持
4.社經地位
5.原住民
6.健康品質
1.Aborigine
2.Health-related Quality of Life
3.Quality of Life
4.RAND 36-Item Health Survey
5.Social Support
6.Socioeconomic Status
臺 灣光復後,中央政府打破日據時代為原住民同胞所設立的藩籬,依據中華民國憲法的精神,積極推動山地鄉的各項建設。在健康事業方面,經由環境衛生的改善及預 防保健措施的介入,山地鄉同胞的平均餘命較光復前已有明顯延長,但卻始終與平地社會存有相當的差距。 基於疾病防治由改造社會環境著手之大勢所趨,並為了瞭解山地與平地間停滯不減的健康差距之可能原因, 本研究1選擇了以泰雅原住民為主要人口的花蓮縣秀林鄉與以漢人為主的台北市北投區兩地為研究地區,針對國中三年級的青少年及65歲以上的老人分別抽樣進行 自填式及面訪式之問卷調查。自民國87年11月底至88年4 月初,在兩地共計完成了502份有效國三學生問卷及590份有效老人問卷。問卷內容主要包括自評健康品質、社會支持系統、社會文化因素(疾病現代觀)、家 庭社經因素、個人生活方式及罹病狀況等資料。結果發現不論是國三青少年或是65歲以上老人,花蓮縣秀林鄉與台北市北投區間的健康品質的確存有顯著的差異, 而老人部份又比青少年在較多不同的層面上顯出差異。而年齡、罹患慢性病狀態、不良生活型態(抽菸、飲酒、嚼食檳榔、未進食早餐)相關社會因子(性別、婚姻 狀態、社會支持系統、疾病現代觀、住屋所有權及家庭社會地位指數)經以多元迴歸分析後,知道其對模型中健康品質之解釋力(決定係數值)以老人部份較高,接 近 0.5;而決定係數值中有一半以上是純粹地與上述的社會因子有關。若將兩類不同調查對象均依居住地別分開統計分析時,發現當控制所有自變項後,就各別地區 來看,是否為原住民籍與健康品質並無顯著相關。 基於本研究發現由職業類別與教育程度所換算之家庭社會地位指數與多層面健康品質有關,而疾病現代觀(疾病成因現代觀與疾病處置現代觀)與健康品質亦有關, 故建議若欲更進一步拉近山地鄉與平地地區間的健康差距,不應將資源過度投入醫療事業,而應於尊重其傳統文化前提下,將大部份的投資用於改善其教育程度及增 進其職業技能,如此方能提高其社會地位。一旦其社會地位獲致提昇後,應能自覺己身不利之健康情形,進而積極主動謀求健康之維護及促進。

To understand and learn the reasons which cause unequal health status between the mountaineers and people in plain area, the author conducts a study which examines people in mountainous Hsolin village, Hualien and people in urban Peitou, Taipei. The survey, by self-administrated and interviewer-aided questionnaires, randomly samples ninth-graders and over sixty-five-year elders. Starting from the late November in 1998 to the early April in 1999, the author collects 1092 valid questionnaires in total, 502 from the teenagers nd 590 from the elderly. The findings show that in both age groups, there exists significant difference in health-related quality of life(HRQL)between subjects of different districts. Social factors(gender, marital status, social position index, social support system, recognition of modern medicine) plays a significant role in explaining HRQL. Especially in the elderly, the coefficients of determinant(r2)of regression model are near 0.5 in several dimensions of HRQL. More than half of the coefficient of determinant of each regression model can be attributed to the pure effect of the above mentioned social factors. The author suggests that to eliminate the existing gap of health status, instead of over-investment of medical service, we should provide mountaineers with appropriate education and vocational training. What more important, however, is to do the above with a respectful mind to local culture and life style. Only when better social conditions are gained, the mountaineers will be aware of the importance of health and then pursue it aggressively.

D.16 完成檢誤日期:2001-11-14
D.17 預定釋出日期:2001-12-17
D.18 初次釋出日期:2001-12-17
D.19_1 最新版釋出日期:2001-12-17
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10.6141/TW-SRDA-E88119-1
http://efenci.srda.sinica.edu.tw/webview/index.jsp?object=http://efenci.srda.sinica.edu.tw:80/obj/fStudy/E88119
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