*中心館藏網址:http://tulips.ntu.edu.tw/record=b2220045*cht

[ 摘要 ]
中文摘要 本研究針對結核病罹病率最高的秀林鄉，進行泰雅族原住民肺結核病患疾病行為之研究。主要目的有三：一、藉由探討秀林鄉肺結核病之疾病治癒率，瞭解可能影響山地鄉肺結核病患治癒結果的相關因素，以作為衛生當局防治措施的考量、以及醫護人員衛教之參考指標；二、藉由探討秀林鄉肺結核病患之個人生病史，瞭解泰雅人可能面臨之危險情境與行為，以及求醫過程中可能面臨醫療資源受限或醫療處置失當的現象；三、藉由探討秀林鄉肺結核病患之危險行為，以提供衛生當局瞭解肺結核病患實際或潛在的危險因子，並進一步指導修正或避免危險行為的產生。 本研究以50名居住於秀林鄉之泰雅肺結核病患為研究樣本，透過問卷調查以瞭解肺結核病患之疾病治癒結果及其影響因素。研究的主要發現為：自覺家庭經濟狀況和每個月月家庭的總收入較差時、認為去看診很麻煩者、曾厭倦需長期數月持續服藥而中斷服藥者、以及曾因藥物副作用而中斷服用某顆藥者，其治癒結果較差；而病情好轉或症狀改善時，仍會繼續服藥的、認為按時服藥很重要，對病情很有幫助的、及服藥後不會影響個案情緒時，個案的治癒結果較佳。 進一步分析社會人口學變項、人文地理特性與健康信念、服藥行為等變項間之相關性後發現，呈正相關變項包括：年齡與中斷服藥因素（包括藥物數量太多、藥味難聞、藥太大顆不好吞、厭倦長期服藥）；婚姻狀態與認為肺結核對肺部會造成很大的傷害、及中斷服藥因素（包括藥味難聞、藥太大顆不好吞）；認為看診很麻煩與中斷服藥因素（藥物副作用）；需家人提醒服藥與服藥方式；及曾有親友給予精神層面的支持與認為同住的家人也會被傳染肺結核。 呈負相關的變項為：每個月家庭的總收入、自覺家庭經濟狀況與曾因藥物副作用而中斷服用某顆藥；主要經濟提供者與曾因藥味難聞而中斷服藥；村別與認為同住一起的家人也會被傳染肺結核；看診單趟交通時間與認為肺結核是很嚴重的疾病、及認為肺結核會危及個人生命；及親友是否曾給予物質層面的支持與服用抗結核藥後是否會影響情緒。上述變項間皆有達到統計上的顯著水準。 筆者建議應透過相關單位或有經驗團體的力量，以專業知識及合乎當地居民需求的措施，協助建立一套合乎當地需求的就醫管道，並全面加強肺結核防治宣導，以提昇當地居民對肺結核的認知及對疾病初期症狀的警覺性，並依個別性給予就醫輔助。

[ 英文摘要 ]
Abstract This thesis explores the factors related to pulmonary tuberculosis, an infectious disease to which the aboriginal Atayal in Hsiu-lin County of Hualien Prefecture in eastern Taiwan have been desperately vulnerable since the 1960''s. Taken fifty Atayal peoples as the participants, this study intends to understand how pulmonary tuberculosis patients deal with their disease, and in what way the curing rate of this disease is or is not achieved. The major findings of this study are as follows: 1.On the socio-demographic factors, the participants'' subjective evaluation of their economic status and household income are positively related to the curing rate--i.g., the better the patients'' economic status, the higher the curing rate. 2.On the healing-related aspects, those aborigines who considered going hospital as troublesome, tiring of having to continuously take pills on a long term basis, and have encountered some kind of side effects of taking doses tend to show a lower curing rate. 3.On the attitude toward healing the disease, those who continued the treating even the symptoms have improved, considered taking pills on time important and helpful to the disease, and felt their emotion little or barely influenced by the medicine tend to have a better result in curing the disease. 4.On the social support system, those participants who have received positive support from the relatives, especially the spousal, tend to demonstrate a higher curing rate. In addition to these statistical findings, the qualitative interview data collected from twelve participants pointed to the same conclusions. In concluding, the author recommended that in order to effectively improve health of the aborigines, the government health departments and voluntary organizations need to: 1) understand the healing patterns of the aborigines; 2) build an effective and convenient healing environment for the local people; 3) effectively advocate the importance of anti-tuberculosis measures to increase people''s accurate and early recognition of the disease; and 4) provide direct and sufficient financial support for curing.