|
|
 |
|
|
|
| |
|
|
| |
|
|
|
智能障礙青少年健康行為、預防保健與醫療利用及其相關因素之研究
|
|
|
| 作者 |
 |
嚴嘉楓 |
| 學校系所 |
|
國防醫學院生命科學研究所 |
| 地點 |
|
全臺 全部
|
| 研究內容 |
|
[ 摘要 ]
透過健康的生活型態與預防保健服務的使用可以有效預防慢性疾病與減緩其嚴重性，但針對智能障礙群體，相關研究資料在台灣地區卻付之闕如。本研究主要目的乃在探討智能障礙青少年的健康行為、預防性健康服務與醫療利用情形及其相關因子。本研究以台灣地區內政部身心障礙資料檔中領有身心障礙手冊之12-18歲之智能障礙青少年為研究母群共計11,549人。研究樣本採年齡分層等比率之隨機抽樣法，抽出所需樣本；研究工具及資料收集為結構性郵寄問卷，主要由智能障礙者的主要照顧者自行填寫回覆，總共寄出5,055份問卷，回收1,419份有效問卷，回收率為28%。結果：在智能障礙青少年健康生活習慣方面發現3.4%的研究對象曾經吸菸，1.4%有吸煙習慣，0.6%有飲酒習慣，嚼食檳榔習慣者佔0.5%，與吸菸習慣有統計上顯著相關的因素為性別、原住民、共同居住者吸菸、是否就學及健康飲食；39.5%的青少年有規律性運動的習慣，其相關因子為原住民、肥胖情形、營養補充劑的食用、預防保健行為。另外發現1.9%的個案沒有刷牙習慣，高達46.9%個案有齲齒卻未治療。在營養攝取習慣上發現智能障礙者在奶類、新鮮水果及蔬菜上的食用頻率明顯低於衛生署針對青少年所公佈之建議量及一般青少年食用頻率；有31.3%的個案為過重及肥胖，與其體位相關因素為個案與主要照顧者性別、早餐外食情形、自覺健康情形、規律運動習慣等。智能障礙青少年健康飲食的預測因子為女性主要照顧者、社經地位較高及自覺健康較佳。在預防保健服務的使用上發現三年內接受視力檢查比率最高(82.6%)，其中定期接受篩檢有25.5%；10.7%有定期接受身體檢查，20.3%有定期接受口腔檢查。三年內曾注射過流行性感冒疫苗僅佔22.1%；27.4%的個案未接種B型肝炎疫苗，三年內接受肺炎鏈球菌疫苗接種者佔2.1%。接受B型肝炎疫苗注射的預測因子為主要照顧者與個案的關係、每月家庭總收入與口腔檢查情形(p<0.05)；接受流感疫苗注射的預測因子為住所為機構者、障礙程度為中重度者、特殊檢查、三年內曾接受健康檢查者及曾經吸菸(p<0.05)。門診、急診與住院利用的危險因素為自覺健康較差者與曾使用口腔檢查、特殊檢查者(p<0.05)；另外智能障礙青少年預防疫苗接種影響因素上，個案的基本人口學特徵、健康行為與醫療利用三面向是彼此獨立。本研究為初探性的調查，發現台灣地區智能障礙者青少年普遍有營養失調的情形，運動量不足，體位呈現兩極化分布，期望未能能藉由本研究發現設計適切的健康促進方案提升整體智能障礙青少年的生活品質。
[ 英文摘要 ]
The benefits of preventing chronic diseases through healthy lifestyles, behaviors and usage of preventive health services have been well documented in the general population. However, the information regarding best practices to address the above characteristics toward people with an intellectual disability are currently unavailable in Taiwan. The aims of the present study were to scrutinize the profiles of healthy lifestyles, behaviors and the utilization of preventive health and medical care services and to exam their determinants for people with an intellectual disability in Taiwan. A cross-sectional survey design was employed in the present study. The study samples choosed by multistage sapmling from the National Register of the Disabled in Taiwan, those individuals with an intellectual disability whose aged 12-18 years were recruited in the study. Finally, there were 1,419 subjects included in the study (response rate 28%). Data was collected by a mail-structured questionnaire that was completed for each individual by their main carers. The results found that 1.5% subjects were smokers, 0.5% used betel-nut, 39.5% did physical activities regularly, and there were 1.9% subjects did not brush teeth regularly. In daily food intake, the results showed that their intake in vegetable, nutritious milk-products and fruits were lower than the general adolescents. The subjects also consumed sweeter beverage than the same age of general population. There were 66.3% subjects used outpatient care, 4.7% were hospitalized and 9.8% used emergency services in the previous 6 months. The risk factors of their health services utilization are self-percepted poor health status, used dental health screening and special health examinations. The predict factors for their nutritious diet are female main carer, higher social class of their parents and good health status. With regard to the use of Hepatitis B vaccination, the factors of institutional inhabitant, household income, and used dental health screening can significantly predict their usage. Those factors of family resident, severe level of disability, general or special health examination and smoking experience were significantly correlated to the use of pneumococcus vaccination. The study suggests that the health authorities should pay more attention to the health promotion to prevent the occurrence of chronic diseases for adolescents with an intellectual disability in the future.
|
|
|
|
|
|
|
|
