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  • 學位論文

屏東縣原住民檳榔嚼食及成癮的盛行率及其危險因子之探討

The Investigation of Prevalence and Risk Factors in Betel Quids Chewing and Dependence in Aborigines of Ping-Tong County

指導教授 : 張永源

摘要


中文摘要 屏東縣原住民檳榔嚼食及成癮的盛行率 及其危險因子之探討 研究背景 由於檳榔在原住民的生活中佔有非常重要的地位,因此在原住民地區檳榔的嚼食率相對的較高。近年來的研究發現嚼食檳榔的族群不但數目增加、年輕化且遍及各行業及階層。由於檳榔不像其他有害人體健康的物質或毒品受到政府嚴格的管控,因此其盛行率不斷的攀升,更成為台灣地區重要的公共衛生問題。觀之近年來有關檳榔方面的研究雖多,但是對於檳榔的成癮性及其危險因子的研究,尤其是在高危險的原住民族群,相對的較少。本研究除了瞭解檳榔嚼食成癮的盛行率及其危險因子外,並配合宜妙汝使用衛教及代替品等方式介入來減輕成癮的研究,以期減低檳榔的危害。 研究目的 1.調查屏東縣原住民檳榔嚼食及成癮的盛行率。 2.調查屏東縣原住民檳榔嚼食及成癮的危險因子。 研究方法 本研究調查針對居住於屏東縣原住民地區設有戶籍且年齡在20歲以上居住於當地之原住民,族別以魯凱族、排灣族為主,有效樣本數為1017人,以問卷調查為方法。統計分析則使用二項對數迴歸分析來分析樣本暴露於危險因子的危險比例來瞭解其相關性及相關程度。 結果 經由二項對數迴歸分析可知屏東縣原住民檳榔嚼食的盛行率為42.7%,其危險因子有性別(男性P=0.049)、年齡層(65歲以上P=0.006)、教育程度(不識字P=0.031、小學P=0.024)、吸菸行為(現在有吸菸P <0.0001、已戒除吸菸P=0.001)、飲酒行為 (現在有飲酒P<0.0001)等等。而在檳榔成癮的盛行率為34.1%,其危險因子有年齡層(50-64歲P=0.006)、檳榔嚼食顆粒數 (每日嚼食10-19顆P=0.037、每日嚼食20-29顆P<0.0001、每日嚼食30-99顆P<0.0001) 等等。 結論與建議 原住民從地理環境與口腔衛生的認知觀念來看,嚼食檳榔是一種自然現象。早期原住民大多居住於高山之中,氣溫偏低。為了禦寒,常藉由嚼食檳榔來產生溫暖;且也因口腔衛生觀念的缺乏,認為嚼食檳榔可以去除口腔中的異味同時清潔牙齒,故家家戶戶大多有栽種檳榔。近年來更因社會的變遷及外來文化的衝擊,使的大多數原來以勞動工作維生的原住民在大環境的改變之下無所適從,只好選擇以嚼食檳榔及喝酒來忘卻疲勞,麻痺自己,以便為鬱悶的生活尋找出口。以上的種種因素造成原住民社會中檳榔嚼食及成癮的嚴重問題。 菸、酒、檳榔等乃具成癮性之物質,應納入精神作用物質範圍內,由教育和衛生單位共同合作及早積極展開預防教育。在社會教育上,除了加強對檳榔危害的認知外,應強化肯定自己、調節情緒,提昇處理壓力和解決問題的能力。加強心理輔導、生活教育及休閒活動,使同儕壓力發揮正面的效能。在推動檳榔防治工作時宜針對相關族群設計適合之衛教課程及防治機能。

關鍵字

檳榔嚼食 成癮 盛行率 危險因子

並列摘要


Abstract The Investigation of Prevalence and Risk Factors in Betel Quids Chewing and Dependence in Aborigines of Ping-Tong County Background As betel quid chewing occupied a very important position in the daily life of aborigines,the prevalence of betel quid chewing is relatively higher. It was found in recent studies that the betel quid chewers not only increased their number but also became younger and populated to all kinds of business and life level.Because betel quid chewing is not strictly controlled by government force like other substances or poisons which can damage human body,its prevalence increased continuously and became an important public healthy problem in Taiwan.Though as we may find that there were lots of researches about the betel quid chewing in recent years,the researches about dependence and risk factors of the betel quid chewing,especially on the high risk aborigines population,are relatively fewer. In this study,in addition to understand the prevalence of dependence and its risk factors on betel quid chewing,we also cooperate with the study of Miao-Ju Yi—the study that uses oral hygiene education and substitute of betel quid to lower the degree of dependence and to decrease the injury of betel quid chewing. Objectives 1. Investigate the prevalence of betel quid chewing and dependence in aborigines of Ping-Tong county. 2. Investigate the risk factors of betel quid chewing and dependence in aborigines of Ping-Tong county. Methods The study is limited to the aborigines who lives in Ping-Tong county and age of 20 and above,mainly clan of Rukai and Paiwan,1017 residents were recruited.They were visited with an questionnaire.Statistic analysis was performed to analyze the difference in exposuring to the dangerous factors. Results The prevalence of betel quid chewing in aborigines of Ping-Tong county is 42.7% and the risk factors included sex(male P=0.049)、age(65 and above P=0.006)、educational level(illiterate P=0.031、primary school P=0.024)、smoking behavior(smoking at present P<0.0001、quit smoking P=0.001)、alcohol consumption behavior(alcohol consumption at present P<0.0001) etc. The prevalence of betel quid dependence is 34.1%,the risk factors consisted of age(50-64 P=0.006)、daily betel quids chewing amount in pieces (10-19:P=0.037、20-29:P<0.0001、30-99:P<0.0001)etc. Concluision and Suggestion From the point of view of geographic environment and comprehensive conception of oral hygiene to understand the betel quid chewing for aborigines,it is a natural phenomenon. Most of the aborigines lived on high mountains under low temperature in the early stage of their history. For cold prevention,they often chewed betel quid to produce body heat. Also because of lacking of oral hygiene conception,misunderstanding that betel quid chewing can exhaust bad odour of oral cavity and clean the teeth, almost every family planted betel nut palm around their house.What is more,because of social environmental change and impaction of foreign culture in recent years,most of the aborigines who used to live on labour working didn't know how to adapt themselves to circumstances in this changing environment and chose betel quid chewing and alcohol consumption to paralyze themselves to forget the tiredness and found outlet in their boring life. All the factors mentioned above produce a severe problem of betel quid chewing and dependence in the society of the aborigines. Cigarette、alcohol and betel quid are dependent substance which should be included into the spectrum of psychiatric active substance and prevented by aggressive teaching through educational and public healthy units in the early period of human life. In the aspect of social education, being sure of oneself,emotion regulation,increasing the ability of stress control and problem management should be enforced. Reinforcement of mental guidance、life education and leisure activity can make peer pressure cause a positive effect. Focus on the risk population group and design suitable sanitation training lesions and preventive mechanism in performing betel nut preventive program.

參考文獻


參考文獻
1.王秀玲。台東縣—原住民與非原住民檳榔濫用與口腔疾病之相關。
【碩士論文】高雄:高雄醫學大學口腔衛生科學研究所;2004.
2.王燕惠。台灣地區原住民嚼食檳榔、吸菸、喝酒使用盛行率及其健
康危害意識調查。【碩士論文】高雄:高雄醫學大學口腔衛生科學

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