- 學位論文
南臺灣社區原住民危害性飲酒之評估及耳穴貼壓介入之成效
Assessment and Effectiveness of Auricular Acupressure Intervention for Community-dwelling Aboriginal People with Hazardous Alcohol Use in Southern Taiwan
摘要
過量飲酒是世界性的議題，也是嚴重影響台灣原住民生命健康的主要問題。本研究目的在調查: (1)南臺灣原住民危害性飲酒之盛行率、相關因素及負面影響。(2)耳穴貼壓介入對原住民危害性飲酒之成效。 本研究以中文版酒精使用疾患檢測量表(The Chinese version of the Alcohol Use Disorders Identification Test, the AUDIT Chinese version)為主要測量工具， AUDIT≥8分者界定為危害性飲酒者。第一階段的橫斷性研究採等距取樣，以南台灣二個原住民鄉之原住民為研究對象，以結構式問卷採家訪方式由受訓後的訪員進行資料收集。有效樣本共449名，有效問卷回收率為80.5%。第二階段的類實驗研究，以第一階段所篩檢出的危害性飲酒者為研究對象，採方便取樣，分派為耳穴貼壓介入組和對照組。介入組(n=35)進行單耳耳穴貼壓一週一次，每次持續貼壓五天，共進行六週。對照組(n=43)不做任何介入，兩組於耳穴貼壓介入前、介入完成後二週及介入完成後三個月進行問卷資料收集。所得資料以描述性及推論性統計進行資料分析。 第一階段調查性研究結果發現: 一、社區原住民危害性飲酒的盛行率為59.7% (268/449)，包括26.7% 中度危險層級(AUDIT 8-15分)及33%高度危險層級(AUDIT≥16分)。二、多變項對數複迴歸分析結果:1.男性、未規則參與宗教活動者、有重大壓力事件者、抽菸和嚼檳榔者有顯著較高的機率屬於危害性飲酒者。2.危害性飲酒者有顯著較高的機率於酒後無法工作及與人爭吵。 第二階段介入性研究結果顯示:耳穴貼壓介入對危害性飲酒無顯著成效。進一步分析其中的指標發現，介入組在後測的飲酒頻率顯著低於對照組(p＝0.040)。 耳穴貼壓方便、非侵入性，研究初步發現能有效改善飲酒頻率，此介入方式可應用於原住民社區，提供衛生所醫護人員做為降低社區居民危害性飲酒之策略。
並列摘要
Excessive alcohol consumption is a worldwide issue and is a serious health problem among aborigines in Taiwan. This study aims to examine the prevalence, correlates and adverse drinking effects of hazardous alcohol use among aboriginal people in southern and to examine the effectiveness of auricular acupressure for hazardous alcohol use. In the first stage, a cross sectional survey was designed. The Chinese version of the Alcohol Use Disorders Identification Test (AUDIT) was used as the main measurement tool in this study. The participants were interviewed in their homes with structured questionnaires by well-trained interviewers. A total of 449 aboriginal people (80.5% valid response rate) were recruited from two townships with interval sampling method in southern Taiwan. In the second stage, hazardous alcohol users (AUDIT scores ≥8) were recruited from the participants of the first stage study, which were divided into an auricular acupressure intervention group and a control group by convenience sampling method. The auricular acupressure intervention on single ear was implemented for the acupressure group (n=35) five days a week for six weeks. The control group (n=43) received no intervention. Data were collected via questionnaires at baseline and at 2 weeks and 3 months after the completion of the intervention. Descriptive and inferential statistics were applied to analyze the data. The results were as follows: the prevalence of hazardous alcohol use among Community-dwelling aborigines was 59.7% (268/449), including 26.7% medium risk level (AUDIT = 8–15) and 33% high risk level (AUDIT ≥16). The analyses of multiple logistic regression indicated that male participants, who were inactive in religious practice, who had experienced serious stressful events, who smoke cigarettes, or who chew betel quid were more likely to engage in hazardous alcohol use. Meanwhile, the aboriginal people who were hazardous alcohol users were more likely to have experienced an inability to work or disputes with others. The results of the intervention study indicated that the auricular acupressure intervention was no significant effect on hazardous alcohol use. After further analysis, the drinking frequency of users in the auricular acupressure intervention group was significantly reduced compared to that of users in the control group at 2 weeks after the completion of the intervention. The auricular acupressure is a convenient and non-invasive method of intervention, which could be implemented as a strategy to reduce hazardous drinking by health care workers in aboriginal communities.