社區民眾健康識能與醫病關係之探究

【研究目的】近年來，健康識能的相關議題逐漸受到重視，國內外許多相關研究指出，健康識能不足的病人可能會有健康照護上的風險，造成就醫困難及照護不良的健康結果。本研究的目的為社區民眾健康識能與醫病關係之探討，除了分析社會人口學特徵分別對於健康識能、醫病關係之相關性，也探討健康識能與醫病關係之相關性。【研究方法】本研究以橫斷面的結構式問卷作為研究工具，「社區民眾健康識能與醫病關係之探討」調查問卷包含了三部分，分別為「成人健康識能測驗」(11題)、「醫病關係調查」(25題)以及「個人基本資料」(9題)，共計45題。本研究以高雄市大岡山地區為主要研究區域，並以該區域之社區民眾為主要研究調查對象。研究個案以立意取樣方式進行，針對高雄市大岡山地區年滿18歲、識字且能自行完成整份問卷之社區民眾，排除嚴重視覺障礙及嚴重失智者，調查其健康識能程度以及與醫療人員互動關係。將所蒐集到的資料，以SPSS 22.0中文版套裝軟體使用複迴歸分析個現象間的相關性。【研究結果】本研究共計發放500份問卷，有效回收份數為425份，有效回收率為85%。研究對象以女性居多佔271位(63.8%)，年齡分布上51-65歲者居多佔157位(36.9%)，學歷部分以高中職或專科畢業者為多佔174位(40.9%)。在人口學特徵對健康識能程度之複迴歸分析結果中發現，當研究對象教育程度越高，健康識能程度也越高。而在人口學特徵與醫病關係複迴歸分析結果中，個人月收入與醫病溝通、信任感、滿意度皆為負相關性。而在健康識能程度對醫病關係之複迴歸分析結果中發現，健康識能程度在整體就醫滿意度上呈現顯著負相關性。【結論與建議】簡言之，教育程度是影響健康識能的因素之一，且教育程度越高，健康識能程度也會越高。另外，個人月收入與醫病關係呈現負相關性。在健康識能程度與醫病關係的部分，兩者也具有顯著負相關。在未來研究建議方面，可透過長期追蹤調查，了解在不同社會脈絡下，民眾健康識能及醫病關係所產生的變化。而在政府政策上，應注意紙本健康訊息的理解困難程度，並能多應用圖形、圖示的輔助，減少醫病間的資訊落差。

關鍵字

健康識能；醫病關係；問卷調查

並列摘要

【Research Purposes】 In recent years, issues related to health literacy have gradually received attention. Many related researches have pointed out that patients with insufficient health literacy may have health care risks, resulting in medical difficulties and poor health outcomes. The purpose of this study is to explore the relationship between health literacy and medical care among community residents. In addition to analyzing the correlation between sociodemographic characteristics and health literacy, doctor-patient relationship, and the relationship between health literacy and doctor-patient relationship. 【Research Methods】 In this study, a cross-sectional structured questionnaire was used as a research tool. The questionnaire on “The Health Literacy and Doctor-patient Relationship among Community Residents” included three parts, namely “Adult Health Qualification Test” (11 questions) and “Doctor-patient Relationship Survey” (25 questions) and the "Personal Basic Information" (9 questions), a total of 45 questions. The research case was conducted by means of sampling. The community in Kaohsiung City, who is 18 years old, literate and able to complete the questionnaire on their own, excludes serious visual impairment and severely demented. The collected data were analyzed by SPSS 22.0 Chinese version of the software using complex regression analysis. 【Research Result】 A total of 500 questionnaires were distributed in this study, and the effective number of copies was 425, and the effective recovery rate was 85%. The majority of the study population was 271 (63.8%), and the age group of 51-65 years old accounted for 157 (36.9%). The number of senior high school or college graduates was 174 (40.9%). In the results of the regression analysis of demographic characteristics on the level of health literacy, it is found that the higher the educational level of the subjects, the higher the level of health literacy. In the results of the regression analysis of demographic characteristics and doctor-patient relationship, personal monthly income is negatively correlated with medical communication, trust, and satisfaction. In the results of the regression analysis of the relationship between the health literacy and the doctor-patient relationship, it was found that the degree of health literacy showed a significant negative correlation with the overall medical satisfaction. 【Conclusion and Suggestion】 In short, education is one of the factors that influence health literacy, and the higher the level of education, the higher the level of health literacy. In addition, there is a negative correlation between personal monthly income and doctor-patient relationship. There is also a significant negative correlation between the two aspects of the relationship between health literacy and medical care. In terms of future research proposals, we can use long-term follow-up surveys to understand the changes in people's health literacy and doctor-patient relationships in different social contexts. In the government policy, we should pay attention to the difficulty of understanding the paper health message, and can use the aid of graphics and illustrations to reduce the information gap between medical treatment.