預防教育介入對嚼食檳榔知識、態度、行為及自我效能之影響研究

The Study in the Effects of Preventive Education Intervention on the Knowledge, Attitude, Practice of Betel Nut Chewing and Self-efficacy of Anti-Betel Nut Chewing

王素真(Su-Chen Wang)

指導教授 ： 蔡吉政

高雄醫學大學/口腔醫學院/牙醫學研究所/博士(2007年)

摘要

分析檳榔嚼食的行為，目的在找出嚼食檳榔的高危險群及危險因子，作為防治檳榔健康危害的課題。問卷調查結果發現：男性嚼食檳榔的盛行率高於女性；都市化程度愈低的地區，嚼食的盛行率愈高。職業學校學生嚼食檳榔的盛行率，皆高於普通高中，以農業學校比普通高中的勝算比最高。好奇是誘使開始嚼食檳榔的主要動機，對其可能產生的健康危害認知普遍不足。嚼食檳榔的行為，除受同儕壓力及父母親行為特質兩大因素影響之外，北部地區較偏重於家庭社會人口因子變項的影響，南、東部地區，較偏向於周遭環境變項的影響。
預防重於治療，為防治學生嚼食檳榔行為的發生，提供充足的資訊使學生對檳榔有足夠的認知，教導拒絕或戒除嚼食檳榔的學習機會，預防性的衛生教育介入是根本之道。
進行預防性校園檳榔衛生教育介入的實驗計畫，目的在探討衛生教育介入對學生在檳榔危害的認知、嚼食檳榔的態度、行為，以及拒絕嚼食檳榔的自我效能等方面的影響效果。立意選取台南縣某醫事技術學院學生，分為實驗組與對照組。結果發現：(1)受試者對於檳榔危害的認知，嚼食檳榔的態度、行為，及拒絕嚼食檳榔自我效能等變項間，有顯著性相關。(2)衛生教育介入對於增強對檳榔危害的認知、強化反對嚼食檳榔的態度、行為，及提升拒絕嚼食檳榔的自我效能等方面，皆有立即性、持續性的影響效果；但若無持續性衛生教育介入，會因時間性而降低其效能。(3)約有八成衛教介入受試者，表示滿意各教學單元內容。
希望能藉由對檳榔健康危害的衛教介入，增強學生反對嚼食檳榔認知、態度，提升拒絕嚼食檳榔的自我效能，達到減少嚼食檳榔的行為。

關鍵字

檳榔 ； 衛生教育介入 ； 知識 ； 態度 ； 行為(KAP) ； 拒絕嚼食檳榔的自我效能 ； 立即性效果 ； 持續性效果

並列摘要

The results of an investigation in the prevalence of betel nut chewing and related factors by a structured questionnaire showed the following: the prevalence of the betel nut chewing habit in male students was significantly higher than in female students; less urbanized areas were associated with a higher prevalence of the betel nut chewing. The vocational school students had a higher prevalence of betel nut chewing than general school students; the odds ratio of agricultural school students to general school students was the highest of all the ex-chewers and current-chewers. The curiosity of students was the main reason for starting betel nut chewing; most chewers, even though they were compulsive betel nut chewers, did not realize that betel nut chewing could lead to addiction reactions indicating that they were apparently ignorant about any risk to health. It was noted that the betel nut chewing behavior is definitely related to peer pressure and parents’ behavior. The betel nut chewing behavior is related to general demographic characteristics in the northern area, and is related to sounder environment factors in the eastern and southern areas. Betel nut chewing habit has different related factors among areas in Taiwan.
Our results were enable us to find the most at risk group of students in terms of betel nut chewing, and to intervene educationally when needed. However, prevention is better than curing, so better health education is necessary to lower the rate of student betel nut chewers.
The purpose of the subsequent study was to explore the immediate and instant effects of preventive health education intervention in the knowledge, attitude, practice of betel nut chewing, and self-efficacy of anti-betel nut chewing for students. Purposeful sampling was employed to select two departments of the division of a medical technology school in Tainan Xian. Individuals were recruited, and divided into experimental and control groups. The results were as the following:
1. The knowledge, attitude, and practice in betel nut chewing were significantly correlated with self-efficacy of anti-betel nut chewing.
2. The effects of knowledge, attitude, practice, and self-efficacy of anti-betel nut chewing aspect were significantly different between pre-test and post-test, between post-test and post-post-test intervention periods. There had been significant immediate and instant effects after health education intervention. Health education enables students to have better reinforcement in the knowledge, attitude, and practice of betel nut chewing, and self-efficacy of anti-betel nut chewing with immediate and instant improvements. The effectiveness may decline if the preventive health education intervention is not performed continuously.
3. About 80.0% of subjects were satisfied with each learning activity and the design contents of the program.
In conclusion, we had showed that health education enable students to better resist the use of betel nut immediately and instantly. Therefore, the oral health education programs in dealing with the health risks of betel nut chewing for the risk group students are important.

並列關鍵字

betel nut ； health education intervention ； knowledge, attitude, practice (KAP) ； the self-efficacy of anti-betel nut chewing ； immediately effect ； instantly effect

參考文獻

Andrew, S., Sally, K., Elizabeth, R., & Sean, H. The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Ame J Public Health. 2001; 91(2):265-269.

Aveyard, P., Cheng, K. K., Almond, J., Sherratt, E., Lancashire, R., Lawrence, T., Griggin, C., & Evans, O. Cluster randomized controlled trial of expert system based on the transtheoretical (“stag of change”) model for smoking prevention. Br Med J. 1999; 319(7215): 948-953.

Bandura, A. Social foundation of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall. Inc. 1986; 390-453.

Chen, J. W., Shaw, J. H. A study on betel chewing behavior among Kaohsiung resident aged 15 years and above. J Oral Pathol Med. 1996; 25: 140-143.

Cornuz, J., Humair, J., Seematter, L., Stoianov, R., & Stalder, H. Efficacy of resident training in smoking cessation: A randomized, controlled trial of a program based on application of behavioral theory and practice with standardize patients. Annuals of Int Med. 2002; 136(6): 429-437.