台灣成年人對預防醫學保健的認知暨成年女性服用荷爾蒙的決定因素

摘要預防醫學著重於保持、促進與維護大眾及特定群體或一般個人的健康，包括預防傳染病、疾病、身體組織變異、癌症與過早死亡的發生，因此涉及多種科學、醫學及公共衛生領域。隨著醫藥進步、飲食習慣改善及社會變遷，國人女性的平均壽命已達77.79歲，平均自然停經年齡為49.33加減3.8歲(內政部統計處，1999)。統計資料顯示，多數婦女有三分之一的人生在更年期後度過。台灣人口分布也已步入老化社會，女性停經人口數正逐年增加中，成年婦女醫療保健成為醫療體系重要的一環；如何養生保健儼然成為共同話題。本研究採用行政院主計處所提供之『民國九十三年至九十七年度』國民營健康狀況變遷調查』計畫 (DOH94-FS-6-4)資料庫，進行成年人對預防醫學認知的檢測，以及成年女性服用荷爾有蒙需求函數之架構分析。本研究目的有三：一是有減重意願的人和BMI值與疾病的關係；其次探討減重與各種疾病的相互關聯性；最後以個人特性探討女性服用荷爾蒙的決定機制。本研究採用Probit模型與均數迴歸模型，進行實證估計。醫學技術的進步、營養過剩、飲食偏好、低耗能的現代生活與勞動型態、藥物副作用、代謝異常問題等，也漸漸導致「肥胖」成為普遍的國民體態現象，在眾多預防醫學保健議題中成為民眾最熱門關切的問題。肥胖不只影響體態美，也是健康的隱形殺手。造成肥胖的重要原因來自代謝不正常，根據國民健康局在2007年進行三高（高血壓、高血糖、高血脂）追蹤調查研究結果顯示，我國20歲以上民眾每5人就有1人罹患代謝症候群，且隨年齡上升而有增加的趨勢。代謝症候群的民眾未來罹患「糖尿病」、「高血壓」、「高血脂症」、「心臟病及腦中風」的機率，分別為一般人的6倍、4倍、3倍、2倍，其衍生醫療費用支出及家庭、社會的負擔與日俱增，儼已成為我國及全世界已開發國家重要的健康議題。由於女性在家庭照料、家庭經濟的支持、種族延續與子女教養上扮演吃重的角色，女性的健康與家人幸福指數締造，有著密不可分的關係。既然女性荷爾蒙攸關女性健康，且在治療更年期荷爾蒙替代療法(HRT)極為普遍下又隱藏致癌風險，「女性賀爾蒙」成為女性健康的一刀雙刃。因此成年女性服用女性賀爾蒙的關鍵決定因素為何，成為本研究想要探究的問題。準此如何採取醫療宣導及正確掌握用藥的對象把握身體治療時機，以降低服用藥物的風險。本研究結果指出台灣成年男女對自我健康的認知，以及如何維持個人在生活中較高身體質量指數之活動型態，對相關健康政策提供具體建議。民國2008國民營養健康狀況變遷調查

關鍵字

預防醫學；保健；女性荷爾蒙；肥胖； BMI值； Probit模型；均數迴歸模型(OLS) ；台灣

並列摘要

Abstract Preventive medicine emphasizes in maintaining and facilitating the health of the public as well as the individuals. It includes the prevention from infectious disease, illness, bodily organization variation, cancer and premature death occurrence. Therefore many fields of science are included, such as medicine and public health domain. Due to the advancement of medicine, improvement of diet balance and the environmental changes, the female life expectancy has reached 77.79 years old and the average natural menopause age is 49.33 years old with 3.8 years threshold. (Ministry of Interior Accounting office, 1999) According to the statistics, most women spend their last 1/3 lives after the menopause. The population distribution in Taiwan also marched into an aged society, and the feminine menopause population is increasing year by year, thus the medical health care of adult women has become a part of the medical system. How to keep a good health becomes an important issue. 　This research adopts the result in the database of the Executive Yuan 'The Report of Health Condition and Nutrition of the Public from 2004 to 2008’ (DOH94-FS-6-4). It investigates adults’ awareness to preventive medicine and presents the analysis of the demand function of the need to take Holland among adult females. This research has three goals: first, to presents the relationship between people’s BMI value who wish to lose the weight and their disease; second, to discuss the relations between the reduction of weight and the relative diseases; finally, to discuss the decisive mechanism of taking the hormone by the females according to their individual characteristics. This research is an empirical research and adopts the Probit model and the mean regression model. Obese is gradually becoming the normal body shape due to the advancement of the medicine, the nutrition surplus, the preference of diets, the lifestyle of low energy consumption, side effects of the medicine and the metabolic disorder. It has become the most concerned topic of the public. Obese influences not only the beauty of the body shape but also a hidden problem to people’s health. The main cause is the metabolic disorder. According to the study report of three heights (hypertension, hyperlipidemia, high blood fats) in 2007, there is one person out of five suffering the metabolic disorder and it is increasing when people get older. The probability of suffering from “diabetes”, “hypertension”, “the hyperlipidemia” and “heart disease and the cerebral apoplexy” are respectively six, four, three and two times of the normal people. And the medical expense and the burden on the family and the society are also increasing. It is an important health issue in Taiwan and other developed countries in the world. Females play an important role in taking care of the family, supporting the family economic, giving birth and educating the next generation. The health of the females is essential to create a happy family. Feminine hormone is the key matter to female health. However, the common treatment of HRT used in the substitution of menopause hormone has the hidden risk of getting the cancer. Feminine hormone is like the double-edged sword to female’s health. This research discusses the determining factor of taking feminine hormone among adult females. It also discusses how to promote medical education, to target on the patients to cure the disease and to lower the risk of taking medicine. The research also presents the understanding of individual health among adult males and females. The suggestions to maintain the lifestyle of a higher body performance are provided and the advices on the relating health policy are given in this research.

並列關鍵字

Preventive medicine ； Health Care ； Feminine Hormone ； Obese ； BMI value ； Probit model ； OLS ； Taiwan

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台灣成年人對預防醫學保健的認知暨成年女性服用荷爾蒙的決定因素

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