國軍戒菸衛生教育介入效果之研究-以金門地區國軍為例

Study on the Effectiveness of Smoking Cessation Intervention Program for the Military in Kinmen County

李金治(Chin-Chih Lee)

指導教授 ： 陳政友

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/博士(2012年)

摘要

本研究旨在發展一套以健康信念模式及自我效能為基礎之國軍戒菸衛生教育課程，並探討此課程在戒菸上的效果。本研究採準實驗設計（Quasi-experimental design）之「實驗組與對照組前測、後測及後後測設計」，以服役於金門縣金門防衛指揮部有吸菸的男性軍人為母群體，以立意取樣，取某營區吸菸之50人為實驗組（實際完成研究者45人）與另一營區吸菸之50人為對照組。實驗組接受本研究設計之國軍戒菸衛生教育課程，對照組不接受任何處理。兩組經前測、後測及後後測的問卷調查及呼氣CO值檢測的客觀測量，並以單因子變異數分析及單因子共變數分析等進行統計分析。研究發現：
一、研究對象之平均年齡為21.07歲，教育程度六成五為中等程度（含國中、高中職），菸齡平均為5.82年，七成的研究對象之同儕半數以上會吸菸，近七成的研究對象之父親有吸菸習慣，母親有吸菸者則有一成四。研究對象之日吸菸量平均值為14.45支，呼氣CO檢測平均值為11.94ppm，屬中度吸菸者。
二、國軍戒菸衛生教育介入後，除了在「自覺戒菸利益性」外，研究對象在「菸害知識」、「自覺吸菸疾病罹患性」、「自覺戒菸障礙性」、「戒菸行動線索」、「戒菸自我效能」等效標上，皆具有良好的立即與延宕效果，惟在「自覺吸菸疾病嚴重性」之效果在後後測才顯現出來。
三、國軍戒菸衛生教育介入後，研究對象在「日吸菸量」、「CO檢測值」及「戒菸率」，皆具有良好的立即及延宕效果，而且戒菸率在介入後一週時為42.2％、在介入後五週時為37.8％，顯示本戒菸衛生教育介入在國軍戒菸上有不錯的效果。
整體而言，以健康信念模式及自我效能為基礎之國軍戒菸衛生教育課程，能有效提升國軍戒菸率與降低吸菸量，具有推動潛能。因此，建議國防部軍醫局未來可參考本研究之衛生教育介入模式，納入國軍的訓練課程，以增加戒菸資源的可及性。

關鍵字

國軍 ； 戒菸衛生教育介入 ； 健康信念模式 ； 自我效能

並列摘要

This study developed a program of smoking cessation intervention based on the Health Belief Model and Self-efficacy Theory for military soldiers, and evaluated the effectiveness of this program. This study employed a Quasi-experimental design that includes pretest, posttest and post-posttest with an experiment group and a control group. Totally 100 subjects with smoking habits were recruited from male military personnel at Kinmen Defense Headquarters in Kinmen County, and they were divided equally into two groups. The experimental group received the program of smoking cessation (45 subjects had completed the full program ), but the control group did not. In order to evaluate the effectiveness of this program, a questionnaire and a carbon monoxide (CO) test were performed for each subject in the two groups at stages of pretest, posttest and post-posttest. One-way ANOVA and One-way ANCOVA were used for statistical analysis.
The main results were shown as follows. Firstly, the results show that all subjects had the mean age of 21.07 with 5.82 years of smoking habit on average. Among them, 65% subjects had middle level education (including junior and senior high schools). There were 68.4% subjects whose fathers had smoking habits and only 14.7% whose mothers had smoking habits. The average number of cigarette per day was 14.45 with the average CO measurements of 11.94 ppm, which was in the range of the moderate level.
Secondly, with the exception of “perceived benefits”, there were significant improvements in the experimental group after the intervention of smoking cessation education in “knowledge of tobacco hazards”, “perceived susceptibility”, “perceived barriers”, “cues to action” and “self-efficacy” regardless of the posttest (1 week after the intervention) or the post-posttest (5 weeks after the intervention) in comparison with the control group. However, the improvement to “perceived severity” was only revealed at the stage of post-posttest. Thirdly, the experimental group had significant decreases in cigarettes per day and CO measurements than those of the control group regardless of the posttest or the post-posttest after the intervention .The rates of quitting smoking reached to 42.2% and 37.8% after the first week and the fifth week respectively from the intervention, indicating the impact and delayed effectiveness of this program of smoking cessation.
In conclusion, this program of smoking cessation intervention for military effectively increases smoking cessation rate, and decreases the amount of cigarettes per day. This program can be adopted by Ministry of National Defense-Medical Affairs Bureau to promote the health for military personnel.

並列關鍵字

Military ； Smoking Cessation Program ； Health Belief Model ； Self-efficacy Theory

參考文獻

王國川（1988）。修改後健康信念模式測量理論基礎之探討-以青少年無照騎車之研究為例。教育心理學報，30(2)，101-121。

行政院衛生署國民健康局（2002）。台灣地區臨床戒菸指南-醫師篇（2002）。行政院衛生署國民健康局，台北。

行政院衛生署國民健康局（2009）。台灣菸害防制年報，台北。

行政院衛生署國民健康局（2011）。菸害防制調查統計報告（93-99年）。政院衛生署國民健康局編印，台北。

李守義，周碧瑟、晏涵文（1989）。健康信念模式的回顧與前瞻。中華公共衛生雜誌，9（3），123-137。