健康識能與醫療院所戒菸服務成效關係之探討

摘要本研究目的在了解接受戒菸服務民眾之健康識能分布狀態；探討其健康識能與何種背景因素與健康因素相關；選擇的戒菸方式受到何種因素影響；接受戒菸服務後其健康識能的變化，以及健康識能高低對戒菸成功影響的程度。本研究以歐洲健康識能問卷中文版與戒菸衛教暨個案管理記錄表為主要研究工具。完整完成初複評問卷的228位民眾，平均年齡為47歲。初評健康識能36.0分，其中超過一半戒菸民眾（50.9%）屬於充分等級，達到優異等級者佔17.1%，而健康識能不足或堪慮的民眾約佔三分之一（32.0%）。研究結果發現，接受戒菸服務民眾其健康識能有明顯提升，三個月後複評健康識能提升至由36.0分提升至39.5分；使用戒菸方式會影響其後續衛教完成次數、戒菸成功與否則與複評健康識能分數、性別以及衛教完成次數相關。由研究結果得知，雖然目前的戒菸方案已涵蓋相關健康識能概念，接受服務的民眾三個月後的健康識能皆能有效提升，但在健康促進領域及健康識能的應用能力的提升上仍有加強空間。而初評時仍有接近三分之一的健康識能不足與堪慮民眾，需要特別安排的教材予以指導。複評健康識能分數與戒菸成功相關，可能代表評估成效當下的健康識能的確與戒菸是否成功相關。本研究僅評估戒菸患者三個月的點戒菸成功率，更長時間的成效追蹤與復抽的評估，也是後續需持續研究的課題。

關鍵字

健康識能；戒菸；歐洲健康識能問卷中文版

並列摘要

Abstract This research aims to discover the health literacy distribution among smoking cessation population, investigate the relationship of health literacy and various demographic characteristics, identify the factors influencing people’s preferences of smoking cessation methods, discover the change of health literacy after receiving smoking cessation services, and discover the relationship of successful smoking cessation and health literacy. This study used Chinese version of European Health Literacy Survey Questionnaire (HLS-EU-Q) and smoking cessation case management chart to collect patients’ information. This study recruited 228 participants with average age of 47. The average initial health literacy score is 36.0. Half of the participants have sufficient health literacy; nearly 1/6 get excellent health literacy scores; 1/3 participants are with problematic and inadequate health literacy. Participants’ health literacy increased after receiving smoking cessation services, and the smoking cessation methods may influence the follow-up frequency. Finally, the smoking cessation successfulness is related to the 3-month follow-up health literacy scores, male gender and the health education frequency received. According to our result, current cigarette smoking cessation program has embedded the concept of health literacy in it. The follow-up health literacy all increased 3 months later, but still left some room for further improvement in health promotion domain and the ability of applying. Nearly 1/3 patients were judged as problematic and insufficient health literacy, and some special arrangement will be needed for that population. The follow-up health literacy is related to the abstinence rate, indicating that health literacy may influence successful smoking cessation. This research used 3-month smoking cessation rate as the main result, but the evaluation of longer follow-up period and relapse of smoking are also important topics in the future.