探討台灣中部地區國中學生正確用藥知識、態度與行為之研究

A Study of the Knowledge, Attitude and Behavior of Correct Medication Usage among Junior High School Students in Central Taiwan

傅中勇(CHUNG-YUGN FU)

指導教授 ： 何清治

中臺科技大學/管理學院/醫療暨健康產業管理系碩士班/碩士(2017年)

摘要

摘 要
背景：台灣藥品費用逐年成長，顯示民眾的正確用藥行為是不容易改變(衛生福利部中央健康保險署，2014)。調查指出歷年藥害救濟申請案件數統計由1999年55件增加至2016年05月2,808件申請藥害救濟。另外，台灣病人安全通報系統匿名病人安全通報事件，發生於醫院的通報事件計50,879 筆，其中藥物事件17,381例，占34.2%，顯見正確用藥的認知、態度及行為的重要性。
目的：探討國中學生正確用藥知識、態度與行為的現況及接受衛教與自我學習後正確用藥知識、態度與行為之差異。
方法：本研究採取類實驗設計法(quasi-experimental design)之前後測設計(pretest-protest experimental design)，收案期間為2017年05月22日至06月09日，收案對象為立意選定中部地區兩所國中八年級學生共144位為主，一所學校為實驗組，共69人，男生37人、女生32人，另一所為控制組，共75人，男生35人，女生40人，實驗組由藥師授課衛教介入，而對照組給予教材自行閱讀，分別給予結構式問卷進行前後測。問卷內容包括學生背景資料、正確用藥知識量表、正確用藥態度量表及正確用藥行為量表。統計方法為描述性統計、t檢定、卡方檢定、皮爾遜積差相關係數分析。
結果：本研究學生的家人主要藥品取得來源以「就醫時醫師開立領回來」最多；在服用藥物的相關資源與知識取得以「醫療人員(醫師、護理師、藥師等)」最多；學習正確用藥知識方法依序前二項為「演講」及「醫護人員衛教宣導(醫師、護理師、藥師)」。實驗組後測正確用藥知識答對率達八成、正確用藥態度及行為得分屬中上程度。實驗組後測五大核心能力用藥態度得分以核心能力三「清楚用藥方法、時間」最高。實驗組後測五大核心能力用藥行為得分以核心能力五「與藥師、醫師做朋友-生病找醫師、用藥找藥師」最高。介入衛教後，實驗組正確用藥知識、態度及行為前後測均達顯著差異。實驗組後側正確用藥知識、態度與行為得分均顯著高於控制組。實驗組後側正確用藥知識、態度與行為兩兩變項均呈顯著正相關。綜合上述顯示本研究的衛教介入是有所成效。
結論：本研究結果可提供教育單位作為日後學校執行正確用藥宣導之參考，使學生得到正確認知及正向態度，藉此提升用藥安全的積極行為。
關鍵字：正確用藥、知識、態度、行為、國中學生

關鍵字

正確用藥 ； 知識 ； 態度 ； 行為 ； 國中學生

並列摘要

Abstract
Background: The rise of cost of medicine in Taiwan shows that the behavior of correct medication usage among people is not easy to change (National Health Insurance Administration of Ministry of Health and Welfare, 2014). The survey indicated that the number of drug relief applications had increased from 55 cases in 1999 to 2,808 cases in May 2016. In addition, the report of anonymous patient safety notification incidents of the Taiwan Patient Safety Reporting System (TPR) occurred in the hospital about 50,879 cases, of which 17,381 cases were drug events, accounting for 34.2%, which indicated that the importance knowledge, attitude and behavior of correct medication usage.
Objectives: To explore the status and difference of knowledge, attitude and behavior of correct medication usage after receiving health education and self-reading among junior high school students.
Methods: This study adopted the pretest-protest design of quasi- experimental design. A total of 144 students of 8 grade of two junior high schools in the central region was enrolled with purposive sampling during May 22 to June 09, 2017. One school with 69 students (male: 37, female: 32) was assigned to experimental group and the other with 75 students (male: 35, female: 40) was assigned to control group. The experimental group was educated by a pharmacist, while the control group was offered by instructional material for self-reading. All the students received the pretest and the posttest with structured questionnaire. The questionnaire included student’s background, correct medication usage knowledge scale, correct medication usage attitude scale and correct medication usage behavior scale. Statistical methods used in this study including descriptive statistics, t test, chi-square test, Pearson product moment correlation coefficient analysis.
Results: The main purchase medication of students’ family in this study was "Bringing back after I go to see a doctor"; the relevant resources and knowledge in taking medication was mainly obtained from "medical personnel (doctors, nurses, pharmacists, etc.)"; the first two items in order of learning the knowledge of correct medication usage were "speech" and "health education propaganda from medical stuff (physicians, nurses, pharmacists)". The post-test accuracy rate of knowledge of correct medication usage was 80%, and the attitude and behavior of correct medication usage reached to middle to upper level in the experimental group. The post-test score of attitude of medication usage among five core competencies in the experimental group, the score of core competencies 3 " clearly understand how and when to take the medication " ranked the highest. And post-test score of behavior of medication usage, the score of core competencies 5 "making friends with pharmacists and physicians- find doctors when sick, find pharmacists when medication" ranked the highest. After the intervention of health education, the pretest-protest of knowledge, attitude and behavior of correct medication usage in the experimental group were significantly different, and the posttest of those medication issues in experimental group were significantly higher than those of the control group. There was significant positive relationships among knowledge, attitude and behavior of the correct medication usage in the experimental group. The above showed that the intervention of this study was effective.
Conclusion: The results of this study can provide educational institutions as best reference for the future implementation of the correct medication usage in the school, so that students can get the right awareness and positive attitude as well as enhance the positive behavior in safe medication usage.
Key words: correct medication usage, knowledge, attitude, behavior, junior high school students

並列關鍵字

correct medication usage ； knowledge ； attitude ； behavior ； junior high school students

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