- 學位論文
南投縣外偶、原民與一般學童生長發育及視力、牙齒健康狀態之比較研究
A comparative study of growth, vision acuity and dental health status of the schoolchildren of marital immigrants and aboriginal and non-aboriginal Taiwanese in Nantou County
摘要
目的-本研究旨在比較南投縣國小外籍配偶（外偶）、原住民（原民）與一般學童的生長發育及視力、牙齒健康狀態並探討其影響之相關因素。 方法-依各族裔居住地區，立意取樣國小學童健康記錄共計有效樣本1674名（外偶337、原民339、一般958）。以SPSS統計軟體分析個案一、四年級時之身高、體重、身體質量指數（BMI）、雙眼視力指數及牙齒齲、補指數。 結果-外偶一、四年級時男童身高、體重、BMI與一般生無差異。原民男童身高顯著低於一般及外偶男童2.7-3.1公分，但體重及BMI三者間無差異。女童身高於一年級時三者間各顯著差異，一般生最高原民生最婑，四年級時則一般女童高於另二者2-3.4公分。外偶女童體重顯著輕於原民及一般女童1.5公斤。與衛生署兒童生長曲線標準比較顯示外偶男生與原民女生肥胖度高於同性別其他族裔。各性別、年級視力原民生顯著優於外偶及一般生，其中雙眼指數平均，原民、外偶、一般生分別為1.16 vs. 0.99 & 0.85，視力正常率為86% vs. 74% & 76%，且男生高於女生。牙齒總龋補數一般及外偶生顯著少於原民，其中齲補指數一般、外偶、原民生分別為為4.21 & 4.24 vs. 6.34、無齲齒率為16% & 14% vs. 2.5%。總修補數是一般生高於外偶及原民（0.99 vs. 0.54 & 0.34），各族裔四年級時齲齒率仍高達九成，一般、外偶及原民分別為81%、85% 及98%。 結論-本研究顯示生長發育外偶男生與一般生無差異，外偶女生顯著較矮及輕，可能是社經地位及傳統觀念影響所致。原民男女生身高較矮，女生較重且肥胖率高，與營養攝取、族裔種族別相關。兒童生長曲線是否適用於各特殊族裔，值得探討。原民生視力顯著優於一般與外偶，顯示受居住環境及生活方式影響。原民齲齒數顯著高於一般及外偶生，但是外偶與原民生之修補數顯著低於一般生，顯示牙齒龋補受家庭環境及社經地位影響所致。各族裔兒童生長及健康問題應受重視，對一般及外偶生加強視力保健，對外偶與原民生之牙齒齲補需積極介入。特殊族裔健康問題與生長差異需持續追蹤探討。
並列摘要
Objectives -The objectives of this research were to compare growth, vision acuity and dental health status and to identify their potential impacting factors among the schoolchildren of the marital immigrants, the aborigines and the Han-Taiwanese in Taiwan. Method-Using a purposive sampling scheme, the study analyzed the height, weight, BMI, vision acuity and dental health status of 377 schoolchildren of marital immigrants, 339 of the aborigines and 958 of the Han Taiwanese. The study also analyzed the potential impacting factors on these health parameters. Results-Boys of the marital immigrants grew as well as the Han-Taiwanese, whereas boys of the aborigines were 2.7-3.1 cm shorter by the fourth grade compared to boys of the other two ethic groups. However, no differences in BMI were observed. In girls, significant differences in height and weight were observed among the three ethnic groups. By grade four, girls of the immigrants and the aborigines were 2-3.4 cm shorter than girls of the Han-Taiwanese whereas girls of the marital immigrants were significantly lighter than the other two ethnic groups. The aboriginal girls had significantly higher BMI compared to girls of the other two ethnic groups. The aboriginal schoolchildren had better vision acuity compared to schoolchildren of the other two ethnic groups. Visual acuity was 1.24 for children of the aborigines, 0.98 for children of the marital immigrants and 0.94 for children of the Han-Taiwanese. The aboriginal children had the worst dental status compared to the other two ethnic groups. The dental caries indexes are 6.34 for Han-Taiwanese children, 4.24 for children of the immigrants and 4.21 for the aboriginal children whereas the total dental caries repair index were 0.99, 0.54 and 0.34, respectively. Conclusion-Results of this study suggest a gender difference in growth rate of the children of marital immigrants. Boys of the marital immigrants have the same height and weight compared to the boys of the Han-Taiwanese but girls of the marital immigrants are lighter and shorter compared to their Han-Taiwanese counterparts. While the real cause of this gender difference is not precisely known, the traditional boy-preference in Taiwanese culture may play a role. The strong preference toward male gender, especially the first child, by many Taiwanese parents and grand parents may create a difference in care and nutritional status and that may impact growth. On the other hand, the aboriginal boys and girls were shorter but not lighter compared to the Han-Taiwanese children, and their BMI was the same in boys but higher in girls compared to their Han-Taiwanese counterparts. Again, the real cause is not precisely known, but genetic differences appear probable. The aboriginal children have better visual acuity compared to their Han-Taiwanese and marital immigrant counterparts. The aboriginal children have more total dental caries but fewer repairs compared to their Han-Taiwanese and marital immigrant counterparts. It is conceivable that the differences in sociodemographic status and lifestyle factors such as the number of hours of reading time and TV-watching, and the level of outdoor activities may play a role. Results of this study suggest that growth impairment do exist in daughters but not boys of marital immigrants compared to their Han-Taiwanese counterparts. Care should be taken to prevent a gender-related bias in growth and development of these children.