探討「增強自我效能與拒絕技巧訓練」計畫對國中生健康態度之影響-以吸菸為例

Study of the Impact of “Enhancing Self-Efficacy and Learning How to Say No” Program on Junior High School Students’ Health Attitude to Smoking

洪琲箴(Hung Pei-Chen)

指導教授 ： 何清松

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2004年)

摘要

從近幾年國內之吸菸盛行率調查報告中，可以發現國內吸菸的人口越來越多；在年齡層的方面，也有普遍下降的趨勢。隨著時代的轉變，現在的青少年已經不再像從前一般，對於老師所說的話，言聽計從。因此若仍採用以傳統衛生教育方式來改變青少年對菸害的認知，成效必定不彰。參考國外成功的範例，本研究希望能夠提供一套既能適合國內青少年，又能配合國內教育體制的預防吸菸教育介入計畫。
藉由「增強自我效能與拒絕技巧訓練」計畫的實施，本研究的目的有三：1.國中生能夠抗拒誘使他們吸菸的社會壓力；2.發展國中生的自信心和自主能力，使他們不須藉吸菸等自傷行為逃避現實；3.培養國中生處理焦慮情境的能力，特別是由生活環境所引發的焦慮。
本研究選取台中縣縣內十一所國中，每所國中擇兩班一年級之學生。將學生分為兩組，一組為實驗組，另一組為對照組。實驗組需接受為期五週、每週一堂課(1小時)的介入課程。實驗組及對照組皆接受前、後及後後測，其實施時間分別在介入課程實施前、介入課程結束後，以及介入課程結束四個月後。
研究結果顯示，在「拒菸態度」方面，實驗組學生在前測時，拒菸態度平均得分是介於「贊同~非常贊同」之間，課程能夠幫助學生使拒菸態度更加趨於正向的空間有限。在「不吸菸意向」方面，實驗組學生於後側及後後測時，其意向有明顯增強，且達到統計上的顯著性。在「教學活動評價」方面，有90.7%的學生表示喜歡此次的教學活動；同時也有91.0%的同學願意推薦其他同學來參加這樣的課程；更有70.8%同學曾應用課程中所教授的技巧，來拒絕別人請他吸菸的狀況。
根據此次研究結果，有五點建議：1.在對青少年進行預防吸菸教育時，亦應對家長進行反菸宣導；2.將課程納入正規教育體系中，並由學校老師親自教學、示範；3.延長介入時間，並做持續地縱貫性研究；4.亦可針對不同年齡層學生做橫斷性研究，以瞭解課程介入對不同年齡學生之成效；5.降低研究對象之年齡，提早開始對學生灌輸拒菸的意識。期望以上的建議，可以讓未來將要進行的預防吸菸介入計畫，更為有成效。

關鍵字

自我效能 ； 拒絕技巧 ； 拒菸

並列摘要

From the smoking prevailing rate investigation reports in Taiwan in recent years, we can find that the smoking population in Taiwan is increasing, and the age of people that smoke is generally descending. With the transition of times, the teenagers nowadays do not always follow the teachers’ advice as before. Therefore, if we still adopt the method of traditional sanitary education to change teenagers’ cognition for the evil of smoking, the result will be ineffective. Making reference to the successful examples abroad, the research expects to provide a set of smoking-preventive educational interference project that is available for teenagers in Taiwan and that can cooperate with the educational system in Taiwan.
By means of the execution of the plan, “Enhancing Self-Efficacy & Learning How to Say No,” the targets to be achieved were as follows: 1. Making the junior high school students be able to resist the social pressure that lured them to smoke. 2. Developing the junior high school students’ confidence and autonomous ability, so that they didn’t have to try to escape reality by the self-hurting behaviors such as smoking. 3. Training the junior high school students’ capabilities to deal with anxious circumstances, especially the ones that resulted from the living environment.
In this research, I chose students from the eleven junior high schools in Taichung County, and selected two classes of the 1st grade students in each junior high school. The students were divided into two groups: experimental group and comparison group. The experimental group must take the interference courses of one class per week (1 hour) that lasted five weeks. Both the experimental group and the comparison group must accept the pre-test, after-test, and later-test. The time was before the interference courses, right after the interference courses, and four months later after the interference courses respectively.
Following are the research results: In the aspect of “antismoking attitude,” the average scores of students of experimental group on antismoking attitude were between “agree” and “very much agree” when they did the pre-test. The degree that the courses could help students to be more positive about the antismoking attitude was somewhat limited. In the aspect of “antismoking intention,” the inclinations of students of experimental group evidently intensified at the after-test and later-test, and the significance on statistics was achieved. In the aspect of “teaching activity evaluation,” there were 90.7% students showing that they liked this teaching activity; meanwhile, there were 91.0% students being willing to recommend other classmates to join in this kind of courses; besides, 70.8% of students had ever used the skills teaching in the courses to refuse other people’s inviting them to smoke.
Based on the research outcome, I have five suggestions: 1. While aiming at the teenagers to make the smoking-preventive education, we should do the antismoking propaganda for parents. 2. To bring the courses into the regular and standard educational system, and to be taught and demonstrated by teachers personally. 3. To prolong the time of interference, and make the vertical research constantly. 4. To make the transverse research aiming at students of different ages in order to know the effects of courses interference on students of varied ages. 5. To lower the age of research object, and start to instill the antismoking consciousness into the students’ minds earlier. I hope the above-mentioned proposals will let the smoking-preventive interference project be more effective in the future.
Key word: Self-Efficacy, How to say no, Antismoking.

並列關鍵字

Self-Efficacy ； How to say no ； Antismoking

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