研究背景: 不當使用抗生素,導致細菌產生抗藥性,造成民眾往後生病時治療上的困難,是長久以來倍受關切的醫藥衛生議題。雖然衛生主管機關多年來以衛教來教導民眾正確的用藥習慣,也以健保給付條件限制醫師對抗生素的選擇。但民眾是否真的有正確使用抗生素的認知、態度與行為,是值得研究與確認的事。因為抵抗力較弱,孩童和老人比較容易罹患細菌感染,因此使用抗生素的機會比較高。此次研究特別關注在孩童的用藥問題,以替孩童做用藥決定的家長為受訪對象。 研究目的: 本研究之目的有二。(一)瞭解目前不同的家長特質對於孩童服用抗生素的認知、態度與行為的差異情形(二) 探討家長抗生素使用認知、態度及行為意向之間的關係。 研究方法: 研究對象為2010年台南市幼稚園年紀介於三至六歲孩童共426名的家長,根據教育部登記有案台南市幼稚園(共96家),以隨機亂數表挑選7間幼稚園並採全部取樣,以結構式問卷自願填寫之方式收集資料,並採用認知-態度-行為模式為基礎架構。統計分析以SPSS For Windows 12.0 版之軟體進行主成分因素分析、單因子變異數分析、多變量變異數分析、薛費氏事後檢定、皮爾森積差相關分析做推論性統計資料分析。 研究結果: 一、結果顯示家長對抗生素使用的認知平均得分為 6.21 分,不同家長基本特質在抗生素使用認知上呈正向顯著差異,分別在高教育程度(F=10.58,P<0.00)、高家庭收入(F=3.681,P<0.01)及具醫藥職業的家長的(F=6.78,P<0.00)。在整體抗生素態度分數家長們呈現正向態度,而母親的照護態度(F=3.271,P<0.05)高於父親,且高教育程度(F=10.459,P<0.05)、高家庭收入(F=5.570,P<0.05)、具醫藥職業的家長的F=4.692,P<0.05)及接受過的衛教(F=5.902,P<0.05)有較高的態度分數。在抗生素使用行為方面,孩童的總就醫次數越高(F=4.669,P<0.05)會有較高的行為分數。 二、研究顯示抗生素使用認知、態度與行為三者彼此呈正相關,表示家長對抗生素使用認知愈豐富,其對抗生素使用態度、行為就愈正向。 結論: 家長對抗生素的認知與其教育程度有關。對於適當使用抗生素和抗生素抗藥性的問題,健康教育的干預是必要的,以糾正普遍使用抗生素的誤解。包括電視,報紙和網路的策略是有效的公眾教育方式。旨在改變干預的重點應放在主要在母親(家庭主要照護者),教育程度、經濟程度較低。重複信息使用短的,量身定制的口號和行動線索將提高抗生素的認知及使用行為,以達到孩童可以避免因錯誤服用方式,而導致早期抗藥性產生。
Background: Improper usage of antibiotics leads to bacteria drug resistance, causing the difficulty to cure diseases while people fall ill, this has become a significant issue associated with medical and health concerns for a long time. Up to date, even though the competent health authority has continually announced the right drug usage habit to the public via health education for years, and has restricted the antibiotics selection of the doctors by the national health insurance proviso. But in reality, whether the public can possess correct Knowledge, attitudes, and practices to utilize antibiotics is deserved to research and confirm. Generally speaking, owing to the weaker resistance, it is more easily to suffer from bacterial infection for both children and the elders; so as to they have more probability to utilize antibiotics. Therefore, the “drug usage” issue for children was deliberately paid attention to in this study, and parents who have their children by determining which medicine to take were selected as our investigative objects. Purpose: There are two purposes of this research: (1) Realizing the difference on Knowledge, attitudes, and practices between parents with various properties for the antibiotics usage of children, at present. (2) Discussing the relationship on Knowledge, attitudes, and practices of parents for the antibiotics usage. Method: Our surveyed objects were the preschools with total 426 children from the ages of 3 to 6 in Tainan City, Taiwan, 2010. According to the registered preschools in Ministry of Education, Taiwan, ROC, we randomly selected 7 ones via Random Numbers Table, then sampling all of them. Data were collected by structured questionnaires and which were filled in voluntarily, and applying Knowledge, attitudes, and practices approach as basic framework through this study. Statistics and data analysis was further conducted via SPSS software with ANOVA , MANOVA, Scheffe's Test, Pearson's product-moment correlation and inferential statistics. Result: The results of this presenting work showed that: (1)An average score was 6.21 regarding the “knowledge” of the antibiotics usage of parents. Different basic properties of parents presented significant and positive effect on the antibiotics usage, such as high education level, high family income, and with medical/healthcare occupation. The entire score for the “attitudes” concern of the antibiotics usage of parents, exhibiting positive effect among our investigations; the situation in mother was higher than father. Comparatively, parents who have high education level, high family income, with medical/healthcare occupation, and were accepted health education, have higher attitudes score as well. In addition to the “practices” of the antibiotics usage concern, we found that children with higher frequency to take medical treatment resulted in higher practices score. (2)In the usage of antibiotics, via the Knowledge, attitudes, and practices approach carried out in this study, we found that they were positive correlation, each other. It indicated that the more abundant in the knowledge of antibiotics usage for parents, the more positive tendency towards attitudes, and practices would be. Conclusion: Knowledge of antibiotics usage was in relation to their education level. With regard to appropriately use antibiotics and to face its resistance problem, health education was imperatively to be intervened, so as to rectify the misunderstanding of using antibiotics generally. By effective strategies of television, newspaper, and network approaches to promote the public education, and even with emphases on the influence of “mother”, educational/economical level of family. Through this study, we might suggest that to develop short/duplicate messages, and “tailor-made” slogans for the critical health education concern, and to adopt some practical actions to enhance the knowledge and practices for the usage of antibiotics, so as to have children not to result in the generation of drug resistance at early stages, owing to incorrect methods to take medicine.