台灣原住民部落對肝病認知及社區評估

Taiwan's Indigenous Tribes of Liver Disease Awareness and Community Health Assessment

葉靜宜(Ching-Yi Yeh) ； 趙櫻花(Ying-Hua Chao) ； 洪兆嘉(Chao-Chia Hung) ； 陳若嵐(Jo-Lan Chen) ； 廖秀慧(Hsiu-Hui Liao) ； 羅林雯(Lin-Wen Lo)

《健康與建築雜誌》 1卷1期 (2013/10) Pp. 64-73

https://doi.org/10.6299/JHA.2013.1.1.R8.64

摘要

背景：泰安鄉為苗栗縣唯一山地鄉，因為地處偏遠、交通不便，導致醫療衛生存在待解決的問題，故藉由社區評估，進行社區健康照護計畫是社區護理管理者之重要課題。目的：探討泰安鄉原住民部落對肝病認知及進行社區評估，進而瞭解該社區問題，提出改善方案，提供社區中的個人、家庭及群體高品質的護理。方法：於民國99年5月至10月間，以擋風玻璃調查、資料查詢、重要人物訪談，參與式觀察及問卷調查等社區評估方法，蒐集泰安鄉部落地理特性、人口特性、生命統計及社會系統等資料進行分析社區健康問題，根據評估結果進行護理診斷及運用默克法則排出社區健康問題的排序，提出有利健康照護建議。結果：泰安鄉原住民肝病問卷調查（N=313）顯示，該鄉B肝帶原率23.6%、C肝帶原率21.7%。在肝病知識方面有一半以上缺乏正確的知識，其中以「肝功能指數GOT、GPT正常，不表示沒有肝病」答對率28%最低。健康行為方面有近三成受檢者，不知自己有或無B型肝炎；不到一成的受檢者知道自己有沒有C型肝炎。高危險行為方面有一成八民眾有每週喝酒三次以上。死亡原因依序為惡性腫瘤、慢性肝硬化與肝病、意外事故、心臟病及心血管疾病等。另外依據衛生所門診看診排行前六位分別為呼吸道感染、痛風、關節炎、肝臟疾病、高血壓、心臟病與糖尿病。結果顯示居民生病與飲酒習性有密切相關，根據默克法則排出該鄉社區問題得分最高為酗酒問題。結論／實務應用：本次社區評估結果能（1）提供社區護理管理者瞭解原住民酗酒問題及衍生的相關疾病（2）提出降低酗酒的途徑之參考，以降低該鄉居民死亡率。

關鍵字

社區評估 ； 默克法則

並列摘要

Background: There are many health problems need to be solved for Taian Township because that located in remote areas. Community nurses use community assessment methods to find problems and provide care plans is an important issue.Objective: To investigate Taian Township aboriginal tribes of liver disease awareness and use community assessment methods to understand the community problems.Methods: Using community assessment methods with windshield survey, interviews, participatory concept police and questionnaire to collect Taian Township tribal geographic features, demographic characteristics, vital statistics and social Systems to confirm community problems and diagnoses, according to Moke's rules to arrange Priority solution.Results: The questionnaire (N=313) showed that hepatitis B carrier rate 23.6%, hepatitis C carrier rate 21.7% of Taian Township Aborigines. There were more than half ratio subjects lack of hepatitis knowledge, which ”If your liver function GOT, GPT are normal mean does not indicate no liver disease” correct rate of 28% is lowest score. About 1/3 subjects did not know whether have hepatitis B, less than 10% of the subjects did not know whether have hepatitis C and about 18% subjects have to drink three or more times per week. Causes of death were cancer, cirrhosis and chronic liver disease, accidents, heart disease and cardiovascular disease. On the other hand, Taian public heath center showed that outpatient visits were respiratory tract infections, gout, osteoarthritis, liver disease, Hypertension, heart disease and diabetes. The results showed patients' drinking habits lead to sick. According to the Moke's rule to arrange community health problems, the highest score is alcohol problem.Conclusions/Implications: The community assessment results can be (1) to provide community care managers to understand aboriginal alcohol problems and derivative-related diseases; (2) providing ways to solve the alcohol problem and to reduce mortality.

並列關鍵字

Community Assessment ； Moke's rule