透過您的圖書館登入
IP:34.228.240.6
  • 學位論文

社區意識與整體環境維護的登革熱防治觀點 一個針對高雄市的社區比較研究

Dengue Prevention from the viewpoint of sense of community and overall environmental health---A community-based comparative study in Kaohsiung city

指導教授 : 丁志音

摘要


摘要 登革熱防治工作逐漸朝向以社區為基礎(community-based)的防治方向發展,經由動員社區義工的方式來幫助政府共同防治登革熱。雖然探討社區介入成效的相關研究不少,惟其介入效果的持久性一直備受質疑,介入計畫始終未能引發真正社區動員的主要原因為,登革熱議題一項不被視為重要的社區議題,且透過知識宣導及孳生源稽查等介入方式,不易引發民眾的共鳴。 本研究以里長、里幹事訪談以及家戶面訪的方式進行社區整體狀態的資料收集,訪問了分屬於高中低三組不同盛行程度社區6個里的里長與里幹事,以及598位社區民眾。希望經由比較不同登革熱盛行程度社區的特質,來探討社區意識的提升以及整體環境的維護,與登革熱防治的關係。 本研究結果顯示:(1) 社區意識與登革熱盛行程度之間存在著關聯性。低登革熱盛行程度之社區其登革熱的相關認知雖較為薄弱,然其社區意識與社區組織活絡程度,明顯優於高盛行程度之社區,且較傾向於將清除家戶以外孳生源的工作責任歸屬於社區居民或鄰里長。 (2)民眾對於維護住家附近環境整潔以及清除家戶以外孳生源的態度有很大的差異。多數民眾(67.1%)認為維護居住環境整潔是居民的責任,但是清除戶外孳生源則僅有14.4%的受訪者認為是居民的責任。顯示倡導維護住家附近環境整潔,會比宣導清除孳生源更容易引發民眾的共鳴。 根據以上的研究結果,本研究因此建議疾病防治應該進入一種更新更廣的思維模式,以登革熱來說,防治並不能僅靠灌輸民眾登革熱的相關認知,或經由斷斷續續的社區介入方案來達成,我們必須跳脫防治單一疾病的思考模式,學習以社區居民的需求來思考問題,才能引發真正的社區動員。執行策略有二:(1)把登革熱防治重新包裝成維護並改善住家環境整潔或釦颾e易引發共鳴,(2)成立社區環境維護組織來提升社區意識,進而促進社區動員。藉由這些非針對單一疾病的策略性觀點,來改善過去社區介入方案的缺陷,鞏固社區動員的持久性,或野i為以社區為基礎的登革熱防治工作開啟另一扇窗。

並列摘要


Abstract Community-based programs focused on the cooperation between government and community members have lately become a widely recognized strategy in dengue prevention and control. Unfortunately the effectiveness and sustainability of these programs have been questioned seriously. In most of the cases, dengue control was not considered by the community citizens as a major health issue. Moreover, conventional intervention strategies such as health education and campaign or container cleaning may not be able to incite and motivate community members to participate. The present research is a comparative community study. Six communities were selected from areas with low, median, and high dengue prevalence rates. Data were collected by in-depth interviewing with community leaders and face-to-face interviewing with community residents from 598 households. Thus both qualitative and quantitative data were integrated to examine community characteristics, dengue-related knowledge, attitudes, and behavioral intentions, and overall outlook on community environmental health in relation to dengue prevalence. The major findings are; (1) Sense of community is strongly correlated with dengue prevalence. Participants came from low prevalence communities, although having poorer dengue knowledge had stronger sense of community, as well as a more actively participating in community activities. Moreover, they also tended to consider the outdoor breeding source cleansing as the community’s rather than the government’s responsibility. (2) A substantial difference was found between the residents’ attitudes towards outdoor breeding source cleansing versus overall community environment maintenance. The latter was much more concerned about by community residents. As many as 67% of the household participants in this study were willing to be responsible for overall environmental health of the community, but only 14.4% considered outdoor container cleaning as their responsibility. The results of the study lead to propose a broader approach to the control of infectious disease. That is, the prevention and control of a specific disease such as dengue should be placed in a more comprehensive frame of conceptualization and actions, instead of the conventional disease-specific approach. From such point of view, dengue prevention should not be targeted simply on the change of knowledge and attitudes through fragmentally implemented community interventions. Community mobilization and participation cannot be fully initiated without taking the citizens’ point of views into account. Two strategies are thus suggested: (1) Re-packaged the dengue control programs from action-for-dengue to action-for-environment and, by emphasizing the change of approach, which can be accomplished through (2) building up community organizations to enhance residents’ sense of community, which in turn may facilitate participation. It is expected that the comprehensive rather than disease-specific approach of infectious disease control can assure not only the effectiveness but also the sustainability of community-based interventions.

參考文獻


7.黃基森、徐爾烈:高雄市登革熱病媒分佈及孳生環境調查。
效果比較研究。健康促進暨衛生教育雜誌 2002; 22: 43-53.
15.Lin TH. Surveillance and control of Ades Aegypti in
epidemic areas of Taiwan. Kaohsiung J Med Sci 1994; 10:
24.Wang CH, Roam GD. Dengue vector control in the urban

被引用紀錄


謝佩勳(2013)。社區參與永續性與登革熱防治-一個對高雄地區的田野比較研究〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2013.01755

延伸閱讀