社區健康營造中心保健志工績效評估之研究-以花蓮縣為例

The Performance Evaluation of Health Promotion Volunteers for Healthy Community Building – Hualien County, Taiwan as an Example

黃馨嬌(Hsin-Chiao Huang)

指導教授 ： 薛亞聖

國立臺灣大學/公共衛生學院/醫療機構管理研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.01634

摘要

我國自1999年7月起，由行政院衛生署開始推動「社區健康營造」計畫，希望藉由社區資源的投入及民眾的參與，讓當地民眾來發掘出社區的健康議題，進而產生共識，並建立社區自主照護健康營造機制。由於保健志工是社區健康營造組織中十分重要的一環，擔任非常重要的角色，因此保健志工是否能發揮功能，是社區營造中心成效相當重要的因素，而如何評估志工績效是非常重要的議題。
本研究主要目的是為瞭解及評估花蓮縣各社區健康營造中心保健志工之績效初探研究。針對衛生局提供之保健志工名冊於2004年4月進行全面性的電話調查，問卷內容以自擬的結構問卷為依據，共訪問290位保健志工，有效完訪共計214位，有效完訪率為73.8％。資料分析方法有描述性分析統計、卡方檢定、複迴歸分析及對數迴歸分析。
本研究結果發現參與社區健康營造中心的保健志工以女性 （92.1%）、中年（68.9%）、家庭主婦（49.1%）、佛教（49.1%）、高中（職）（40.2%）、家庭平均收入20001-40000最高（34.6%），招募訊息中以地方機關宣導效果最佳（39.7%），服務年資與推薦人數成正相關。在投入方面：保健志工每月平均服務時數7.5小時，每月平均服務48人次。在工作內容方面：以一般服務（39.4%）與營造中心內部事務（34.2%）為主，居家關懷（20.8%）與居家照護（2.1%）偏低。在滿意度方面：對營造中心（79.3% -「8-10分」）與對其他志工的滿意度表現呈現滿意（76.1%-「8-10分」），對自已滿意度則介於普通與滿意之間（46.0%）。再者，保健志工對自已滿意度與服務時數、志工年齡與平均時數與對營造中心滿意度皆呈現正相關。在參與前後健康行為方面：大部份的志工都有良好健康行為，少數不良健康行為的志工在參加營造中心之後，有改變良好的趨勢。在規勸及鼓勵他人改變行為方面：規勸行為以酗酒行為（73.8%）偏低。在瞭解社區健康問題方面：大部份志工（81.8%）表示瞭解，但大部份無法確實的指出健康問題。
由本研究依據研究結果建議衛生主管機關與後續研究者發展社區健康營造中心保健志工具體的績效指標。另外，社區健康營造中心也需朝向服務多元化、年齡普遍化的發展，以期達到全民參與以及全民均健的目標。

關鍵字

保健志工 ； 社區健康營造 ； 績效

並列摘要

In July 1999, the Republic of China’s Department of Health, Executive Yuan, launched the “Health Promoting Community” Program. The Program hopes that by involving its residents and resources, the locals are able to identify health issues in their community, and reach consensus on how to address these issues as well as developing a community-based self managing health building mechanism.

The success of the program depends on a number of factors and key among them is the effectiveness of the health promotion volunteers. As the volunteers play a vital role in the community health building structure, the issue of how best to assess their performance has become of great importance.

The key objective of this study is to conduct a preliminary evaluation of the performance of the health promotion volunteers at the community health building centers of the Hualien County, Taiwan. Health promotion volunteers registered with the Health Bureau of Hualien County Government were involved in this study. They were interviewed by means of telephone. Of the 290 volunteers interviewed, a total of 214 answered all the questions posed to them, hence, a response rate of 73.8%. Descriptive statistics analysis, Chi-Square test, regression analysis and logistic analysis were used for the statistical analysis.

The study found that the bulk of the health promotion volunteers were female （92.1%）, homemaker（49.1%）, Buddhist（49.1%）, age between 41-60 years （68.9%）, middle school education level（40.2%）, monthly household income of NT$20,001-NT$40,000（34.6%）. The local administrative agencies （39.7%） ranked highest among the volunteers in terms of disseminating recruitment information. There was a positive correlation between ‘years of service’ and ‘no of persons the volunteers would recommend to join the service’. The volunteers averaged 7.5 hours per month of volunteering time, and serving 48 persons per month. The types of activities involved by the volunteers were mainly related to the ‘common services’（39.4%）and ‘administrative work’（34.2%） of the community health building center. Only 2.1% and 20.8% of the volunteers were involved in the ‘home care service’ and ‘home visit’, respectively. On the level of satisfaction, 79.3% of the volunteers gave a score of ‘8 points and above’（Very Satisfied）for the overall performance of the community health building center and 75.7% gave the same score range for the performance of their fellow volunteers. As for their own performance, only 46.0% of the volunteers rated them ‘8 and above’. The overall average score was 7.08 points. The level of personal satisfaction and number of hours volunteered were found to be positively correlated. Moreover, positive correlations were also observed between level of satisfaction of the community health building center and the age group of the volunteers as well as the average hours spent on volunteering. On the change of health habits before and after joining the volunteer service, it was found that majority of the volunteers（~90%）already adopted good health habits before joining. Of the minority with bad health habits, most had indicated that they had started moving away from the old habits and changed for the better. On counseling and encouraging others to move away from undesired health habits, the effort put on alcoholism problem was the lowest（73.8%）. In the area of health issues faced by the community, 81.8% of the volunteers expressed that they understood the problems. However, they were not able to correctly pinpoint the health issues specifically.

The findings in this study could serve as the baseline of all future studies on assessing the performance of health promotion volunteers of the community health building centers. This study also concluded that the community health building centers must diversify their services and activities to meet the needs of different age groups so as to achieve the target of participation of all citizens and ‘Health-for-All’.

並列關鍵字

Health Promotion Volunteer ； Performance. ； Health Promoting Community

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