以PRECEDE模式探討青少年避免二手菸行為及其相關因素

The investigation of avoiding secondhand smoke behavior and related factors among adolescents by PRECEDE Model

李美芳(Mei-Fang Li)

指導教授 ： 王瑞霞 副教授

高雄醫學大學/護理學院/護理學系研究所/碩士(2003年)

摘要

本研究以PRECEDE模式探討青少年避免二手菸行為，研究目的為（1）了解青少年避免二手菸行為的執行情形；（2）探討青少年社會人口學變項、素質因素（包括二手菸的知識、避免二手菸的態度、避免二手菸的自我效能）、使能因素(學校避免二手菸健康資源的現況)、加強因素(自覺家人執行避免二手菸行為、自覺同儕執行避免二手菸行為、同住家人是否吸菸、同儕是否吸菸)與避免二手菸行為的相關性；（3）探討青少年避免二手菸行為之重要預測因素。
研究對象為南區技術學院附設五專部20所學校，經方便取樣徵求學校同意參與研究，最後共五所學校同意，以集束抽樣方式，由每一樣本學校1-4年級隨機抽取一個年級，再由抽中之年級再隨機抽取一班，抽中班級之所有學生選為本研究之樣本，共抽取有效問卷208份。研究工具為結構式問卷，包括社會人口學變項、避免二手菸行為、二手菸的知識、避免二手菸的態度、避免二手菸的自我效能、學校避免二手菸的健康資源現況、自覺家人執行避免二手菸行為、自覺同儕執行避免二手菸行為、同住家人是否吸菸、同儕是否吸菸。量表經信度及效度檢定，包括內部一致性信度、再測信度、內容效度及建構效度。所得資料以因素分析、百分比、平均值、標準差、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關、逐步複回歸分析。
研究結果發現：（1）青少年避免二手菸行為的得分指標為75.47，顯示青少年的避免二手菸行為在中上程度；（2）女性避免二手菸行為顯著較男性好，年齡和家庭社經地位在避免二手菸行為上沒有顯著差異；（3）二手菸的知識與避免二手菸行為沒有顯著相關；（4）避免二手菸的態度愈正向其避免二手菸行為愈好；（5）避免二手菸的自我效能愈高其避免二手菸行為愈好；（6）學校避免二手菸資源現況與避免二手菸行為沒有顯著相關（7）自覺家人執行避免二手菸行為愈多者其避免二手菸行為愈好；（8）自覺同儕執行避免二手菸行為愈多者其避免二手菸行為愈好；（9）同住家人是否吸菸在避免二手菸行為沒有顯著差異；（10）同儕不吸菸者其避免二手菸行為較好；（11）避免二手菸的態度、自覺同儕執行避免二手菸行為及自覺家人執行避免二手菸行為是青少年避免二手菸行為的重要預測因子，可解釋51.1％的變異數。
根據本研究結果可作為學校衛生教育之參考，並提供未來研究方向的建議。

關鍵字

青少年 ； 二手菸 ； PRECEDE model ； 素質因素 ； 使能因素 ； 加強因素

並列摘要

This study used the PRECEDE model to investigate the adolescent behaviors of avoiding secondhand smoke. The purposes were to: (1) understand the conducts of avoiding secondhand smoke among adolescents; (2) investigate the relationships between avoiding secondhand smoke behavior and the following factors: social-demographic factors, predisposing factors (including knowledge of secondhand smoke, attitude of avoiding secondhand smoke, and self-efficacy of avoiding secondhand smoke), enabling factors (present situation of school health resources of avoiding secondhand smoke), reinforcing factors (perceiving families and peers in avoiding secondhand smoke and the existence of smokers among their families and peers), and (3) identify the important factors that affect the behaviors of avoiding secondhand smoke.
The targeted population contained twenty Junior Programs Technical Colleges in southern Taiwan, R.O.C. Five colleges were chosen using sampling by the convenience method and schools’ consents were obtained. One grade from each school was randomly chosen and one class from that grade was then randomly selected, based on cluster sampling method. A total of 208 effective questionnaires were collected. A constructed questionnaire, containing questions of social-demographic factors, avoiding secondhand smoke behavior, knowledge of secondhand smoke, attitude of avoiding secondhand smoke, self-efficacy of avoiding secondhand smoke, health resources of avoiding secondhand smoke at schools, perception of avoiding secondhand smoke behavior in families and peers, and smokers in families or peers was used for the study. The reliability and validity of the questionnaire were evaluated, including internal consistency, retest reliability, content validity, and construct validity. Data analysis was performed using percentage, mean, standard deviation, independent t-test, one-way ANOVA, Person’s product moment correlation, and stepwise multiple regression analysis.
The results showed: (1) the standardized score of avoiding secondhand smoke behavior was 75.47, considered in upper medium level; (2) avoiding secondhand smoke behavior of female adolescents was better than that of male ones; (3) correlation between knowledge of secondhand smoke and avoiding secondhand smoke behavior was not significant; (4) relationship between attitude and behavior of avoiding secondhand smoke is positive; (5) higher self-efficacy led to a better avoiding secondhand smoke behavior; (6) school health resources of avoiding secondhand smoke was not significantly related to the behavior of avoiding secondhand smoke; (7) stronger perception of avoiding secondhand smoke behavior in family demonstrated a better avoiding secondhand smoke behavior, (8) strong perception of avoiding secondhand smoke behavior among peers presented a better avoiding secondhand smoke behavior; (9) Smokers in a family did not correlate with the behavior of avoiding secondhand smoke significantly; (10) Non-smoking among peers presented a better behavior of avoiding secondhand smoke; and (11) attitude and perception in families and peers of avoiding secondhand smoke were more important predictors of avoiding secondhand smoke behavior among adolescents, which represented 51.1﹪of the total amount of variance.
Results of this study can serve as a reference on the subject of avoiding secondhand smoke behavior among adolescents when considering school health education programs, and can provide suggestions for further research in this field.

並列關鍵字

adolescents ； secondhand smoke ； PRECEDE model ； predisposing factors ； reinforcing factors ； enabling factors

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