運用互動式手冊於國小學童家長糖尿病預防教育之介入研究

陳合如(HO JU CHEN)

指導教授 ： 劉潔心

國立臺灣師範大學/教育學院/衛生教育學系/碩士(2002年)

摘要

摘要
本研究主要目的在發展「互動式糖尿病預防手冊」教育介入，並探討教育介入之成效。
本研究採「實驗組控制組前測後測設計」，以石牌國小和文林國小二所學校的五年級學童家長為研究對象。實驗組學童家長接受二週的互動式糖尿病預防互動式手冊介入計畫，而對照組則不接受任何實驗處理。在實驗介入前，研究對象同時接受前測，後測在介入後一週進行。所取得的資料以t檢定、卡方檢定及單因子變異數分析等方法進行分析，所得的結果如下：
一、 互動式糖尿病預防手冊介入後，實驗組學童家長「糖尿病預防知識」的後測得分顯著高於前測且達統計上顯著差異，但就實驗組與對照組的比較結果來看，本研究介入計畫僅對原本糖尿病預防知識較低之學童家長具顯著的提升效果。
二、 互動式糖尿病預防手冊介入後，對於「糖尿病態度」方面，實驗組學童家長的後測得分顯著高於前測且達統計上顯著差異；而對於「運動態度」方面，則無顯著的影響。
三、 互動式糖尿病預防手冊介入後，對於「降低脂肪攝取自我效能」上，實驗組學童家長的後測得分顯著高於前測且達統計上顯著差異，但就實驗組與對照組的比較結果來看，則實驗組與對照組在介入後無顯著的差異；而對於「增加身體活動和運動自我效能」上，實驗組學童家長的後測得分顯著高於前測且達統計上顯著差異，但就實驗組與對照組的比較結果來看，本研究介入計畫僅對原本增加身體活動和運動自我效能較低之學童家長具顯著的提升效果。整體來看，在控制前測得分下，實驗組學童家長「糖尿病預防自我效能」的後測得分顯著高於對照組且達統計上顯著差異。
四、 互動式糖尿病預防手冊介入後，在控制前測得分下，實驗組學童家長「糖尿病預防行為意向」的後測得分顯著高於對照組且達統計上顯著差異，且實驗組與對照組間有顯著差異。
五、 約七成的學童家長認為本研究所設計的手冊能幫助他更瞭解糖尿病預防的知識、能幫助其建立更正向的糖尿病預防態度，且使其信心去採取糖尿病預防行為，也有六成多的學童家長表示大部分會照著手冊教導的去做。
整體而言，本研究對於糖尿病態度、糖尿病預防自我效能、糖尿病預防行為意向等變項具有顯著的教育介入成效，而對於原本糖尿病預防知識較低者可增加其知識，原本增加身體活動和運動自我效能較低者可增加其自我效能。綜上可知，在教育媒體的發展過程中，若能結合社會認知理論、健康信念模式、理性行動論及溝通說服模式等，以行為科學理論為基礎的互動式手冊介入計畫，對於糖尿病的知識、預防態度、自我效能及行為意向都能有所提升，且學童家長對於本手冊表達正面的評價，可見此具理論背景及架構之介入計畫是具有果效的。另外，以學校為管道、學童為傳播媒介之家長的教育介入方式是可行的，建議未來可以透過此種管道針對社區民眾進行糖尿病或其他慢性病的預防教育。

關鍵字

糖果預防教育 ； 互動式手冊 ； 學童家長

並列摘要

Abstract
The purpose of this study is to develop an involvement program through educational channel at “Interactive Diabetes Prevention Manual” (IDPM) and to discuss the efforts of this program.
The research is conducted by an experiment with the subject consisting of students and their parents of fifth grade in Shi-Pai and Wen-Lin elementary school. This group of participants is divided into two groups--the control and experimental group--who take pro/post questionnaire for further analysis. Members of experimental group receive a two-week involvement program of IDPM while the control group remains in their original status. The subject, both control and experimental groups, takes pro questionnaire before the experiment begins and answers the post questionnaire one week later. The information collected from this experiment is to be analyzed by pair-t test, Chi-square test and one-way ANCOVA that result in an amount of findings. The main points of the findings are listed as following:
1. After the involvement program of IDPM:
1.1 The students and parents in experimental group apparently get higher scores on “diabetes prevention conception” in the post questionnaire, which has a great difference with pro questionnaire. When it comes to compare the difference between control and experimental group, the research proves that the involvement program of IDPM only enhances the conceptions of diabetes prevention for those has little knowledge in this area.
1.2 The students and parents in experimental group apparently get higher scores on “ the attitude toward facing diabetes” in the post questionnaire, which has a great difference with pro questionnaire. However, their scores on “the attitude toward working-out” has mere differences comparing to pro questionnaire.
1.3 The students and parents in experimental group apparently get higher scores on “efforts of self discipline in fat intake reduction” in the post questionnaire, which has a great difference with pro questionnaire. As to compare the results between control and experimental groups, it is hardly to see the difference after the the involvement program of IDPM. The students and parents in experimental group obviously get higher scores on “increasing self-discipline of body stretching and working-out ” in the post questionnaire, which has a big difference with pro questionnaire. When it comes to compare the difference between control and experimental groups, the research proves that the involvement program of IDPM only enhances the self-discipline of body stretching and working-out for those has lower intention to do so. In all, while controlling the pro questionnaire scores, on “personal efforts on diabetes prevention” in post questionnaire the students and parents in experimental group scores significantly higher than control group.
1.4 While controlling the pro questionnaire, the students and parents in experimental group obviously get higher scores on “intention of diabetes prevention” in the post questionnaire, which has a great variation with pro questionnaire. The variation also occurs when it comes to compare the scores between control and experimental groups.
2. Some 70 percent students and parents consider the IDPM using in this experiment is helpful for them to understand more about diabetes prevention. In addition to it, the IDPM also leads them to a more positive attitude toward facing diabetes and builds them higher confidence to prevent this disease. What we are happy to see is that 60 percent of all questionnaire participants are willing to follow the instructions of what IDPM says in the future.
In summary, there are significant efforts with the involvement of diabetes education through educational media in many aspects: the attitude toward facing diabetes, efforts of self discipline on diabetes prevention, and the intention of diabetes prevention. For those used to have little knowledge of diabetes prevention, it enhances their comprehension of the disease; and for those have fewer self discipline on body stretching and working-out, it helps them to be more aware of exercise more for their health. From above-mentioned points, it concludes that, during the development of educational media, an education medial involvement program bases on scientific behaviorism theory (such as: Social Cognitive Theory, Health Belief Model, The Theory of Reasoned Action, Communication- Persuasion Theory, and the like) is greatly helpful to enhance students and parents’ attitudes, conceptions, self-efforts, and self-intentions to diabetes. As students and parents viewing this manual with positive comments, it proves that the involvement program with scientific theory supports is significant effective. It also proves that the education of parents through school and students, as the media channel, is workable. We suggest proceeding diabetes or other chronic diseases prevention education to the residents in communities through educational media channel, schools and students, in the future.