中壢市嬰幼兒使用中醫門診相關因素之研究

A Study on Factors Related to Children's Use of Chinese Medicine Clinics in Chung-Li City

吳明玲(Ming-Ling Wu) ； 季瑋珠(Wei-Chu Chie)

《中華公共衛生雜誌》 15卷4期 (1996/08) Pp. 303-318

https://doi.org/10.6288/CJPH1996-15-04-03

摘要

本研究的目的在於探討嬰幼兒使用中醫門診的相關因素，採用Andersen的健康行為模式(Health behavior model)為研究架構，以系統抽樣法選取中壢市12-18個月的516位幼兒為研究對象，於民國81年9月至11月間，對其主要照顧者進行問卷訪視，共得有效樣本420位，完成率為81.4%。結果顯示：(1)1至1歲半之幼兒，生病時曾接受之不同醫療照顧方式如下：西醫門診、中醫門診、西藥房、中藥房，各為99.0%、39.0%、11.4%及5.2%。(2)接受中醫門診醫療的164位幼兒中，71.3%利用過1-3次，24.3%利用過4-10次，4.3%利用次數超過10次。(3)生病時曾接受中藥醫療照顧之幼兒，其第一次接受中藥月齡為未滿1個月至18個月，中位數7個月，其原因主要為呼吸道疾病(74.7%)及腸胃道疾病(16.3%)。(4)對數複迴歸分析顯示影響嬰幼兒是否使用中醫門診的因素主要有「幼兒籍貫、照顧者就醫習慣、對中式醫療滿意度、中西醫療行為取向、照顧者評定之幼兒健康狀況」等五項。綜合官之，具以下幾種特質之幼兒較傾向於使用中醫：本省籍幼兒，勝算比1.62（95%信賴區間1.07-2.44）；照顧者本身有使用中醫習慣者，勝算比1.69（95%信賴區間1.28-2.23）：對中式醫療綜合意度為普通及很好者，勝算比分別為1.48（95%信賴區間1.06-2.05）、2.39（95%信賴區間1.73-3.29）；中西醫療行為取向為中立或傾向中醫者，勝算比分別為1.90（95%信賴區間1.12-3.23）、3.16（95%信賴區間1.90-5.24）；照顧者評定之幼兒健康狀況為普通及不好者，勝算比分別為1.32（95、信賴區間1.00-1.75）、2.27（95%信賴區間1.27-4.06）。根據本研究的結果，吾人建議政府及國人共同重視嬰幼兒醫療保健照顧，培養正確育兒知識，並對醫療體系作一整體規畫，促進中西醫療之整合，以使不同型態的醫療服務，發揮最大的功效。

關鍵字

中醫門診 ； Andersen的健康行為模式 ； 傾向因素 ； 能力因素 ； 需要因素

並列摘要

The aims of the study were to investigate factors related to children's use of Chinese Medicine clinics. Using the Andersen's Health Behavior Model, a questionnaire-interview was taken in Chung-Li city from September to November in 1992. A systematic sample of 516 children aged 12-18 month was selected, 420 cases accomplished the study (the response rate was 81.4%). The subjects of this interview were chief care-taker of children. The major results were as follows: (1) The proportion of children who received each type of medical care when they were sick were Western Medicine clinics 99.0%, Chinese Medicine clinics 39.0%, Western Medicine dealers 11.4%, Chinese Medicine dealers 5.2%, respecitively. (2) In the 164 children who have visited Chinese Medicine clinics, the percentage of 1-3, 4-10, over 10 visits were 71.3%, 24.3% and 4.3%, respectively. (3) The age of children who received Chinese-style medical care for their illness in the first time was less than I month to 18 month, median 7 month. The major causes were respiratory tract disease (74.7%) and gastrointestinal disease (16.3%). (4) Logistic regression showed that children with characteristics listed below tend to use Chinese-Medicine clinics: nativity of Taiwan, odds ratio (O.R.)=1.62, 95% confidence interval (C.L)=1.07-2.44; the habit to use Chinese-style Medicine of chief care-taker, O.R.=1.69, 95% C.I.=1.28-2.23; moderate or high satisfication to Chinese-Medicine services, O.R.=l.48 (95% C.I.=1.06-2.05) or O.R.=2.39 (95% C.I.=1.73-3.29); moderate and high degree of behavior predisposition to Chinese-style Medicine, O.R.=1.90 (95% C.I.=1.12-3.23); or O.R.=3.16 (95% C.I.=1.90-5.24); fair and poor perceived health status by chief care-taker, O.R.=1.32 (95% C.I.=1.00-1.75) or O.R.=2.27(95% C.I.=1.27-4.06) respectively. Finally, the policy and research implications were discussed in this article.

並列關鍵字

chinese medicine ； Andersen's health behavior model ； predisposing enabling and need factors