腸病毒衛教介入對幼兒園教保人員腸病毒之知識及防制行為成效初探

Effectiveness of Enterovirus Educational Intervention on the Knowledge and Preventive Practice for Kindergarten Teachers

楊玉宜(Yu-Yi Yang)

指導教授 ： 李淑杏

中山醫學大學/醫學院/護理學系/碩士(2021年)

https://doi.org/10.6834/csmu202100030

摘要

研究背景：
腸病毒是全球性的公共衛生問題，主要影響五歲以下的兒童及嬰幼兒。幼兒園是台灣0-5歲的嬰幼兒白天活動的主要場所，而嬰幼兒對疾病的抵抗力差、自我保護能力不足，容易不自覺感染或散播細菌跟病毒。當疾病發生，若照顧者第一時間無法及時控制感染源，會造成嬰幼兒相互感染，造成群聚事件，引起大流行。
目的:
本研究旨在探討衛教介入對幼兒園教保人員腸病毒之知識及防制行為之成效。
研究方法:
本研究採類實驗性研究，於某私立幼教集團中部地區的幼兒園進行收案。以幼兒園為單位，分層隨機抽樣，實驗組接受一次30分鐘的腸病毒衛教介入方案，控制組則未接受衛教介入。介入前，兩組學員進行前測，衛教介入後，兩組學員進行三次後測，評量衛教介入的效果。研究工具包括：教保人員基本資料、腸病毒知識問卷及腸病毒防制行為問卷。本研究共收136人，其中實驗組73人，控制組63人，排除資料不完整問卷，有效樣本為127人，其中實驗組66人，控制組61人。立即後測實驗組與控制組分別為60 vs.57人、一週後測50 vs.48人、四週後測55 vs.52人。研究資料以SPSS/PC22.0版進行描述性、卡方檢定、獨立t檢定、單因子相依變異數分析及廣義估計方程式等方式進行分析。

研究結果:
經卡方檢定及獨立t檢定結果顯示：實驗組與控制組在人口學變項及前測兩組沒有顯著差異(p>.05)，顯示兩組同質性高。經衛教介入後，經廣義式估計方程式(GEE)分析結果顯示：實驗組教保人員之腸病毒知識在衛教介入活動結束時 (T1；ß=2.55，p<.001)、介入結束一週後(T2；ß=2.04，p<.001)與介入結束四週後(T3；ß=1.71，p<.001)，較前測之進步幅度顯著大於控制組；實驗組教保人員之腸病毒防制行為在衛教介入活動結束時 (T1；ß=2.92，p<.01)、介入結束一週後(T2；ß=3.29，p<.01)與介入結束四週後(T3；ß=2.55，p<.05)，較前測之進步幅度顯著大於控制組。
結論與建議：
研究顯示腸病毒衛教介入能有效提升教保人員腸病毒知識及防制行為，且效果能維持至四週。建議於幼兒園定期舉辦衛教介入活動以提升教保人員對於腸病毒的知識與防制行為。

關鍵字

腸病毒 ； 教保人員 ； 幼兒園 ； 衛生教育 ； 介入 ； 知識 ； 防制行為

並列摘要

Background:
Enteroviral infection is a global public health problem, which mainly affects children and infants under five years old. Kindergarten is the main place for infants and young children aged 0-5 years in Taiwan for daytime activities. However, Infants and young children have poor resistance to diseases and insufficient self-protection capabilities. They are prone to infect or spread bacteria and viruses unconsciously. When a disease occurs, if the caregivers are unable to control the source of infection at the first moment, it will cause infants and young children to infect each other, cause cluster events, and cause a pandemic.
Objective:
This study explored the effectiveness of enterovirus educational intervention on the knowledge and preventive practice for kindergarten teachers.
Material and Methods:
This study was a quasi-experimental study and was collected in the kindergartens in the central area of a private preschool education group. With kindergarten as the unit, stratified random sampling, the experimental group received a 30-minute enterovirus health education intervention program. Two groups of trainees conducted a pre-test before the intervention and conducted three post-tests after the intervention to evaluate the effectiveness of the intervention of health education. The tools of this study included: basic information of kindergarten teacher, enterovirus knowledge questionnaire and enterovirus preventive practice. The study involved a total of 136 participants, including 73 participants in the experimental group and 63 participants in the control group. Excluding the incomplete data questionnaire, the valid sample was 127 participants, including 66 participants in the experimental group and 61 participants in the control group. The experimental group and the control group were 60 vs. 57 participants after intervention, 50 vs. 48 participants in one week later, and 55 vs. 52 participants in four weeks later. Data of the study were analyzed by SPSS/PC22.0 version, such as descriptive, chi-square test, independent t test, repeated measured ANOVA and generalized estimation equations.
Results:
The results of chi-square test and independent t test showed that there was no significant difference between the experimental group and the control group in the demographic variables and pre-test part of the two groups (p>.05), indicating that the two groups had high homogeneity. The generalized estimation equation analysis showed the health education intervention indeed improved the kindergarten teacher’s enterovirus knowledge at T1 ( ß=2.55, p<.001), at T2 ( ß=2.04, p <.001) and at T3 ( ß=1.71, p<.001) in the experimental group; the health education intervention indeed improved the kindergarten teacher’s enterovirus preventive practice at T1 ( ß=2.92，p<.01), at T2 ( ß=3.29，p<.01) and at T3 ( ß=2.55，p<.05) in the experimental group.
Conclusion and Suggestion:
Our study showed that enterovirus health education intervention may effectively improve the kindergarten teachers’ knowledge and preventive practice of enterovirus, and the effect may extend to four weeks. Therefore, it is recommended to organize regular intervention activities in kindergartens to enhance the kindergarten teacher’s knowledge and prevention of enterovirus.

並列關鍵字

Enterovirus ； health education ； knowledge ； prevention ； intervention

參考文獻

中文文獻

內政部 (2019)‧中華民國107 年兒童及少年生活狀況調查報告-兒童篇‧內政部。https://www.mohw.gov.tw/dl-4774-38443aa5-6aed-48eb-b18b- 898455651749.html

王貞懿 (2017)‧居家托育人員腸病毒預防行為及其相關因素研究－ 以雲林縣為例 [未發表之碩士論文]‧國立雲林科技大學。http://hdl.handle.net/11296/6qucfk (國立雲林科技大學)

白華枝 (2007)‧幼稚園教師、幼兒家長對於腸病毒的認知、防治意見與預防行為之研究-以臺南縣市為例〔未發表之碩士論文〕‧國立台南大學。https://hdl.handle.net/11296/5t3aew

余妍蓉 (2017)‧台北市私立托嬰中心家長對傳染病控制的知識、態度與行為之調查研究[未發表之碩士論文]‧中國文化大學。http://hdl.handle.net/11296/6sn9we (中國文化大學)