組織台北市某社區健康促進委會之形成過程及結果

The Process and Outcome of Organizing one Healthy City Committee in Taipei

莊瑞菱(Jui-Ling Chuang)

指導教授 ： 陳靜敏

臺北醫學大學/護理學院/護理學研究所/碩士(2001年)

摘要

論文摘要 論文名稱：組織台北市某社區健康促進委員會之形成過程及結果 研究所名稱：台北醫學大學護理學研究所 研究生姓名：莊瑞菱 畢業時間：九十學年度第二學期 指導教授：陳靜敏 台北醫學大學護理學研究所副教授 繼世界各國開展健康城市運動後，我國衛生署也於1999年開始積極推展「社區健康營造」計劃；期望經由整合運用社區中有助於居民健康促進與保護的資源，去形塑每個國民的健康生活型態。因此，本研究擬以促進社區健康為切入點，藉由社區充能與賦權策略，組織一「社區健康促進委員會」；以（1）瞭解組織社區健康促進委員會之形成過程；（2）探討充能與賦權策略運用於社區健康促進委員會組織功能之情形；（3）探討充能與賦權策略對社區健康促進委員會成員之社區健康意識之提昇情形。 本研究採行動研究法，以立意選取合作度高、且俱健康問題之社區為個案社區，並招募社區中對健康營造有興趣之民眾，組織一社區健康促進委員會，於89年11月下旬至90年6月中旬，共經過八次的充能與賦權之委員會議討論；藉由會議之進行，從中瞭解組織社區健康促進委員會的過程，並經由「組織功能量表」測試及訪談瞭解委員對該委員會組織功能之看法。此外，亦運用「社區健康意識量表」，於第五次會議及第一次社區活動後的討論會進行前、後測，以瞭解委員在經此營造策略後對社區健康意識之提昇情形。 營造過程的步驟乃根據美國印第安州那健康城市計畫包括：1.社區的簽字認可、2.形成健康的社區委員會、3.發展社區領導能力、4.社區採取行動、5.提供資料庫給政策制定者、以及6.行動研究與評值。本研究中以尋求地方領導人的支持、地方組織及社區居民的認同與協助等方法來達到社區參與健康營造的承諾；並藉由宣傳與溝通、說明研究計畫、及請里長推薦對此議題有興趣之民眾，並運用委員的宣誓等方式，以增加其責任感，來組成一個社區健康促進委員會；以加強與主任委員溝通、並利用問卷、腦力激盪等方式來加強委員的領導能力；以會議資料作為每次開會的指引，引導委員對於社區健康議題的討論，最後決定以「社區的環境衛生」之綠、美化為第一次活動主題，並於舉辦社區活動後進行活動之檢討，及提供相關資料給地方政府。 在經過半年多的充能與賦權的營造後，委員對社區健康意識中的「環境認知」有顯著的提昇；居住於社區愈久的委員，其於「情感連結」的提昇愈高。在委員會組織功能部份，委員對於「主任委員的角色」平均得分最高（M=4.34，SD=0.49），「組織結構」平均得分最低（M=3.49，SD=0.85）；在委員會與成員的互動部份，則以「對組織的滿意度」平均得分最高（M=4.09，SD=0.48），「參與組織的付出」最低（M=3.57，SD=0.99）；女性委員的「參與動機」高於男性委員，無業者對「組織結構」比有工作的委員清楚，居住於社區時間較長的委員對「主任委員的領導力」較不滿意，申報稅級為6﹪的委員，在「參與組織付出」得分上較其他人為高。 從本研究中得知，由社區草根性組織的觀點介入，可以實際瞭解社區的健康問題，設計符合社區居民需求的改善方案，並藉由尋求社區資源的協助，來解決社區健康問題，以落實社區健康營造的理念。 關鍵詞：社區健康營造、社區健康促進委員會、社區健康意識、組織功能

關鍵字

社區健康營造 ； 社區健康促進委員會 ； 社區健康意識 ； 組織功能

並列摘要

Abstract Title of Thesis: The Process and Outcome of Organizing one Healthy City Committee in Taipei. Institution: Graduate Institute of Nursing, Taipei Medical University Author: Chuang, Jui-Ling Thesis directed by: Chen, Ching-Min , R.N., D.N.S., Associate Professor The Department of Health in Taiwan began to promote the healthy community project enthusiastically in 1999 after the worldwide healthy city movements. The aim of this project is to promote every Taiwanese citizen’s health by applying all the resources helpful to human’s health in their own communities. Therefore, the purpose of this study is to promote the health of the local community by empowering the community committee. The major objectives include: 1. to describe the organizing processes of the community health promoting committee, 2. to explore the process of applying empowerment strategies on organizing the committee, and 3. to explore the committee’s members’ enhancement of community health sense after the empowerment. By using action research, the case community was purposively selected due to its high cooperation and with major health problems. From November 2000 to June 2001, 28 interested residents were recruited to participate this health promoting committee. Through eight empowered committee meetings, researcher would explore the organizing process and outcome of this health promoting committee. Also, scale of community health sense and scale of community organization function were used to investigate the committee function and the improvement of the committee member’s community health sense. Based on the process of Healthy City Indiana, this project use the supports of citizen delegates, localized organizations, and community residents participation to get the community commitment. In order to organizing the healthy city committee, purpose the research plans, search for the interested and qualified to residents through the community leaders, and declaration ceremony were used. In the third step, community leadership development strategies included improving the relationship and abilities of the leaders of the committees, developing questionnaire and brainstorming were used. In city action, through promoting the discussion among the committee members, development of conference agenda, committee had decided and implemented the community clean-up as the topic for the first community action. Based on the results of community action, related informations were provided to policy makers in order to build the healthy public policies. Finally, action research was applied in each step, and evaluation was done after the community action. After the implementation of community empowerment, the committee members had significantly improved their perception of community environment. The longer the members living in the community, the higher scores in community connection they had. Regarding committee members’ perceptions toward the organization functions, “the function of leader’s role” got the highest mean score, and the “organization structure” was the lowest. When the interaction between committee members was evaluated, the “satisfaction toward organization” was the highest, and the “devotion toward organization” got the lowest mean score. Besides, the female members had higher “participatory motivation” than male members did. Members without jobs would have better understanding on “organization structure” than those with jobs. The members lived in the community for a longer time would have more complain about “the function of the leader’s role” than other members would. The members pay 6% income tax would have higher “devotion toward organization” than other members would. Results of this study indicated that the grass-root approach could build the healthy community successfully. Through empowering the community health promoting committee, the community could identify its own problem, develop its own health promotion program, and use its own community resources to solve community problem. Key word: healthy community, health promoting committee, community health sense, organization functions

並列關鍵字

healthy community ； health promoting committee ； community health sense ； organization functions

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