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台灣公共衛生雜誌/Taiwan Journal of Public Health

臺灣公共衛生學會,正常發行

5-year IF 0.271
0.271 2023 年
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  • Journals

肥胖是全球引起死亡的第五大風險因子,並造成個人代謝相關疾病及國家醫療財政負擔。造成肥胖的因素很多,可分為遺傳及基因因素、環境因素、生活型態因素、內分泌或藥物因素,本文旨在以三個層面來探討環境及生活型態因素對台灣近年來肥胖率增加的影響。(1)家庭層面:探討家庭社經地位、家庭生活品質、父母體型、飲食習慣變遷及靜態活動增長和肥胖的關係。(2)學校層面:探討運動時間減少及升學壓力造成睡眠時間減少和肥胖的關係。(3)社會層面:探討西式速食、含糖飲料、媒體廣告影響及肥胖稅和肥胖的關係。本文回顧現有文獻及統計資料並提出可行的解決方案,以期政府能透過政策執行來改善影響國民健康甚鉅的肥胖問題。

  • Journals

照護連續性為初級照護的重要基礎。台灣全民健保實施後,高度就醫可近性和缺乏轉診機制,可能不利於照護連續性的提升。本文回顧照護連續性的概念、測量指標的演進和照護連續性與照護結果實證研究議題。我們搜尋MEDLINE及CEPS中文電子期刊服務之資料庫於1950年至2012年之研究,同時採用逐篇審視被引用文獻的方式定義出照護連續性相關的文獻,共計納入61篇文章。整體而言,照護連續性概念的定義已漸趨一致,人際面和資訊面為照護連續性兩個核心面向;由於行政資料庫的發展,照護連續性測量多以標準量化的指標為主。相較於早期的實證研究無一致性的結論,近期多數研究支持照護連續性可帶來較佳的照護結果和較低的醫療費用。本文建議未來的相關研究在方法學上,對於研究設計與處理時序性的議題、照護連續性測量指標的選擇等,應依研究目的考量其適用性。其次,有關照護連續性對照護結果的作用機轉,以及照護連續性各面向對於照護結果的相對影響力等議題,皆值得後續研究。

  • Journals

目標:兒童與青少年行為之長期發展研究(簡稱CABLE計畫)因面臨研究樣本隨教育階段改變(國小、國中、高中、大學)而調整資料收集方法,本研究目的為描述兒童與青少年長期追蹤未回應之趨勢及原因,並分析其相關社會人口學因素。方法:CABLE計畫自2001年起針對台北及新竹國小一年級(世代一)和四年級學童(世代二)進行追蹤,以獲有父母同意書之學童為研究樣本(分別為2,852、2,663人)。未回應係指每年追蹤調查的應施測名單中未能回收問卷者。以世代分層Group-based Trajectory Model探討未回應趨勢及相關社會人口學因素。結果:經軌跡分析,世代一、二均呈現四個未回應軌跡:持續回應(世代一、二之百分比分別為73.4%、76.0%)、後期未回應(11.2%、5.4%)、漸增持續未回應(9.3%、8.2%)、及早期未回應後期回應(6.1%、9.7%)。相對於持續回應者,居住於台北、父母教育為高中及以下、父母婚姻為非結婚者,分別有較高之機會屬於不同狀況之未回應軌跡。結論:以CABLE持續追蹤資料進行推論時宜處理未回應之社會人口學差異。

  • Journals

目標:探討台灣天主教醫院護理人員情緒勞務和心理健康之間的關係。方法:橫斷式、相關性研究,研究對象為6家天主教醫院。以林尚平之情緒勞務量表與世界衛生組織發展的心理健康自評問卷Self Reporting Questionnaire 20(SRQ-20),於2010年7月1日到2010年10月30日蒐集資料。結果:共有653位護理人員進入研究,其中有效問卷624份(95.56%)。以SPSS 18.0之描述性、變異數分析、相關及迴歸等統計檢測後發現:(1)護理人員情緒勞務負擔程度偏高(M±SD=5.41±1.19);心理健康狀況不理想(M±SD=2.81±1.05),SRQ-20 50.4分;(2)情緒勞務的基 本情緒表達、表層情緒控制及心理健康會因教育程度、職務與科別之不同而呈現統計上顯著差異;(3)年齡、年資與基本情緒表達、表層情緒控制及心理健康呈顯著高度正相關;年齡與深層情緒偽裝呈顯著低度正相關;(4)基本情緒表達、表層情緒控制、互動程度、深層情緒偽裝與心理健康呈顯著高度正相關;(5)情緒勞務可解釋心理健康狀況21%變異量。結論:護理人員情緒勞務負擔程度偏高、心理健康狀況不理想。所以,醫療產業對此應加以重視。

  • Journals

目標:本研究從組織理論的角度切入,探討組織健康文化與企業主所關心之健康促進效能的關係,此效能包括健康促進規劃成效、產出、成果與品質四個面向。方法:以立意抽樣法選取了55家台灣企業,由企業中負責職場健康促進業務的人員填寫測量組織健康促進效能的組織問卷,並自每家企業中選取20位專職員工,共1,100人,填寫測量組織健康文化知覺的員工問卷。再將同一組織內員工的知覺得分透過聚合程序進行加總平均,產生各企業組織的組織健康文化得分。回收之有效問卷包含54份組織問卷與1,011份員工問卷,有效問卷回收率為91.91%。研究資料以SPSS 17.0進行描述性統計、相關分析與層級迴歸分析。結果:組織健康文化只有對健康促進規劃成效、健康促進產出等過程面指標及健康諮詢率有所影響。而對於病假率、意外事件發生率、健康促進活動出席率與滿意度等指標則無顯著影響。結論:組織健康文化對於公司的健康促進規劃與產出等成效有正向影響,表示組織健康文化是影響職場健康促進計畫成功的關鍵因素,透過組織健康文化的形塑,才能將健康促進的理念深耕於組織與部門之中。

  • Journals

Objectives: This study aimed to determine the association between the frequency of fruit and vegetable consumption and cognitive function in older Taiwanese. Methods: We analyzed the 1999 and 2003 datasets of the ”Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were 4440 ≥53-year-old Taiwanese men and women. The frequency of consumption of fruits and vegetables in 1999 was examined for its possible cross-sectional association with cognitive status and for a possible association with the risk of cognitive decline four years later. Cognitive status and cognitive decline were rated with the SPMSQ scale. A reduction of 2 SPMSQ points was designated as a decline. Results: In a regression model that controlled for gender, age, years of education, smoking, drinking, betel quid chewing, physical activity, leisure activity, intake of nutritional supplements (fish oil & lecithin), and illness (hypertension, diabetes, heart disease, stroke) and other possible confounders, the cross sectional analysis showed that more frequent consumption of fruits and vegetables (≥5 times/wk) was associated with a 31% reduction in cognitive impairment (OR = 0.69, 95 CI = 0.57-0.84, p = 0.001); the longitudinal analysis showed that those who consumed fruits and vegetables ≥5 times/wk had a 23% reduction in cognitive decline 4-years later when compared to those who consumed fruits and vegetables ≤4 times/wk (0.77, 0.59-0.99, p = 0.048). Other food categories such as meat and poultry, fish, seafood and dairy showed no significant associations. Conclusions: More frequent fruit and vegetable consumption was associated with a reduction in cognitive impairment and can protect against future cognitive decline. These results suggest that the intake of fruits and vegetables may offer protection against cognitive decline. The study also highlights the importance of diet in delaying aging-associated memory deterioration; however, these findings should be confirmed with more robust studies.

  • Journals

目標:發展與驗證印尼居家看護自覺所需照顧支持問卷之信效度。方法:三階段進行,第一階段為問卷發展及內容效度檢定,第二階段為印尼文翻譯及效度檢定,第三階段則邀請120位印尼籍居家看護進行印尼版問卷信效度檢定。參考House所提工具、資訊、情緒及評價等四種社會支持資源為架構,來擬定照顧支持問卷。以內在一致性檢定信度,以探索性因素分析及驗證性因素分析(結構方程模式)檢定建構效度,並以皮爾森相關係數檢定同時效度。結果:照顧支持問卷起初擬22題,經探索性因素分析縮減至11題,依題意亦歸為情緒、資訊、工具與評價支持等四個因素,各因素負荷量0.63~0.82,總解釋變異量61.74%,經結構方程模式驗證,顯示此四個因素之模式適配度、收歛及區別效度是良好,具有效度。題數縮減後,內在一致性KR-20為0.53~0.65,顯示具可信度。各因素與研究對象之人口學特徵達顯著相關,顯示具同時效度。結論:本研究所發展之照顧支持問卷,經檢驗具良好的信效度,並能有效供評估印尼籍居家看護照顧所需之支持參考。

  • Journals

Objectives: To analyze inappropriate prescriptions at the market and hospital levels by examining antihypertensive medication ordering quality in out-patient departments (OPD) in Taiwan hospitals. Methods: Our sample included 398 accredited acute hospitals located in 23 regions. Information about hospital's ownership, rank, teaching status, OPD visits and hospital number published by the Department of Health (DOH) and information from the 2009-2011 Quality Database of Medications Indicators published by National Health Insurance were collected. The population density (PD) and physician density per 10000 population (PDPP) in the 23 regions were generated from DOH data. Two inappropriate prescription indicators were defined as duplicate medications of oral blood pressure-lowering agents or hypertension patients with a history of hyperkalemia using PSD or AA. We used MLLR models to assess multilevel effects on the probability of good or bad hospital quality for medications. The market concentration in the 23 regions was calculated by Herfindahl-Hirschman Index (H) using OPD visits to measure hospital competition. Results: Our study showed that higher H and PD led to greater probability of low duplicate medications. A higher PDPP led to lower probability of low duplicate medications. When compared to hospitals located in the Eastern region, the probability of low duplicate medications in Taipei, Southern, Kaohsiung-Pingtung areas is lower. The probability of low duplicate medications in teaching hospitals is lower than non-teaching hospitals and medical centers are higher than local hospitals. The probability of appropriately treating patients with hyperkalemia in Taipei, Northern, Southern, and Kaohsiung-Pingtung areas was higher than that of Eastern areas. Overall, the variation of medication quality can be explained 10.25%-17.63% by hospital-level variables and 73.40%-82.52% by market-level variables. Conclusions: Hospital and market characteristics impacted inappropriate prescriptions of anti-hypertensive drugs in the OPD setting over the past 3 years.