Title

影響北市社區健康營造志工推行健康促進活動成效相關因素之探討

Translated Titles

Factors affecting the accomplishment of health promoting activities among healthy communities volunteers in Taipei

Authors

莊宜佳

Key Words

社區健康營造志工 ; 健康促進活動 ; 成效 ; healthy communities volunteers ; health promoting activities ; effect

PublicationName

臺北醫學大學護理學系碩士暨碩士在職專班學位論文

Volume or Term/Year and Month of Publication

2001年

Academic Degree Category

碩士

Advisor

陳靜敏

Content Language

繁體中文

Chinese Abstract

自1974年Marc Lalonde指出個人生活方式對健康影響的重要性後,世界各國紛紛將健康促進活動列為最主要的衛生政策,但目前多針對醫療專業團體或政府組織機關主導推行該活動方面的探討,唯對以社區志工為主導推行該活動之成效尚未探究。因此,本研究將針對培訓之社區健康營造志工,以(1)瞭解志工推行健康促進活動的知識、態度、意願及成效;(2)探討志工基本特質與推行健康促進活動知識、態度、意願之相關性;(3)探討影響志工推行健康促進活動成效之相關因素。 本研究為相關性研究設計,採方便取樣方式,篩選有提供定點健康篩檢服務及家戶訪視之台北市信義區、石牌地區健康營造社區,並經由保健志工課程培訓完成之志工共65名。研究調查工具共有兩份:第一份自擬問卷乃依研究目的、架構並參考國內外相關文獻自擬而成,採志工當場填寫回收及郵寄方式收集。第二份問卷乃沿用衛生署於評值社區健康營造計劃成效中使用之家戶三大健康議題行為追蹤量表,前測由志工第一次接觸家戶或社區個案時,評值其三大健康議題之行為現況,並依據衛生署製作的健康DIY教材給予行為衛教,後測則由研究者以電話訪談方式評值家戶或社區個案健康行為改善程度。 本研究發現參與推行社區健康促進活動的志工,以女性、中年、高中(職)、有配偶、家庭主婦、佛教信仰、目前仍為全職工作者、全家每月平均收入介於15001元至65000間者為多,且家人對其擔任志工多數表贊同意、擔任志工經驗比率將近1:1。參與原因依序為「自我導向」之學習保健知識與技巧、從服務中獲得自我成長,以「他人導向」之貢獻社會幫助別人、深入社區服務使更多人受益及以「情境導向」之可以多結交朋友。在參與程度部份,定點執行健康篩檢服務1.56次/月,至社區中進行家戶訪視0.58次/月,目前家戶訪視個案累計數平均為1.07戶,已接受自助式健康教材平均共計1.25戶。其參與服務後的滿意度及未來持續參與意願方面,整體而言皆達到滿意程度以上,並願意繼續參與推行健康促進活動。但對繼續推動家戶訪視及發放自助式健康教材的意願程度則較低。在推動家戶或社區個案執行三大健康議題行為之改善程度方面,僅健康飲食及運動行為執行頻率之前、後測達顯著提昇。由結果中並得知,志工年齡越輕其健康促進活動知識得分越高。教育程度在大專(含)以上、參與原因以「他人」及「情境」導向者,對推行社區健康促進活動的看法較為正向。推行健康促進活動意願方面,與全職工作者、家人對擔任志工的看法及以「自我」及「他人」導向為參與原因者,達統計上顯著差異。有關影響志工推行健康促進活動成效之因素方面,以志工基本特質中的工作內容、以「他人導向」為參與原因者,與定點值勤之次數有相關性存在;全職工作者的滿意度高於兼職者;家人對其擔任志工持反對看法者未來持續參與意願高於贊成及無意見者。預期民眾參與的看法越正向者,其參與後滿意度及未來持續參與意願越高;但與家戶健康訪視戶數及分發自助式健康教材戶數成負相關。 由研究得知,社區護理人員應充份運用其專業學識與技巧,隨時注意最新相關健康促進策略,並依據志工服務需求來擬定適當的培訓計畫,讓志工能不斷有新的能源以服務社區民眾,以期能更有效率地達到社區健康營造目標。 關鍵詞:社區健康營造志工、健康促進活動、成效

English Abstract

Since Marc Lalonde pointed out that the life-style had significant influence on individual’s health, every country in the world had reformed its policy to promote its citizens’ health. However, most of health promoting projects had been led by the health professionals and the governmental organizations, accomplishment of this type of activities that were leading by healthy communities’ volunteers had not yet been studied. Therefore, this research will focus on the effects of trained healthy communities’ volunteers in Taipei. The major objectives were as following:(1)to describe community volunteers’ knowledge, attitude, willingness and efforts toward health promoting activities, (2)to explore the relationship between volunteers’ personal characteristics and their knowledge, attitude and willingness toward health promoting activities, and(3)to explore related factors that influence the volunteers’ effects of health-promoting activities. The correlational design was used. The convenient was utilized to select two health communities in Taipei(Hsin-Yi district and Shih-pai district) that provide health check up duty and home visiting. A total of 65 volunteers trained with health promotion related courses were recruited. There were two instruments used in this study. The self-developed questionnaire was filled in on the spot and send by mail to evaluate volunteers’ knowledge, attitude, willingness and effects. The second instrument was developed by the Department of health to evaluated the effects of volunteers in changing community residents’ health behaviors. The scale was pre-tested when the volunteers first approached the residents. Then, volunteers would utilize the health DIY brochures to educate residents to implement the health promotion behaviors. Three months later, researcher would use the same scale to call the residents to evaluate their health behaviors. Study results identified that the volunteers who participate at this project were mostly women, the middle age, married, housewives, Buddhists, with high school education and with full-time job. Their monthly family income was mostly between 15,001 and 65,000. Most of their families support their participation at such volunteer works. The ratio of the volunteer with and without experience was 1:1. The reasons for their participation were respectively "self-directed" as for learning health related knowledge and technique, self achievement from providing services; "other-directed" as for social contributions and helping more people; and "situation-directed" as for making more new acquaintances. In level of participation, the mean serve for health check up was 1.56 times/month, and the average home visit was 0.58times/month. Each volunteer had visited 1.07 home in average; the number of families that accept health DIY brochures was 1.25 in average. In evaluating volunteers’ satisfaction and their willingness to participate the relevant activities in the future were great in deed. However, volunteers’ willingness to conduct home visit and dispensing health DIY brochures were much reluctant. As for the effects of promoting the individual family and community to change their healthy behaviors, healthy diet and regular exercise were all significantly improved. The younger volunteers, the better their knowledge regarding health-promoting activities. The highly educated and "other-directed" or "situation-directed" participants held positive attitude toward the community’s health promotion project. Volunteers with high participation willingness were those with fulltime job, with their family’s support and as the "self-directed" and "other-directed" participants. In evaluating factors related to volunteer’s effects on promoting health activities, volunteer’s job status and as "other-oriented” participate were relate to the frequency of on-duty. Full-timers were more satisfied with their work than the part-timers. Those who did not earn much family member’s support were more willing to participate such activities in the future than others. Those who positively expect the public’s attendance were more satisfied and were more willing to participate the relevant activities in the future; however, This type of attitude was negatively relate to level of participation in home visit and brochures distribution. Based on results of this study, the community health nurses have to apply their professional knowledge and technique on promote the relevant activities. We must also pay attention to the latest health promotion strategies in order to propose proper training courses for the volunteers to help them to serve the community to further achieve the goal of establishing a healthy community. Key words: healthy communities volunteers, health promoting activities, effect

Topic Category 醫藥衛生 > 社會醫學
護理學院 > 護理學系碩士暨碩士在職專班
Reference
  1. 林純美(1992)•台灣地區大型企業實施員工健康促進活動之研究 •國立台灣大學公共衛生研究所碩士論文。
    連結:
  2. 林瑞欽(1988)•師範師生任教意願職志相關因素研究•國立臺灣師範大學教育研究所博士論文。
    連結:
  3. 李蘭(1988)•衛生教育與健康促進•台北:巨流。
    連結:
  4. 馬慧君(1997)•志願服務工作者參與類型之初-以埔里鎮五個團體的志工為例•國立暨南國際大學社會政策與社會工作研究所碩士論文。
    連結:
  5. 陳美燕(1994)•預防慢性病從健康促進的生活方式開始•長庚護理,5(2),57-61。
    連結:
  6. 楊朝祥(1984)•技術職業教育辭典•台北:三民。
    連結:
  7. 劉雪娥(1999)•健康促進之概念•台灣醫學,3(2),235-237。
    連結:
  8. Englwood Cliffs, NJ : Prentice Hall. Brudney, J. L. (1990). Fostering volunteer programs in the public sector. San Francisco, CA : Jossey - Bass. Chang, P.Y.(1993). Social and economic development in Taiwan : Health policy implication. Research in Human Capital & Development, 7(3), 3-27.
    連結:
  9. Cnaan, R.A., Kasternakis, A. & Wineburg, R. J. (1993). Religious people, religious congregations, and volunteerism in human service : Is there a link? Nonprofit and Voluntary Sector Ouarrterly. 22(1), 333-51.
    連結:
  10. Dever, A.G.E.(1976). An epidemiological model for health policy analysis. Social Indicators Research, 2, 453-456.
    連結:
  11. Evans, R. (1982). A restropective on the new perspective. Journal Health Polit Policy Law, 7, 325-344.
    連結:
  12. Mobley, W. H., Griffeth, R.W., Hand, H. H. & Meglino, R. M. (1979). Review and conceptual analysis of the employee turnover process. Psychological Bulletin, 86(3), 493-522.
    連結:
  13. Mullen, P. D., Holcomb, J. D. (1990). Selected predictors of health promotion counseling by three group of allied health Professionals. American Journal of Preventive Medicine, 6(3), 153-160.
    連結:
  14. York, A. S. & Itzhaky, H. (1991). How can we measure the effects of client participation on the effectiveness of social work intervention?British Journal of Social of Social Work, 21(6), 647-662.
    連結:
  15. 參考資料 中文部份
  16. 王麗容(1992)•婦女參與志願服務之行為動力分析•婦女參與研討會。 王秀紅、邱啟潤、王瑞霞與李建廷(1992)•婦女健康促進行為及其相關因素的探討•公共衛生,19(3),251-265。 日本厚生省(1988)•厚生白皮書•日本:厚生省。 行政院衛生署(1999)•十大死因衛生統計•台北:行政院衛生署。 行政院衛生署(1990)•醫療保健計畫-建立全國醫療網第二期計畫•台北:行政院衛生署。 行政院衛生署(1993)•國民保健六年計畫•台北:行政院衛生署。 行政院衛生署(1993)•衛生白皮書•台北:行政院衛生署。 行政院衛生署(2000)•衛生白皮書-跨世紀衛生建設•台北:行政院衛生署。 行政院青年輔導委員會(1997)•青年對志願服務之看法•台北:行政院青年輔導委員會。
  17. 江一聖(1998)•醫院社會工作服務成效之研究•東海大學社會工作研究所碩士論文。 余玉眉、江永盛(1992)•國民保健六年計畫草案-計劃緣起與過程•衛生報導,2(7),8-12。
  18. 呂又惠(1994)•社會福利機構管理及運用志工方案之評估研究-以臺北市心路文教基金會為例•東海大學社會學研究所碩士論文。
  19. 林萬億(1993)•現行公務機關義工人力運用情形之探討•台北:行政研究發展考核委員會。
  20. 林昭文(1991)•社會福利志願服務供需體系之芻議•社區發展季 刊,45,45-50。
  21. 林雅琪(1999)•埔里地區福利社區化方案評估-以老人「電話問安」與「居家關懷」為例•國立暨南國際大學社會政策與社會工作學研所碩士論文
  22. 李宗派(1997)•探討志工服務與社區營造之關係•社會福利,133,38-45。
  23. 李昭蓉(1996)•老人福利資源運用與社工人員服務績效之關係•東海大學社會工作研究所碩士論文。
  24. 李增錄(1993)•八十年度大專學生社會服務對象之意見調查研究•台北:行政院青年輔導委員會委託研究。 社會大學(1993)•全國義工(志工)調查•台北:財團法人社會大學文教基金會民調中心。
  25. 胡益進(1993)•臺灣地區醫療保健團體有關人員推行健康促進計畫之認知、態度及需求研究•國立臺灣師範大學衛生教育研究所碩士論文。
  26. 胡愈寧(1985)•志願工作者在社會服務過程中之工作分析•東吳大學社會學研究所碩士論文。
  27. 黃靖惠(1993)•臺北地區成人環境議題涉入程度與擔任環境義工意願之研究•國立臺灣師範大學社會教育研究所碩士論文。
  28. 黃淑貞(1991)•美國推展「健康促進」之現況及其成本效益評估•公共衛生,18(1),55-63。
  29. 黃蒂(1988)•生命線志願工作人員工作價值與工作滿足之研究•東海大學社會學研究所碩士論文。
  30. 黃淑霞(1988)•臺北市兒童福利機構志願工作者持續服務意願相關因素之研究•文化大學兒童福利研究所碩士論文。
  31. 陳明璋(1979)•組織效能研究途徑及其衡量•中國行政,29,48-71。
  32. 陳武雄(1997)•志願服務應有的認識與作法•台北:臺北市志願服務協會。
  33. 陳政智(1999)•非營利組織中志願工作者之管理:從人力資源管理關點•社區發展季刊,58,117-127。
  34. 陳定銘(1999)•非營利組織志工招募與甄選的探討•社區發展季刊,58,128-141。 省政府社會處•臺灣省省民對社會福利措施意向調查報告•臺灣省:省政府社會處。
  35. 湯美霞(1997)•精神科護理人員知識、態度及處理病患性問題方式與自信程度之探討•國立臺灣大學護理學研究所碩士論文。
  36. 郭芳汝(1998)•志工選擇服務醫院務之關鍵因素及其決策行為之探討•國立東華大學企業管理研究所碩士論文。
  37. 曾騰光(1994)•大學生對志願工作特質的認知和參與意願的研究•東海學報,35,151-172。
  38. 蔡啟源(1995)•台灣地區高齡志工及協助高齡者工作模式之研究•台北:雙葉。 鄭煒東、楊誠恕、王德芳與侍台平(1996)•如何提升社區健康•國防醫學,23(1),74-76。
  39. 梁偉康(1990)•社會福利機構行管理與實踐•香港:集賢社。
  40. 彭文賢(1986)•組織原理•台北:三民。
  41. 葉俊郎(1993)•臺北市政府社會局擴大辦理長青榮譽服務團實施方案評估研究•東吳大學社會工作研究所碩士論文。
  42. 劉明翠(1992)•志願服務人員組織承諾相關因素之研究-以青少年輔導機構為例•東吳大學社會學研究所碩士論文。
  43. 賴怜密(1992)•台北市衛生所公共衛生護理人員對推展健康促進活動的角色認知、態度及意願調查研究•國立臺灣師範大學衛生教育研究所碩士論文。
  44. 蘇信如(1985)•志願服務組織運作之研究•臺灣大學社會學研究所碩士論文。
  45. 簡秀昭(1997)•公部門志願服務者管理之研究•政治公共行政研究所碩士論文。
  46. 雷天楠(1997)•新銀行內部講師專業能力之研究•國立師範大學商業教育研究所碩士論文。
  47. 潘玲莉(2000)•基隆市老人居家服務之評估研究•東海大學社會工作研究所碩士論文。
  48. 嚴幸文(1993)•醫院志願服務人員人格特質和工作滿意度之研究•東海大學社會工作研究所碩士論文。 英文部份 Alderfer, C.P. (1972). Existence, relatedness, and growth : Human need in organization settings. NewYork, NY : Free. Baron, R.A. & Greenberg, J. (1990). Behavior in organizations : Understanding and managing human side of work (3rd ed.). Boston, MA: Allyn & Bacon. Becker, H.M. & Rocenstock, I.M. (1989). Health promotion, disease presention, and program retention. In H.E. Freeman, S. Levine (Eds.), Handbook of Medical Sociology (4th ed.). ( pp.92-118).
  49. Dunn, P.C. (1995). Volunteer management. In R.L. Edwards (Ed). Encyclepedia of social work. (pp. 193-214), Washington, DC : NASW.
  50. Gabor,P.A. & Grinnell, R. M. (1994). Evaluation and quality improvenment in the human service. Boston, MA : Allyn and Bacon. Green, L.W. & Johnson, K.W. (1984). Health education and health promotion. In J. Matavazos, S. Weiss, J. Herd, N. Miller & Weiss (Eds.), Behavior health: A handbook of health enhancement and disease prevention. New York, NY: Wiley. Guidotti, T. L. (1989). Health promotion in perspective. Canadian Journal of Public Health, 80, 400-405.
  51. Jarvis, P. (1990). Professional education. London : Croom Helm. Kettner, P. M., Moroney, R. M., & Martin, L. L. (1990). Designing and managing program: An effectiveness-base approach. Newbury Park, CA : Sage . Lalonde, M. A. (1974). New perspective on the health of canadians: A working document. Ottawa, Canada: Ministry of National Health and Welfare, Government of Canada. Martin, L. L. & Kettner, P. M. (1996). Measuring the performance of human service programs. Newbury Park, CA : Sage . Mueller, D. J. (1986). Measuring social attitudes : A handbook for researchers and practitioners. New York : Teacher''s college, University of Columbia press. Mcleroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4). 351-377.
  52. Noack, H. (1987). Concept of health and health promotion : In measurement in health promotion and health protection. WHO Regional Office for Europe. O''Donnell, M.P. (1986). Definition of health promotion. American Journal of Health Promotion,1(1), 4 -5.
  53. Pender, N. J., Barkauskas, V. H., Hayman, L, Rice, V. H. & Anderson E. T. (1992). Health promotion and disease prevention : Toward excellence in nursing practice and education. Nursing Outlook, 40(3)106-112.
  54. Palmen, G. R. & Short, S. D. (1989). Health care and public policy: An Australian analysis. Aouth Melbourne : The MacMillan Campany of Australia Pty Ltd. Phillips, C., Palfrey, C. & Thomas, P. (1994). Evaluating health and social care. The Macmillan press . Schwartz, J. S. (1991). Internists'' practice in health promotion and disease prevention. Annals of Internal Medicine, 114, (1), 46-53.
  55. Schindler, R.E. & Lippitt, R. (1975). The volunteer community : Creative use of human resource. California, CA : University Association. Smith, M. J. (1982). Persuasion and human action : a review and critique of social influence theories. California, CA : Wadsworth. Skidmore, R.A. (1990). Social work adminstration : Dynamic management and human relationship. Englwood Cliffs, NJ : Prentice Hall. Stachtchenko, S. & Jenicek, M. (1990). Conceptual differences between prevention and health promotion : Research implications for community health programs. Canadian Journal of Public Health, 81, 53-59.
  56. U. S. Department of Health, Education, and Welfare. (1979) Healthy people: The Surgeon general''s report on health promotion and disease prevention. Washington, DC : U. S. Gorvernment Printing Office. U. S. Department of Health, and Human Service. (1990) Healthy people 2000 : National health promotion and disease prevention objectives, conference edition. Washington, D. C.:U. S. Government Printing Office. World Health Organization (1987). International conference on health promotion: Ottawa charter for health promotion, PAHO Bulletin, 21(2), 200-204.
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