智慧障礙者人口學特徵與障礙成因初探：以台灣官方身心障礙人口資料檔調查分析

An Exploratory Study of Etiological and Demographic Characteristics of Intellectual Disability: Analyses Based on NDRD, Ministry of the Interior in Taiwan

嚴嘉楓(Chia-Feng Yen) ； 林金定(Jin-Ding Lin) ； 羅慶徽(Ching-Hui Loh) ； 李志偉(Chi-Wei Li) ； 吳佳玲(Jia-Ling Wu)

《台灣家庭醫學雜誌》 14卷4期 (2004/12) Pp. 173-183

https://doi.org/10.7023/TJFM.200412.0173

摘要

本研究試圖從智能障礙者的主要照顧者之描述中了解身心障礙者可能致因、發現管道以及其他相關人口學變項等之分布，並窺探其間之關係，本研究以民國89年底內政部身心障礙者人口資料檔為研究母群，以結構性問卷為研究工具，經系統抽樣共回收1,071問卷進行資料分析（有效樣本回收率為21.02%）。研究結果發現，研究對象男性較女性多，智能障礙者平均年齡為25.5歲，障礙等級以中度為最多(36.0%)，教育程度以國小最多(31.1%)。整體而言，家庭一個月開支在四萬元以下者佔了74.3%，智能障礙者家庭收支情形以支出大於收入佔最多(47.4%)，家庭的收支情形與智能障礙者的障礙程度、合併其他疾病及健康情形都具顯著的相關，家庭經濟情形隨著智能障礙者之健康情形及其障礙程度有愈嚴重而愈有入不敷出的趨勢。此外智能障礙者的香現管道大多是透過醫療院所一般門診(37.5%)，在障礙原因方面，先天（遺傳）佔了21.3％、原因不明則佔了42.8%；另一方面發現，有29.1％的智能障礙者之親屬同樣具有智能障礙，而有6.9％的智能障礙者家庭是至少有三個人以上具智能障礙，而「發現管道」與「是否有其他親屬同為智能障礙者」兩者之問具有顯著相關。本研究結果顯示，智能障礙家庭聚集的情形普遍，而且經濟狀況入不敷出的情形愈嚴重，其智能障礙者的障礙程度、健康情形也愈嚴重，合併其他障礙、罹患其他疾病的比例也較高，顯示改善智能障礙者的健康情形，不僅僅是醫療衛生單位單方面的努力，完整的社會福利措施、全面的社區家庭支持系統更是根本之道；探討智能障礙之病因學，除了能夠協助政府制定相關預防策略之外，最重要的是能夠作為規劃智能障礙者日後醫療照護、社會福利等相關政策之參考。

並列摘要

Intellectual disability is a heterogeneous condition which is associated with hundreds of clinical entities and syndromes. An appropriate monitoring of the etiology and demography of intellectual disability is necessary for our health care system to formulate adequate health policies for people with intellectual disability and to provide adequate care for them. The aim of this study is to explore the etiological, demographic characteristics and to examine the different channels in which these cases of intellectual disability are being discovered. A structured questionnaire was conducted by mailing survey of a sample from the National Disability Registration Database, Taiwan, stratified by administrative geographical area, was systemically selected for the study. Statistical analysis of 1071 respondents (response rate: 21.02%) was made to determine etiological and demographic characteristics for people with intellectual disability. Findings showed that outpatient visits were the main channel (37.5 percent) to discover the intellectually disable population in Taiwan. In terms of the etiology of intellectual disability, approximately 21.3 percent were caused by hereditary problems; and 42.8 percent still had no clear etiology of their intellectual disability. We also found that the prevalence of intellectual disability had a family cluster effect. 29.1 percent of families with an intellectually disabled member also had another intellectually disabled relative, and 6.9 percent had a third intellectually disabled relative. The channel for discovering intellectual disability was significantly related to the family cluster effect of the intellectually disabled. In order to ensure the quality of health care services for persons with intellectual disability, the examination of etiology and demography should be defined accurately to allow healthcare professionals to identify cases more precisely and effectively.

並列關鍵字

Causes ； demography ； etiology ； intellectual disability

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