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題名:國中小學生噪音型聽閾升高盛行率及聽力保健教育計畫實施成效之研究
作者:李明洋
作者(外文):Mong-Yang Lee
校院名稱:國立高雄師範大學
系所名稱:特殊教育學系
指導教授:陳小娟
學位類別:博士
出版日期:2012
主題關鍵詞:噪音型聽閾升高聽力保健噪音預防noise-induced threshold shifthearing conservation programnoise prevention
原始連結:連回原系統網址new window
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本研究共包括3項子研究,子研究一以隨機取樣方式,針對高雄縣市982名國小四年級至國中三年級學生實施聽力檢查,以瞭解國中小學生噪音型聽閾升高的發生率;子研究二亦以隨機取樣方式,針對臺灣地區22116名國小四年級至國中三年級學生進行問卷調查,建立國中小學生聽力保健知識、態度和行為的常模;子研究三採前後測不等組實驗設計,以高雄縣市1003名國小四年級至國中三年級學生為對象,隨機分成2組實驗組與1組對照組,然後以兩種方式(上網自學、聽檢諮詢)分別實施於兩實驗組,並於教學前、後針對所有對象進行前後測,以瞭解聽力保健教育計畫對國中小學生的實施成效。研究者於上網結束後,尚針對上網學生進行訪談。本研究所得結果如下:
一、國中小學生噪音型聽閾升高比率約介於2.04%至17.41%,其中,採林政佑標準判定,則國中生的盛行率為21.07%,顯著高於國小生(12.16%),鄉村地區學生的盛行率為21.10%,顯著高於都市地區(15.41%),單側盛行率為15.38%,高於雙側(2.04%),凹谷聽閾則以發生於6K Hz的比率最多,佔9.47%。
二、國中小學生聽力保健行為相當缺乏而亟需增進,保健態度尚屬積極,唯對於採取防範措施的態度顯得較為被動,至於保健知識則對於「耳朵生理」的認知最薄弱,其他如「噪音的特質」、「噪音的危害」,以及「噪音的防範」等概念,也有模糊不清之處,乃亟需進一步提升。
三、國中小學生在「國中小學生噪音預防聽力保健量表」各分量表5、10、25、50、75、90和95百分位數的得分情形,知識:16、19、23、27、29、31與31;態度:22、23、26、28、30、32與33;行為:11、12、14、16、19、22與23。
四、國中小學生在「國中小學生噪音預防聽力保健量表」各分量表的得分均會因就學地區和教育階段的交互作用而有顯著差異:在保健知識方面,就國中生的得分而言,北區、中區和南區均顯著高於東區,北區又顯著高於中區;就國小生的得分而言,北區顯著高於中區和南區;就各地區的得分而言,北區、中區和南區國中生均顯著高於國小生,東區的國中小學生則無顯著差異。在保健態度方面,就國中生的得分而言,南區和東區均顯著高於北區和中區;就國小生的得分而言,東區顯著高於北區、中區和南區,而中區又高於南區;就各地區的得分而言,中區國小生顯著高於國中生,南區則是國中生顯著高於國小生。在保健行為方面,就國中生的得分而言,北區和南區均顯著高於東區,北區亦顯著高於中區;就國小生的得分而言,東區顯著高於中區和南區。就各地區的得分而言,北區國中生顯著高於國小生,東區則是國小生顯著高於國中生。
五、聽力保健教育計畫實施後,實驗組在「國中小學生噪音預防聽力保健量表」知識、態度與行為分量表的得分均顯著優於對照組。
六、聽力保健教育計畫實施後,學生在聽力保健知識的學習成效方面,會因為不同教育階段及不同實施方式而有顯著差異:就「教育階段」而言,國小生顯著優於國中生;就「實施方式」而言,「上網自學」顯著優於「聽檢諮詢」。在聽力保健態度的學習成效方面,國小生顯著顯著優於國中生。而在聽力保健行為的學習成效方面,「上網自學」顯著優於「聽檢諮詢」。
七、國中小學生對於聽力保健互動教學網站的滿意度頗高(總分10分得8.2分),也願意將網站推薦給親友。
This study consisted of three sub-studies: the sub-study 1 adopted questionnaire, audiometric testing and compliance testing to examine 982 junior high and elementary school students randomly selected from Kaohsiung City and County in Taiwan to estimate the prevalence of noise-induced threshold shifts (NITS) from the 4th grade to the 9th graders. The sub-study 2 adopted questionnaire to survey 22116 4th grade to 9th grade students randomly selected to establish the norm of elementary and junior high school students’ knowledge, attitude and behavior toward hearing conservation. The sub-study 3 enrolled 1003 junior high and elementary school students and adopted pre- and post- nonequivalent group design to investigate the effectiveness two types of of hearing conservation program (HCP) which implemented by means of website learning and audiometric testing respectively. Oral interviewing data were also collected from 24 subjects enrolled in the experimental group to explore their satisfaction with the HCP website.
The results of this study were listed as follows:
1. The prevalence of NITS for the 4th grade to the 9th grade students was (1) between 2.04% to 17.41%, (2) higher in Junior high school students than elementary school students, (3) higher in non-metropolitan students than the metropolitan students, (4) higher in one-side involved ear than bilateral involved cases, and (5) the occurred more often at 6K Hz than 4K Hz and 3K Hz.
2. Subjects’ knowledge, attitude and behavior toward hearing conservation need to be improved.
3. Students’ score of the 5th, 10th, 25th, 50th, 75th, 90th, 95th percentile in three subscales of HCP was: (1) knowledge subscale: 16, 19, 23, 27, 29, 31, 31, (2) attitude subscale: 22, 23, 26, 28, 30, 32, 33, and (3) behavior subscale: 11, 12 , 14, 16, 19, 22, 23.
4. The interaction between areas and education levels had a significant effect in the scores of three HCP sub-scales.
5. After HCP, scores of the experimental groups were significantly higher than those of the control group in all three sub-scales of HCP questionnaire.
6. After HCP, the website learning group scored significantly higher than the audiometric testing group in HCP sub-scales of knowledge and behavior. The elementary school students scored significantly higher than the junior high school students in HCP sub-scales of knowledge and attitude.
7. The junior high and elementary school students were satisfied with the HCP website very much, and were willing to recommend it to other people.
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