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題名:蘭嶼雅美人求醫行為之研究
書刊名:中華公共衛生雜誌
作者:吳炳輝季瑋珠洪其璧
作者(外文):Wu, Ping-fuaiChie, Wei-chuHorng, Chi-byi
出版日期:1997
卷期:16:4
頁次:頁329-338
主題關鍵詞:蘭嶼雅美人求醫行為Orchid islandYami tribeHealth care seeking behavior
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(2) 專書(0) 專書論文(0)
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     蘭嶼雅美人的經濟及健康條件低落、文化特殊、地形隔絕,往往使衛生及醫療政策在當地的執行成果不彰。緣此,本研究之研究目的在於瞭解蘭嶼雅美人的求醫行為,包括影響健康的風俗習慣、醫療信仰和疾病的處理方式,並探討影響雅美人求醫行為的因素,據以提出政策改善的建議。本研究以蘭嶼鄉年滿20歲及以上的成年人為對象、戶為單位,用Kish表家戶內隨機抽樣的方式,每戶抽一人,總計樣本數為712人,由公共衛生護士以結構式問卷進行家戶面訪。調查內容包括:傾向、能力、需要因素、醫療服務的可用性與滿意度、與文化相關的健康信念,及腹瀉與關節痛發生時 的求醫行為。扣除空戶及拒訪,共得有效樣本701人。分析結果發現:雅美人的經濟能力低落、健康保險比率偏低、蘭嶼的醫療資源缺乏、滿意度普遍不佳。雖然目前蘭嶼雅美人生病是以現代醫學療法為主,但是受訪者中尚有半數以上民眾在腹瀉及關節痛時使用傳統醫療。年齡在中年、職業非軍、公、學生、對現代醫療的滿意度低、以及現代健康信念低者,腹瀉時傾向於使用傳統醫療;關節痛時使用傳統醫療的相關因素,除年齡無顯著相關外均與腹瀉時相同。據此,吾人建議:政府相關機構應適量增加當地的醫療資源,提升民眾健康教育,使能融合傳統與現代,並重塑正確的 文化與健康信念。
     The Yami tribe on the Orchid Island (Botel Tobago) have been suffering from poor economic and health condition for decades because of their culture background and geographic isolation. Past health policy had only limited achievements. The aims of this study were to understand the medical care seeking behavior and associated factors of this tribe and to make policy suggestions accordingly. Based on the records of the Orchid Island household registry office, we did random sampling to select 712 family units and one person aged 20 and above in each family with the Kish Table. Trained public health nurses did home visit and face-to-face interview with a structured questionnaire. The questionnaire covered predisposing, enabling, need factors, availability of and satisfaction with medical services, culture-related health beliefs, and health care utilization when having diarrhea and joint pain. Multiple logistic regression were used to study the effects of the possible associated factors. A total of 701 completed the interview. We found that Yami people had low income and coverage of health insurance, inadequate medical resources and low satisfaction. Although modern medicine was the major source of care, more than half of the subjects used traditional treatment. Middle-aged, those whose occupation were not government employee, military, and students, those who were unsatisfied with modern medicine, and had low modern health beliefs, tended to use traditional medicine when having diarrhea. The result of joint pain was the same except that the age had no significant association. In conclusion, we suggested the government to enrich local medical resoures, improve health education, and incorporate the modern health beliefs and practice with the traditional one.
期刊論文
1.Rosner, T. T.、Namazi, K. H.、Wykle, M. L.(1988)。Physician use among the old-old: Factors affecting variability。Medical Care,26,982-991。  new window
2.Kish, Leslie(1949)。A Procedure for Objective Respondent Selection within the Household。Journal of the American Statistical Association,44,380-387。  new window
3.吳淑瓊、楊志良、吳新英(1982)。影響傷病發生與醫療行為之多變數分析研究。中華民國公共衛生學會雜誌,2(1),35-45。  延伸查詢new window
4.Suchman, Edward A.(1965)。Social Patterns of Illness and Medical Care。Journal of Health and Human Behavior,6,2-16。  new window
5.Andersen, A. S.、Laake, P.(1983)。A causal model for physician utilization: analysis of Norwegian data。Medical Care,21,266-278。  new window
6.Cox, C.(1986)。Physician utilization by three groups of ethnic elderly。Medical Care,24(8),667-676。  new window
7.Suchman, E. A.(1965)。Staeres of illness and meaical care。J Health Soc Behav,6,114-128。  new window
8.Arthur, M. Kleinman(1975)。Medical and Psychiatric Anthropology and Study of Traditional Froms of Medical in Modern Chinese Culture。中央研究院民族研究所季刊,39,115。  new window
9.張禹罕、社友蘭(1977)。民眾對衛生所利用情況之調查研究。中華醫誌,24,170-231。  延伸查詢new window
10.Sharpe, T. R.、Smith, M. C.、Barbre, A. R.(1985)。Medicine use among the rural elderly。J Health Soc Behav,26,113-127。  new window
11.Tanner, J. L.、Cockerham, W. C.、Spaeth, J. L.(1983)。Predicting physician utilization。Medical Care,21,360-369。  new window
12.吳就君(19810400)。臺灣地區居民社會醫療行為研究。公共衛生,8(1),25-49。  延伸查詢new window
13.許志成、季瑋珠(19960200)。門診高度使用者之特性:以大溪鎮群醫中心門診病人為例。中華公共衛生雜誌,15(1),91-96。new window  延伸查詢new window
14.張珣(19841200)。臺灣漢人的醫療體系與醫療行為--一個臺灣北部農村的醫學人類學研究。中央研究院民族學研究所集刊,56,29-58。  延伸查詢new window
15.Rosenstock, Irwin M.(1974)。The Health Belief Model and Preventive Health Behavior。Health Education & Behavior,2(4),354-386。  new window
16.Markides, K. J.、Levin, J. S.、Ray, L. A.(1985)。Determinants of Physician Utilization Among Mexican-Americans: A Three-Generations Study。Medical Care,23(3),237-245。  new window
研究報告
1.Andersen, R.(1968)。A Behavioral model of Families' use of Health Services。Chicago:University of Chicago Press。  new window
2.Abernathy, W. J.、Schrems, E. L.。Distance and Health Services: Issues of utilization and facility choice for demographic strata。Stanford University, Graduate School of Business。  new window
學位論文
1.蔡淑芬(1982)。烏腳病地區居民醫療行為之研究(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.張笠雲、張理、胡幼慧(1989)。台灣地區山地鄉居民健康狀況及醫療需求調查第二年報告。台北:中央研究院民族學研究所。  延伸查詢new window
2.張笠雲、張玨、胡幼慧(1988)。台灣地區山地鄉居民健康狀況及醫療需求調查第一年報告。台北:中央研究院民族學研究所。  延伸查詢new window
3.Aday, L. A.、Anderson, R.、Fleming, G. V.(1980)。Health Care in the United States: Equity for Whom?。London:Sage。  new window
4.姚克明(1982)。雅美族與健康有關的生活方式及其特異的衛生觀念與行為之調查研究。台灣省公共衛生研究所。  延伸查詢new window
圖書論文
1.Becker, M. H.、Maiman, L. A.(1983)。Model of healthrelated behavior。Handbook of Health, Health care, and the Professions。NY:The Free Press。  new window
 
 
 
 
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