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http://ir.cmu.edu.tw/ir/handle/310903500/11207
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| 題名: | 原住民肺結核病患需求評估 |
| 作者: | 蔡文正(Tsai,Wen-Chen);龔佩珍(Kung, P.T.);沈光漢;楊文達 |
| 貢獻者: | 公共衛生學院醫務管理學系 |
| 關鍵詞: | 肺結核;原住民;病患需求;tuberculosis;Aborigines;Patient Needs |
| 日期: | 2006-12-31 |
| 上傳時間: | 2009-09-01 15:07:48 (UTC+8) |
| 摘要: | 近年來世界各國結核病的發生有逐年增加的趨勢，而國內所有因傳染性疾病死亡的民眾中，肺結核死亡之比例仍屬最高，世界衛生組織也提出警告要求各國注意疫情的發展。然而，至有效的抗結核藥物問世，一百多年以來，結核病至少已經奪走全球二億個寶貴的生命！即使到了今天，全球仍然有三百萬條人命因結核病而犧牲。台灣地區經過五十多年的努力，結核病死亡率大幅下降，罹患病症的人數已在穩定的控制中，但是卻仍舊無法改變結核病排名第十二大死因的事實；更令人震驚的發現是，原住民山地鄉的結核病發生率比台灣地區又高出許多。就行政院衛生署疾病管制局統計數據顯示2002年全國每十萬人口結核病發生率為64.84人，山地鄉則為289.81人，而每十萬人口結核死亡率為5.68人，山地鄉則為30.17人。山地鄉多為原住民居多，其生活環境、醫療資源、經濟來源等條件較一般民眾不良，若欲改善原住民結核病患之完治率降低其死亡率，瞭解原住民肺結核病患之需求為勢在必行的工作。因此，本研究將透過公衛護士或疾病管制局輔導員針對原住民肺結核病患進行問卷調查，以瞭解原住民肺結核病患之基本特性、治療情形、健康行為、疾病認知，以及評估原住民肺結核病患之需求（包含醫療層面、心理層面、生理層面、經濟層面、交通層面、人際關係層面）。並利用檔案分析，分析疾病管制局2004至 2005年結核病通報管理資料庫，以瞭解國內原住民之結核病的發生率、盛行率等流行病學資訊。針對原住民結核病患問卷方面，本研究首先進行描述性之統計分析，並利用雙變項分析山地鄉與非山地鄉原住民結核病患在病患基本特性、治療情形、健康行為及疾病認知方面、病患需求是否有顯著差異。最後採用複迴歸（multiple regression）進行推論性統計分析，分析影響原住民結核病患之病患需求相關因素。本研究主要分六個階段，第一階段為文獻歸納，以瞭解原住民罹患結核病之現況（發生率及盛行率），並蒐集影響結核病患需求之相關研究，第二階段則利用焦點團體法取得多方看法，第三階段以第一與第二階段蒐集之資料結果設計問卷，第四階段透過公衛護士或疾病管制局輔導員進行問卷調查。第五階段則是彙整分析問卷調查之結果。最後一階段，乃利用一至五階段之結果召開專家會議將邀請專家學者、原住民結核病患、衛生單位相關人員，針對研究結果歸納出原住民結核病患之需求進行討論，並對行政機關擬出具體明確建議。
The incident rate of tuberculosis is continuous increasing in the whole world during these years, and the mortality rate of tuberculosis is the highest among the infectious disease in Taiwan. Therefore the World Health Organization (WHO) requests every country to keep an eye on this epidemic situation. However, until the anti-tuberculosis medicine came out, tuberculosis still caused at least two hundred million people dead during hundred years. Even till now, there are still have 3 million human lives die because of tuberculosis in the whole world. The mortality rate of tuberculosis in Taiwan has been dropped by a wide margin because of the government??s efforts in the past fifty years. The number of morbidity patients has been under steadily controlled, but tuberculosis still ranks in the 12th of leading causes of death. Under this fact, we found that aborigines who live in the mountain areas have much higher incident rate of tuberculosis than other areas in Taiwan. From the statistics reports of center of disease control (CDC) in 2002, the tuberculosis incidence rate is 64.84 people per hundred thousand population nation-wide, and 289.81 people per hundred thousand populations in the mountain areas. And the tuberculosis mortality rate is 5.68 people per hundred thousand population nation-wide, and 30.17 people per hundred thousand populations in the mountain areas. In the mountain area, the majority residents are aborigines. They have worse conditions in community environment, medical resources, and economics income etc. than normal people. If we want to improve the incomplete treatment rate and decrease the tuberculosis mortality rate of aborigines, knowing the demands of aboriginal tuberculosis patients are the first issue we need to focus on. Therefore, this study will progress on the investigation of aboriginal tuberculosis patients by questionnaires which will implement by public health nurses or social assistances from center of disease control. The questionnaire will include patients?? characteristics, treatment conditions, health behaviors, disease cognitions, and valuate the demands of tuberculosis patients of aborigines (including medical level, psychology level, physiology level, economic level, traffic level, and level of social relationship). And the study will analyze the dataset which is the statistics reports of CDC from 2004 to 2005, to understand the epidemic data such as incident rate, prevalence rate of tuberculosis for aborigines. For the questionnaire of tuberculosis patients of aborigines, the description statistics will be used. And bivariate analysis will be applied to analyze the differences of patients?? characteristics, treatment conditions, health behaviors, disease cognitions, and the demands of patients between aboriginal tuberculosis patients in mountain area and in non-mountain area. At last, the multiple regression analysis will be conducted to analyze the related factors affecting aboriginal tuberculosis patients. This study mainly has six steps. The first step will be literature review, it will help us to understand the status about the tuberculosis prevalence conditions of aborigines, and it will also collect related studies about affecting factors of demands for tuberculosis patients. Next step will use focus group to acquire different opinions from related experts. The third step will design the questionnaire according to the related data from the first and second steps. Then the public health nurses and associate assistances from CDC will conduct the questionnaire investigation. The fifth step will collect and analyze the questionnaire. For the last step, the study will generalize the outcome and will proceed on the discussion according to the previous steps, and will also propose the |
| 顯示於類別: | [醫務管理學系暨碩士班] 研究計畫
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| 95-DC-1011.pdf | | 4230Kb | Adobe PDF | 644 | 檢視/開啟 |
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