民眾如何理解接連而來的新興流感？

How lay people make sense of successively emerging influenzas?

目標：本研究探索一般民眾對陸續出現之新興流感的認知反應。方法：透過最大變異原則，選取25位民眾以深入訪談法收集質性資料，採用跨個案的取向進行分析並歸納出特定主題。結果：共歸納出望名生義、超越名稱的內蘊知識、及密集流行下的資訊衝擊等三大主題。民眾初識以病毒類別及其亞型命名的新興流感後，有的以整體的集群視之，有的則根據英文字母H與N及相應的數字，發展出感染源、嚴重程度、新舊程度（出現順序）等不同面向的區辨。人畜共通傳染的想法逐漸浮現。會過度外推地將新興呼吸道傳染病如SARS等都歸於流感家族中。而在暴露於多波的新興流感流行之下，民眾開始感知不同於細菌的另一種病原體－病毒的存在。值得重視的是，有的受訪者開始對宣導訊息因資訊超載而導致對預防的疲乏。結論：民眾對新流感的認知與理解始於其名稱。他們個別化的知識再建構不能單純以當代科學知識來評斷其正確與否。相反的，我們應該儘可能掌握這些逐漸形成的常民知識與行為反應，來發展更有效的流感防疫介入計畫。

Objectives: This study explored lay persons' cognitive responses to emergent influenzas. Methods: Using a maximum variation sampling design, 25 participants were selected and subjected to in-depth interviews. Qualitative data were analyzed following a cross-case approach through which the main themes were extracted inductively. Results: We identified three main themes from the analysis: meanings derived from flu names, connotative knowledge beyond names, and information impact during intensive epidemics. After coming into contact with several 'new' influenzas named for flu viruses and subtypes, some participants considered them to be one single undifferentiated disease entity. Others assigned meaning to each name designated by the form of HxNy, and considered them distinctive in terms of source of infection, severity, and time of emergence. Zoonotic transfer has gradually become recognized as a source of disease transmission. Participants also had a tendency to generalize other emerging respiratory infectious diseases such as SARS as members of a big flu family. Of greater importance, as a result of successive contacts with several flu epidemics, these participants became aware of the existence of a type of germ other than bacteria - viruses. Parallel to recurrent epidemics are prevention fatigue and information overload caused by intensive exposure to flu-related communications. Conclusions: Lay people's initial grasp of new influenzas came from 'seeing' their names. This idiosyncratic re-construction of knowledge cannot be judged simply by contemporary scientific standards. The gradually shaped lay knowledge and behavioral reactions in response to emergent influenzas should be closely investigated. Only by doing so can we develop effective programs for influenza control.