臺北市公立國中學生求醫行為之相關因素研究

The medical care seeking behavior and its influential determinants of junior high school students in Taipei city

本研究主要根據Andersen的醫療服務利用行為模式，探討臺北市公立國中學生的求醫行為，並分析模式中的傾向、能力和需要等三類因素與求醫次數間的關係。本研究以臺北市公立國中一、二年級全體學生為母群體，採多步驟抽樣法選取調查樣本，並利用自填問卷進行資料收集，共得有效樣本733人。所得資料以描述性統計、卡方檢定、t檢定、單因子變異數分析、Pearson積差相關及複迴歸分析等統計方法進行分析，所得重要發現如下：一、研究對象在調查前半年內的求醫次數，以1～2次較多，約佔四成；其次為3～4次，有近三成；有一成左右的對象求醫次數在七次以上；而僅僅一成以下的學生半年來未曾求醫。二、在Andersen的醫療服務利用行為模式的傾向因素中，認為中醫效果越好者，求醫次數越多；認為信仰療法效果越好者，求醫次數越少。三、在能力因素中，住家附近醫療單位數目越多者，求醫次數越多。四、關於需要因素與求醫行為的關係，可發現主觀覺知健康狀況越差者，求醫次數越多；健康問題發生次數越多者，求醫次數亦越多。五、以傾向因素、能力因素、需要因素來預測臺北市公立國中學生的求醫次數，結果發現中醫信念、信仰療法信念、住家附近醫療單位數目、主觀覺知健康狀況和健康問題發生次數等五個變項可以有效預測，其解釋力達總變異量的19.6％。根據研究結果，提出普遍設置青少年門診、提昇家庭醫師的青少年專科知能、教導國中生正確的保健與求醫觀念等建議，作為未來國內推動完善的青少年醫療保健工作之參考。

Based on Andersen' behavioral model of health services use, this study investigated the health status and the medical care seeking behavior of junior high school students in Taipei city, and explored the relationships among predisposing characteristics, enabling resources, need factors and the medical services utilization. By using a multi-stage sampling method, 733 subjects were surveyed with selfadministrated questionnaires. Data were analyzed by Chi-square test, t-test, one-way ANOVA, Pearson's product-moment correlation and multiple regression. The main findings of present study were as follows: 1 .During the previous six months, about 40% subjects had 1~2 times medical services, near 30% had 3~4 times medical services, only less than 20% never had medical service. 2.In predisposing characteristics, the subjects' Chinese medical belief and religious medical belief had statistically significant difference in the health services utilization. 3. In enabling resources factor, numbers of medical service agency nearby had statistically significant difference in the health service utilization. 4. 1n need factor, the subjects' perception of own health status and health problems had statistically significant difference in the health service utilization. 5. The best predictive variables for the medical services utilization are Chinese medical belief, religious medical belief, the number of medical service agency nearby, perception of own health status and health problems. These five variables account for 19.6% total variance. From these findings, related suggestion for adolescent medical services were recommended.