國小學童家庭型態、特殊疾病、學業成就與校園傷病頻率的關係－－以南部某國民小學為例

The Relationships among Family Condition, Illness, and School Achievement of Primary School Students to School Illness and Injury Rates-- a Pimary Shool in Suthern Taiwan

學校衛生護理人員為達事半功倍的護理成效，確認需要高關懷的學童給予合適的介入措施，是學童健康管理重要的楔子。本文為縱貫性研究設計，研究群體以南部某國民小學91學年入學的104學童為對象，資料來源為學生健康系統資料庫，研究目的旨在探討學童的傷病頻率與學童個人特質、學業成就及其家庭型態間的關係。研究假設有三，包括：單親及新移民家庭學童的傷病頻率顯著高於雙親家庭的學童；有特殊疾病學童的傷病頻率顯著高於沒有特殊疾病的學童；學業成就得分較低學童的傷病頻率顯著高於學業成就得分較高的學童。以百分比、平均數及標準差描述受試者的基本資料，利用t檢定及複迴歸驗證研究假設。結果發現，學童傷病的總次數為15.0±13.2次／人，其中學生在六年級時不論受傷（2.9±2.5次／人／年）或疾病（0.8±1.4次／人／年）發生的頻率均最高，在一年級時次高；自二年級開始受傷頻率隨著年級增加而增加，除六年級外疾病頻率則隨著年齡增加而減少。組間差異比較發現單親家庭、國語或數學學業成就表現不佳學童的受傷頻率均較高，並達到統計上的顯著水準。綜合而言，學童傷病頻率的預測因子包括：單親家庭、新移民家庭、國語學業成就的表現，這些變項解釋總變異量介於32.5％～63.0％。本研究結果有助於學校實務工作者了解不同年級學童、家庭型態、宿疾與傷病間的關係，並作為加強管理學童健康需要或提供健康照護服務策略的參考，達到促進學童健康的目標。

There is no doubt that an active intervention by school nurses for the ones who are in possible high risk of health issues in elementary school is the most effective way of school health promotion. With the design of longitudinal studies, this study is based on a collective data from the school health data system of the 104 elementary school students who entered school in the year of 91 in southern Taiwan. The purpose of this study is to discuss about school injury and illness rates and their relationships between family conditions, individual characteristics, and school achievements. There are three study hypotheses which include, first, single parent families and new immigrants have a higher school injury and illness rate compare to the families with parents. Second, the students with particular illnesses will perform a noticeable rate on injury and illness than general students. Last, the ones with lower school achievements will be resulted negatively compare to the ones with better school achievements. By using percentage rate, average rate, standard deviation to describe the basic data of the participants, then the t-test and the multiple linear regression were used to examine the hypothesis. The total result of school injury and illness rate for six-year period is 15.0±13.2 (time/person). On the other hand, grade six students has the highest injury rate of 2.9±2.5(time/person/year; t/p/y) and illness rate of 0.8±1.4(t/p/y) with first grade ended the second highest on injury and illness rates among all other grades. The injury rate increases along with the grades, but the illness rate resulted on the contrary. In the comparison of the variables, Single family or the ones with bad performance on Chinese language or math have a significantly higher injury and illness rate. The predictors of student injury and illness rates include single parent, new immigrants, and bad performance on Chinese language or math achievements with an explaining variation of 32.5% to 63.0%. The value of this study will help school nurse to provide a better school health management strategy for different grades, family conditions, diseases, injuries, and illnesses in order to promote elementary school students' health issues at school.