老年人肺結核知識、態度和預防行為之探討：以鳳林鎮為例

Knowledge, attitude and preventive behaviors relative to tuberculosis in the elderly - a study in Fenglin Township, Taiwan

目標：結核病是台灣法定傳染病中死亡數最多的疾病。被感染後一生中有5~10%會發病，現在65歲以上老年人，在台灣結核病高盛行年代感染機率高，隨著年紀增長抵抗力下降，對老年人的健康威脅值得注視。本研究目的在瞭解鳳林鎮老年人肺結核知識、態度及預防行為情形及其相關因素，提供疾病防治建議。方法：以鳳林鎮各關懷據點65歲以上老年人為研究對象，採問卷調查進行。結果：肺結核知識答對率64.5%。在態度層面，民眾最害怕被別人知道罹患肺結核(40.9%)；並期望已經在治療且醫師也說不會傳染的肺結核病人戴口罩(73.1%)。受訪民眾的預防行為，以到醫院時戴口罩的情況最低(56.5%)。同時控制相關因素後，衛福部社家署補助之關懷據點的民眾採取預防行為勝算比是原住民委員會等單位補助的2.55倍，達統計顯著意義。結論：肺結核知識中，老年人最欠缺傳染途徑的訊息。不同關懷據點之民眾在預防行為上有所不同，未來應分別就不同關懷據點，加強老年人的肺結核知識、態度，以改善其預防行為。

Objectives: Tuberculosis (TB) is the leading cause of death among communicable diseases in Taiwan. People infected with TB bacteria have a lifetime risk of falling ill with TB of 5-10%. The elderly have a high prevalence of TB accompanied by an increase in chronic health problems. They should be concerned about the threat from TB. The aim of this study was to understand the knowledge, attitude, and preventive behaviors with regard to TB by the elderly in Fenglin. Methods: A cross-sectional study with a structured questionnaire was designed to collect data. Results: A total of 193 seniors were included in the study; 64.5% of them knew the right answers to questions about TB. Their attitude about prejudice showed that 40.9% feared that other people would know that they or a family member was diagnosed with TB. On the preventive dimension, 73.1% expected that TB patients should wear masks. Only 56.5% believed that people visiting the hospital should wear a mask. After controlling for all associated factors, we found that those who came from care centers subsidized by the Ministry of Health and Welfare had a 2.25 times odds ratio of taking preventive measures than did those in the center subsidized by the Council of Indigenous Peoples. Conclusions: Knowledge about TB transmission was low among the participants. The elderly from different care centers displayed a significant difference in preventive behaviors. It is necessary to consider the care center as an important factor when advocating for measures to control TB in the future.