以能量理論進行城鄉社區健康評估

Applying Energy Theory to Compare Community Health Assessments Conducted in Urban and Rural Areas

台灣由於地狹人稠，社區的概念方興未艾，單一社區的分野模糊不清，民眾與資源在社區的流動十分頻繁，因此作者用國內首見的社區評估模式──Helvie發展的「能量理論」來評估社區，包括核心（人口）、四種內在能量（化學、物理、生物、精神），及環境中的九大次系統（交通、健康、教育、娛樂、經濟、政治、溝通、文化、社會福利）。並提供城、鄉二個社區案例，以突顯台灣的社區特性。結果發現不同的社區有不同特質及潛力；不同的社區環境及能量互動，對社區健康的影響大不相同。城、鄉社區各有其不同優勢及獨特的健康需求，社區衛生護理人員應就其獨特性，反思社區真正的健康需求，落實三段五級預防，發揮不同層次之專業角色。本文期望能作為社區衛生護理人員洞悉社區健康問題，發展進階角色功能，及推動健康工作計畫的參考。

Taiwan's high population density frequently blurs the administrative boundaries between communities, leading to indistinct community identifications among the population. The authors used the Helvie energy theory to assess different communities in Taiwan, employing a core (population), four internal energies (chemical, physical, biological, and psychiatric) and nine environment subsystems (transportation, health, education, entertainment, economy, politics, communication, culture, and welfare) in an analysis of urban and rural community samples. Authors found significantly different influences on community health due to different environments and energy exchange factors between the two samples. Urban and rural communities have advantages and requirements that are distinct from one another. The community health nurse (CHN) should consider the specific demands of each community and develop professional roles to incorporate the three degrees of prevention. Authors hope that this article can inspire CHNs to define the critical health problems in their communities, facilitate the development of advanced professional roles, and serve as reference in implementing health plans.