就醫路關卡多：成年聽覺障礙者就醫經驗之研究

Hitches Abound along the Way: A Study of Deaf Adults' Experiences in Seeking Medical Care in Taiwan

本研究旨在於探討成年聽障者在就醫過程當中遇到的困境。而研究者之一是聽障者，從障礙觀點社會模式的角度詮釋聽障者就醫經驗。研究發現有：聽障者由於缺乏手語翻譯員，只能用紙筆與醫護人員溝通，難以深入討論病情。聽障者面對醫護人員配戴口罩時而無法接收訊息。目前仍有許多醫療機構缺乏聽障無障礙設施，讓聽障者無法完成就醫程序。此外，目前台灣手語翻譯服務制度仍未能滿足聽障者的溝通需求。臺灣對聾文化缺乏討論，讓醫護人員不知如何與聽障者溝通，也對聽障者的中文能力有誤解，難以提升醫病之間的有效溝通。此外，有些醫護人員對聽障者的態度不佳，也不配合聽障者的溝通需求，讓其產生不被尊重的感受。

NaF 5% is a fluoride that commonly used as a dental topical application treatment. As the technology develops nowadays, nanoparticle is possibly used as dental material because it has greater penetration to enamel, dentin, and dentin-enamel junction. To compare the effect of NaF 5% and Nanofluid to the enamel endurance of permanent teeth toward dental caries. Twenty-seven teeth were divided into three groups; a control group, NaF 5% group, and NanoNaF group. NanoNaF was produced using HEM. NaF 5% and NanoNaF were application for 12 hours and then through demineralization and remineralization process for 14 days. Some test was used such as Microhardness Vickers, SEM, EDX and XRD tests. Miling process using HEM resulting NanoNaF particle size of 295 nm. SEM from NanoNaF group showed smoother enamel surface than from control and NaF 5% group. Microhardness Vickers test result showed 81.18 HV (control), 100.57 HV (NaF 5%), and 78.72 HV (NanoluorNaF) with p=0.76 (p ＞ 0.05). Fluor content in control was 0.07%, NaF 5% was 0.26%, and in NanoNaF was 0.04% with p=0.08 (p ＞ 0.05). XRD test showed that fluorapatite was detected in control (11.2%), NaF 5% (9.75%), and NanoNaF (30.11%). Kruskal Wallis test resulted p=0.60 (p ＞ 0.05). NanoNaF penetration also maintained hydroxyapatite for 63.37%. NanoNaF application can increase the amount of fluoride, fluorapatite, and can maintain hydroxyapatite in enamel better than the NaF 5%. NanoNaF application did not affect the hardness of the enamel surface compare to NaF 5% application.