從PRECEDE模式中教育與行為診斷來探討青少年事故傷害發生之影響因素

Educational and Behavioral Factors Influencing the Adolescent Unintentional Injuries In the PRECEDE Model

事故傷害是今天青少年所面臨最嚴重的健康問題，然而大部分的事故是可以藉由採取健康行為來事先防範的，所以本研究的目的在於應用PRECEDE模式思考架構來探討有那些因素對於青少年事故傷害發生具有影響力，以提供未來學校、社區與家庭實施傷害防制工作之參考。臺灣地區八十四學年度公私立國中、高中與高職日間部全體學生為母群，採多階段分層群集隨機抽樣法獲得完全有效樣本9,770人，以青少年事故傷害發生之調查問卷為資料蒐集工具，以多變項複迴歸與邏輯迴歸分析為探討問題之統計方法。結果發現青少年事故傷害發生率受到交通與防火方面之預防行為所影響，而預防暨保護行為又受到素質因素中情感與價值觀念，以及使能、增強因素中學校、社區的宣傳與家庭的重視所影響，但素質比使能、增強因素的影響力來得大；同時，使能、增強因素亦可經由素質因素之途徑間接影響到此預防暨保護行為。因此，PRECEDE模式對此問題提供了一個很好的教育與行為診斷。

Today the unintentional injuries are the most serious health problems facing the adolescent How-ever， most of the accidental injuries can be prevented in advance. The major purpose of the study， based upon the PRECEDE model， is to explore the etiology of the adolescent unintentional injuries， and to provide information for the future injury control and prevention in schools， communities， and families. The survey was undertaken to 9，770 students who were randomly sampled through the multi-stage stratified cluster sampling with probabilities proportional to sizes from the 45 junior， senior， and vocational high schools in Taiwan of the 1995-1996 academic year. The data were collected via the self-report questionnaire with better validity and reliability， and were analyzed through multivariate multiple regression and logistic regression analyses. The results revealed (1) the adolescent unintentional injuries were influenced by their preventive behaviors in the traffic and fire safety， (2) their preventive and pro-tective behaviors were influenced by the predisposing， enabling， and reinforcing factors， where the for-mer factor was more influential than the latter two factors， and (3) the enabling and reinforcing factors indirectly influenced those behaviors through the cause and effect path of the predisposing factor. As expected， the educational and behavioral factors in the PRECEDE model permitted more accurate un-derstanding of the adolescent unintentional injuries.