氣喘學生生活適應問題、學習表現與身體活動情形研究－－以臺北市五所中小學為例

Psychosomatic symptoms, social adjustment, school performance and physical activity in adolescents with asthma

國內兒童氣喘盛行率急遽增加，已成為學生常見慢性疾病。氣喘的早期、反覆、不可預期性發作可能影響青少年身心發展。本研究的目的在了解氣喘學生之生活適應問題、學習表現與身體活動情形，並與健康學生比較，期能作為未來提供適切照護與教育之參考。研究立意選取台北市三所國小四至六年級和兩所國中全體學生為對象，採用ISAAC錄影帶問卷篩檢疑似氣喘者，再經護理人員確診訪談找出360位氣喘學生。接著，在每位氣喘學生班上選出兩位同性別、社經地位相近的健康學生作為參照組。最後，以結構式問卷為工具評估兩組學生的適應和學習情形，實際有效樣本數為1,070人。主要發現如下：國中氣喘學生的生理、心理和人際適應問題，以及吸菸率均高於健康參照學生；另外，氣喘組自覺體育活動表現較差；學習體育困難度較高；請假較多。國小氣喘學生與健康參照學生的生理和心理適應問題，以及請假、休學等有顯著差異，且以氣喘組適應較差。本研究結論氣喘會影響學生的生活適應和請假狀況，尤其對是國中階段的學生而言。建議學校和氣喘學生的照護人員能關切其疾病適應上的困擾，適時提供合宜的輔導和教育措施。

Asthma is the most common chronic disease during childhood and adolescence. A condition such as asthma, with an early onset, has the potential to complicate the physical and emotional development and the psychological adjustment of the child. The present study is to understand the psychosomatic symptoms, social adjustment, and school outcomes of students with asthma and to compare the difference between asthmatic students and their healthy peers. Five primary and junior high schools in Taipei city were selected purposely. The grade 4~9 students with asthma and two healthy classmates in these schools are included as subjects. Totally, 1,070 students provided information about the psychosomatic symptoms, social adjustment, and school functioning. The main findings of the present study were as follows: 1. Asthmatics reported having more psychosomatic symptoms, and having more social adjustment problems. 2. Tobacoo use was higher among asthmatic compared with non-asthmatic students in the junior high subjects. 3. Children with asthma were absent from school significant than were their nonasthmatic peers. The findings of the present study suggest that adolescents with asthma represent an important vulnerable group of school children. Asthma education may need a greater life-style change focus, besides asthma self-management training.