運用不同視角探討學童近視防治工作之困境

Using Variable Angular Fields of View to Explore Myopia Prevention Dilemma in Elementary School Children

背景：台灣的近視人口居高不下，年齡往下延伸，近視預防工作相當困難。本研究目的在探討學童近視防治困難之成因。方法：採取質性研究法，針對近視相關工作計畫者、執行者、與計畫接受者，使用深度訪談。訪談對象包括眼科醫師、學校衛生護理師、導師、課輔老師、家長、衛生組長、兒童。結果：運用不同視角分析臺灣近視防治困境的原因屬於交錯複雜性之因素，發現最重要的面向有教育面向及科技生活面向，另外，主要照顧者佔有相當大的關鍵因素，再者，兒童眼球生理變化及個性特質與喜好亦不能忽略。結論：近視防治工作困難度高，整體上保護兒童視力防治工作應從多角度進行新世代行為分析與方案策劃。建議：未來近視防治工作，可朝向社會氛圍的重新建構，從預防的角度，運用有層次的危險評估架構，除了以學校為基礎的工作模式，應增加科技環境負向生活影響的處理能力。

Background: Myopia prevention is difficult due to the increasing number of people with myopia in Taiwan and the decreased average age of onset. This study explores the factors contributing to the difficulties in the prevention of myopia for school children. Method: This study employs a qualitative method. Data are gathered through in-depth interviews with planners, executors, and subjects of myopia-related works. Participants include a physician, school health nurses, an ophthalmic optician, teachers, parents, and elementary school children. Results: Analysis reveals the following causes of the dilemma in myopia prevention with variable angular fields of view: education, technology lifestyle, parents and other caregivers, child's preferences or personality traits, and physiological changes in the eyeball. Conclusion: Myopia prevention is difficult. In general, protecting the eyesight of children for prevention and control works can use behavior analysis from multiple views on new generations and scheme programs. Suggestions: Future tasks related to myopia prevention should be oriented to the reconstruction of a social atmosphere that applies a hierarchical structure of hazard assessment, as based on prevention. Besides being school-based, the working modes should also include the ability to deal with the negative influences of the living environment brought about by technology.