一所國小守護學童口腔衛生和健康體位之行動研究

An Elementary School's Action Research about Protecting Students' Oral Health and Healthy Posture

政府每年都為一、四年級國小學童實施健康檢查，本校學生一、四年級齲齒罹患率為92%；在健康體位方面，體位不良率為43%，與新竹縣各國小學生比較，其比率分別高居全縣國民小學的第四、七位。因此，我們警覺到學生的健康正面臨威脅，於是積極投入健康促進計畫的推動，其目的在於強化學生及家長對口腔保健的正確認知、態度和行動的實踐，進而降低學童齲齒比例和提高齲齒矯治率，並且培養學生健康飲食觀念和自主運動習慣，達到提高學生健康體位的人數比率。健康促進計畫推動的策略有教學與活動、檢核學生的行為、整合政府與社區醫療資源、建立親師生合作模式、營造活潑溫馨氛圍，逐漸養成健康自主管理的生活習慣等。本研究同時採用量化與質性研究法，有口腔保健和健康體位問卷量表，調查學生在實施前、後的知識、態度、行為的改變，以及學校行政會議紀錄、教師教學省思、學生學習單、家長回饋單、會談記錄及學生日記、家庭聯絡簿等，進行相互的分析和比較。獲得的結論有：1.經過健康促進計畫的推行，大多數學生已形成餐後潔牙的習慣，學生齲齒率由92%降為66%、齲齒矯治率從72.7%提高至100%；2.本校學生在口腔保健問卷量表前、後測結果發現學生在態度與行為層面，均呈現顯著差異，雖然在認知層面未達顯著差異，但學生已逐漸建立起平日清潔牙齒的習慣和運用正確的方法刷牙；3.本校學生健康體位問卷調查前、後測結果發現學生在知識、態度、行為均呈現顯著改變，表示學生較過去有正確的健康知識、較佳的健康信心及良好的飲食和運動習慣；4.全校學生健康檢查體位不良的人數由75人降至71人，體位不良的人數比率也由43%降至41%。

The government put implementation of health investigation in first-and fourth-grade students annually. In our school, the prevalence rate of dental caries in first-and fourth-graders was 92%;in healthy posture, the posture defect rate was 43%,and it was fourth and seventh high compared to other elementary schools in Hsinchu county. Along with this, we are alert to the health of students was under threat and were eager to process the health promotion programs in order to strengthen and establish students, and parents, knowledgement of oral hygiene and healthy habits, thereby reducing the dental caries prevalence and increasing the healthy posture rate. The healthy promotion programs included the practices of students, integrating the resources of government and community, establishing the cooperation model, and training a healthy lifestyle. This paper adopted quantitative and qualitative researches to investigate the changes in pre-and-post- interventions and found that after the implementation of health promotion programs, most students paid more attention to oral hygiene and healthy habits than before, and the dental caries rate and the numbers of improper healthy posture showed significant improvement, which decreased from 92% to 66% and decreased from 75 to 71,and the radio decreased from 43% to 41%.