台北市某國中學生預防齲齒行為之研究－健康信念模式之應用

Abstract

本論文依據健康信念模式來探討國中學生預防齲齒行為現況及其相關因素。研究母群體為九十七學年度第二學期就讀於台北市某國中之全體學生，以分層集束抽樣法，於三個年級各抽出四個班為樣本，進行自填式問卷施測，共得有效樣本383人。研究之重要結果如下： 一、研究對象家庭社經背景以高社經地位為主，口腔保健知識得分高於中間值。 二、研究對象之「齲齒罹患性認知」、「預防齲齒行為障礙性認知」量表得分偏中下程度，「齲齒嚴重性認知」、「預防齲齒行為利益性認知」偏中上程度。「預防齲齒行為行動線索」整體接觸上偏多。 三、研究對象之「預防齲齒行為自我效能」量表得分為中上程度，而不同情境下之自我效能分別為：「家裡」高於「學校」又高於「學校以外之其他公共場所」；「時間充足」高於「時間緊迫」；「洗手台及水源充足」高於「洗手台及水源不足」；「有人提醒」高於「無人提醒」；「潔牙用具齊全」高於「缺少潔牙用具」。 四、研究對象之「預防齲齒行為」量表得分為中上程度，介於「有時如此」和「經常如此」之間，但仍有努力的空間。而預防齲齒行為以「我每天晚上睡前都會刷牙」、「我每天早上起床都會刷牙」最多，「我每週都會使用含氟漱口水」最低。 五、在性別方面，男生的「齲齒罹患性認知」高於女生；女生之「預防齲齒行為」表現優於男生。年級方面，七年級生之「預防齲齒行為」表現為三年級中最佳。家庭社經背景方面，高社經背景學生「預防齲齒行為自我效能」優於中社經地位者。 六、研究對象之「口腔保健知識」、「利益性認知」、「自我效能」越高者，而「罹患性認知」、「障礙性認知」越低者，越傾向採取「預防齲齒行為」。 七、研究對象之背景因素、健康信念、行動線索等變項對預防齲齒行為變異的解釋力為46.5％。其中顯著的預測變項為「性別」、「年級」、「障礙性認知」、與「自我效能」，而又以「自我效能」影響力最大，「障礙性認知」次之。Based on the Health Belief Model, this research investigated preventive behavior of dental caries and related factors among junior high school students.

Samples were selected from 7th to 9th grade students and data were collected with a self-administered questionnaire by using stratified cluster sampling method. Total valid samples were 383.

The results of this research are as follows：

1. The family’s social/economic status of participants is high degree, and the score of oral healthy knowledge is higher than standard. 2. The score of participants in “perceived susceptibility of dental caries” and “perceived barriers of action to prevent dental caries” is below the medium. The score in “perceived severity of dental caries” and “perceived benefits of action to prevent dental caries” is above the standard. The contact degree of participants of “cues to action to prevent dental caries” is high. 3. The score of participants in “self-efficacy to prevent dental caries” is above the medium. Self-efficacy in different situations is as listed below: “At home” is higher than “at school”, and “at school” is higher than “at a public place except the school”. “There’s plenty time” is higher than “there’s instant time”. “Sufficient wash basin and water source” is higher than “absent wash basin and water source”. “Reminded by someone” is higher than “no one reminded”. “Complete tooth apparatus” is higher than “absent tooth apparatus”. 4. The preventive behavior of dental caries of participants is between “sometimes” and “ often.” The score of it is higher than standard. It could be better than this. The most popular preventive behaviors of dental caries are “I brushed my teeth every night before sleeping” and “I brushed my teeth every iii morning when I woke up”. The worst one is “I used mouthwash with fluoride every week”. 5. For sex of the participants, “perceived susceptibility of dental caries” of male is higher than female. “Preventive behavior of dental caries” of female is better than male. For grade, the 7th grade students show best “preventive behavior of dental caries”. For the family’s social/economic status, students comes form high degree family’s social/economic status show better “self-efficacy to prevent dental caries” than from medium ones. 6. The participants get high score in “oral healthy knowledge”, “Perceived benefits of action”, “self-efficacy,” and low score in “Perceived susceptibility”, “Perceived barriers of action”, have a higher tendency to adopt “preventive behavior of dental caries”. 7. The following factors: “the population change indices”, “cue in action” and “Health belief”; explain 46.5% of participants’ decision to preventive behavior of dental caries measures. Main four predictive factors are as listed below: sex, grade, perceived barriers of action and self-efficacy. The most effective one is self-efficacy, and the next one is perceived barriers of action.