高度近視併發症防治教育介入效果研究 --以國立台灣師範大學一年級高度近視學生為例

Abstract

摘要 本研究旨在研發與驗證一套運用健康信念模式做為研究理論基礎，加入成人教育的特殊元素來設計高度近視併發症防治教育介入課程，探討大學生高度近視併發症防治教育介入的效果。本研究採等組前後測及後後測真實驗設計，以國立台灣師範大學一年級高度近視學生為研究母群體，在103年度大學部新生體檢時，初步篩檢出近視度數(球面當量)600度及以上的學生，願意參加研究者按照研究計畫隨機分派為實驗組與控制組，實驗組接受本研究研發之「高度近視併發症防治教育」課程，兩組學生於前測、後測及後後測時進行問卷調查。有完整三次問卷資料者始納入研究資料的統計，統計方式採單因子共變數分析來鑑別實驗組與控制組間的差異。本研究重要結果如下: 一、 全體研究對象在高度近視併發症防治教育介入前，對於高度近視併發症防治知識的了解程度在及格邊緣，且欠缺防治行為概念。綜合自覺罹患性及自覺嚴重性的結果，全體研究對象對於高度近視併發症威脅性的感知相當高，而研究對象的自覺行動利益的價值可能沒有被釐清，存在「知易行難」的行動障礙。絕大多數的研究對象的周遭環境缺少行動線索，研究對象也很少主動搜尋媒體網路上的行動線索。對於切身相關的高度近視併發症防治知能略顯不足，只有制約式反應的自我效能，而預防性健康行為的自我效能不佳，健康行為偏向被動。 二、 針對大學高度近視新生實施「高度近視併發症防治教育」介入後的立即效果與延宕效果評估顯示，教育介入可有效增加學生對高度近視併發症防治知識，並可透過觀察學習、情境模擬、言語說服等課程，提高並維持自我效能，雖在整體行為意向中只見到立即效果，但是防治行為中的「自我檢查行為」具有延宕效果。表示教學介入對實驗組學生確實產生教育效果，產生了行為改變。 目前台灣大學生的生活環境中，相關的高度近視併發症防治資訊相當不足，也沒有一套有效的課程與教材教具，本研究所設計的課程與特殊教具，針對提升高度近視併發症防治知識、自我效能與行為意向，經研究證實具有相當成效。日後於學校或相關衛生單位實施防治教育宣導時，應可多加運用推廣，建立高度近視族群健康自主管理概念，達成高度近視併發症「及早診斷、及早治療」的防治效果。ABSTRACT The purpose of this study was to create and evaluate the effectiveness of a high myopic complications preventive intervention program, based on Health Belief Mode, among high myopic freshmen. The study employed a true experimental design, based on the Health belief model and adult education special elements, at National Taiwan Normal University, Taipei, Taiwan. High myopia subjects (myopic spherical equivalence 6 D or more) were identified at routine freshmen physical examination program and were allocated randomly as experimental or control group if subject agree to join the study. Subjects in the experimental group were enrolled in the intervention program, while subjects in control group were not. Questionnaires were distributed at three time points and one-way analysis of covariance (one way-ANCOVA) was conducted. The main research findings are as follows: (1) At the baseline, all of the recruited subjects revealed insufficient knowledge about high myopia complications and concepts of prevention. Their perceived susceptibility and severity in respect to high myopic complications were high, and their perceived benefits and barriers about preventive behavior were high in the same issues. Sources of “cues to action” for high myopia health education were limited. In addition, “self-efficacy” of prevention of high myopic complications was limited in conditioning reaction, “self-efficacy” of subjective preventive health behavior was poor. (2)Compared to the control group, high myopic freshmen in the experimental group performed better post-test in “knowledge”, “self-efficacy”, and “preventive health behavior” issues of high myopic complications prevention. While in the post post-test, experimental group performed better only in “self-efficacy” and part of “preventive health behavior” issues. In conclusion, this study demonstrated that high myopic complications preventive intervention program had immediate effective with respect to promote high myopic complications preventive knowledge, self-efficacy, and preventive health behavior. Also this program was proved to have prolonged effect in self-efficacy and self-examination behavior. There are lack of information and instruction course about high myopic complications prevention in our college and community. This program could be adopted by school or local governmental departments for high myopic students or residents, in the purpose of self-management of health and “early diagnosis and early treatment” of high myopic complications.