北縣東南亞籍配偶醫療服務利用行為之探析－以中文學習班為例

Abstract

本論文研究主要目的為調查台北縣東南亞籍配偶在台醫療服務利用行為，運用R. M. Andersen模式與健康照護行為模式，探討傾向、使能、需要、環境等四項因素與醫療服務利用行為的關係。 研究以九十五年二至五月就讀於台北縣新住民中文識字班之東南亞籍配偶為母群體，進行自填式問卷調查，共收集有效樣本276人，重要結果歸納如下： 一、研究對象感覺身體不適時，76.8％會選擇以「西醫」作為治療方式；在最近一年內以利用「身體健康檢查」最多，佔17％（47人）；最近一個月內以利用「西醫門診」最多，佔25％（69人）；來台之後所接受過民俗療法之中以「刮痧」為最多，共51.2％（41人）；接受過「藥籤」及「拔罐」最少僅佔0.1％。 二、傾向因素中，國籍與一個月內到牙科就診、藥局自行購藥有關；年齡與一年內生產有顯著相關，年齡越低，生產狀況越高；家庭型態與一年內研究對象是否進行產前檢查有關；配偶有無工作與研究對象是否利用預防注射有關；在原國家接受教育年數越多、自覺來台本國語言說、聽、讀、寫的能力越好，一年內身體健康檢查情況越高；自覺在台灣整體適應狀況越好，利用中醫與牙科門診情況越多。 三、使能因素中，就診花費的交通時間越高，一年內急診情況越高。 四、需要因素中，自覺健康狀況越好、自覺與同年齡他人比較之健康狀況越好，一年內預防注射情況越高、一個月內西醫門診情況越低。.健康問題的發生次數越多，利用住院、西醫門診、牙科門診、到藥局購藥的情況越高。 五、環境因素中，醫療院所是否提供翻譯與是否利用產前檢查有關。 六、東南亞籍配偶醫療服務利用之影響因素中，自覺健康狀況較差者對於西醫利用與住院利用機率較自覺健康狀況較好者高。六個月內感冒次數在「1-4次」的西醫利用與接受預防注射機率較高；六個月內感冒次數在「5次以上」自行至藥局購藥的機率較高。家庭型態屬「大家庭」之東南亞籍配偶在身體不適狀況發生時至藥局購藥機率較「小家庭」高；家庭型態屬「折衷家庭」之東南亞籍配偶產前檢查機率較「小家庭」高。 根據研究結果，可得知東南亞籍配偶醫療服務利用之特性，建議醫療院所加設語音利用系統，並加強與教育系統合作，推動外籍配偶之相關衛生政策及衛生教育。

A procedure is based on Andersen’s Behavior Model of Health Cara Utilization and Behavior Model for Vulnerable Population, this study investigated the medical services utilization behavior of south east foreign spouses in Taipei county, and explored the relationships among predisposing characteristics, enabling resources, need and environment factors and the medical services utilization. By using a simple sampling method, 276 subjects were surveyed with self-administrated questionnaires. The main findings of present study were as follows: 1. Utilization of medical services: when feel uncomfortable,76.8% of south east foreign spouses utilized western medicine . In the past year, health check up were the most be utilized. In the past 1 month, western medicine clinic were the most be utilized .After inhabited in Taiwan, treatment for sunstroke by scraping the patient’s neck or back were most be utilized. 2. In predisposing characteristics, the subject「nationality」 had statistically significant difference in the dental specialist clinic and bought medicine at pharmacy. The subject「age」had statistically significant difference in delivery. The subject「structure of family」had statistically significant difference in prenatal examination. The subject 「spouse’s work」had statistically significant difference in protection shot. The subjects「education of original country」and「local language」had statistically significant difference in health check up. The subject「acclimatise to life」had statistically significant difference in Chinese medicine clinic and dental specialist clinic. 3. In enabling resources factor, The subject「the time of see a doctor」had statistically significant in emergency treatment. 4. In need factor, the subjects「perception of own health status」had statistically significant difference in protection shot and western medicine clinic. 5. In environment factor, the subject「translators」had statistically significant difference in prenatal examination. 6. The best predictive variables for the utilization of medical services are perception of own health status, health problems and the structure of family. From these findings, related suggestion for medical services of south east foreign spouses were government should set up telephone service in mother tongue and improve to collaborate with department of education in order to provide better service quality and ensure the equality of right in health care service and health education.