| 摘要註: |
臺灣已是高齡化社會，因此老人安養行業蓬勃發展；養護及安養機構溫度控制適宜，提供蟑螂孳生的環境，而蟑螂可媒介之病原體超過100種；綜觀蟑螂對殺蟲劑的抗藥性並造成環境污染之影響，蟑螂防治需使用包含化學及非化學之綜合防治技術(Integrated Pest Management; IPM)，故本研究將對養護及安養機構中蟑螂進行監測及探討發生之相關因素，並進行綜合防治之研究。研究方法：以高雄市有意願配合監測之69家養護及安養機構為研究對象，進行蟑螂之監測；共62家機構配合調查，使用結構型問卷調查機構建築結構、環境衛生及管理者對蟑螂防治之知識、態度及行為與蟑螂發生之關係；自有捕獲蟑螂之機構，隨機抽樣20家進行綜合防治，化學防治為施用餌劑，非化學防治則包含：IPM教育、環境清理、及定期訪視監測等；將上述收集資料進行統計檢定分析，統計方法使用Wilcoxon Rank Sum test、Wilcoxon Signed Rank test 以及χ2-test, α level = 0.05 , p<0.05表示統計上達顯著性之差異。結果顯示，於高雄市隨機抽樣之69家養護及安養機構中，侵害率為65.2% (45/69)，蟑螂之密度為1.01 隻/每個捕蟑盒；養護及安養機構蟑螂之發生與其室內環境衛生達統計學上顯著性之相關(p<0.05)，而其他變項則未達顯著性之相關；綜合防治進行至第16週之結果顯示，防治組建築結構縫隙度、家具損壞度及室內環境衛生均較防治前呈顯著改善，捕獲蟑螂數平均降低96%，降低數量達統計學上顯著性之差異，防治效果顯著，對照組與防治前比較則均未達顯著性差異(P>0.05)。 自上述結果得知，養護及安養機構中蟑螂是否侵襲，與機構之室內環境衛生息息相關，室內環境衛生較好之養護及安養機構，顯著較無受到蟑螂侵襲；依不同機構情況所進行適當之綜合防治，改善機構之建築結構及環境衛生情形，適時搭配使用餌劑，能有效降低蟑螂侵襲之數量，其可能爆發由蟑螂媒介感染之疾病也將相對降低。 Taiwan has become an ageing society; therefore, it promotes the demand for long-term care organizations. Furthermore, the environmental condition in long-term care organizations is conducive to the breeding of cockroaches, which can be vectors of more than a hundred pathogens. However, considering the side effect of using insecticide such as insecticide resistance and environmental pollution, it’s necessary to implement an integrated management consisting of chemical and nonchemical management (IPM, Integrated Pest Management). The study is aimed to monitor the cockroaches as well as probe into the related factors of infestation in long-term care organizations, and research on the IPM performance. Methodology: 69 long-term care organizations willing to participate in the study were implemented with cockroach baseline surveillance. In the 69 long-term care organizations, 62 of them were willing to participate in the investigation of cockroach infestation variables, which included building structure, environmental sanitation, as well as the knowledge, attitude and the practice of the managers, were investigated by using a valid questionnaire. Twenty long-term care organizations selected from infested ones were randomly divided into IPM group and Control group. The IPM implementation included bait treatment as chemical management as well as IPM education, sanitation, regular visit and repeated monitoring as nonchemical management. Statistical analysis used by Wilcoxon Rank Sum test, Wilcoxon Signed Rank test and χ2-test, α level is 0.05 , p<0.05 shows significant difference.The results show that, the cockroach infestation rate of the 69 long-term care organizations is 65.2%, and the cockroach density is 1.01 per trap. Statistical analysis shows the indoor sanitation is significantly correlated with the cockroach infestation while the other variables are not. The results show that, the crevice degree, the furniture damaged degree and the indoor sanitation of IPM group significantly improved after 16 weeks of intervention, which resulted in the significant reduction of cockroach number captured by 96% while there’s no significant difference in control group. To sum up, whether the long-term care organizations are infested with cockroaches or not, is closely associated with indoor sanitation. Long-term care organizations with proper indoor sanitation is obviously less infested than those with poor indoor infestation. Appropriately implementing integrated management depending on different circumstances and baiting in due time can also decrease the cockroach numbers effectively, and lead to lower risks of infectious diseases transmitted by cockroaches. |