| 摘要註: |
本研究主要探討金門縣結核病行為之防治,來暸解其對結核病防治的認知,並推論出社區傳播的可能途徑及結核病行為防治的健康促進生活型態,針對上述議題進行深度訪談,加以分析整理,找出本研究受訪個案隱涵的危險因子,導出可能的傳染源,建議具體的防治行為,俾助於公共衛生防治與結核病的散播。本研究以金門縣2013-2014年經中央傳染病監視系統中確診個案為研究對象,採立意抽樣,進行個案深度訪談,共16位個案接受訪談。研究結果如下:1.金門縣結核病患平均人數無明顯增減,整體罹病平均年齡層逐年下降,隨著外來人口及兩岸經商人口增加,發病個案已不只是當地居民。2.結核病高暴露風險族群,除了同住之曝觸者及已知曾接觸過結核病外,屬密閉式空間、室內換氣流量不足、及依個案病患的生活習性,可能為社區傳播中很大的一群危險因子。3.研究對象皆較缺乏健康促進生活型態的概念,未落實規律運動的習慣、亦無正確自我防護措施保護的觀念、長期熬夜、睡眠不足等生活作息不規律。因此,未來在公共衛生防治應注重社區結核病衛教時,將正確健康概念傳輸到社區民眾的觀念中,融入到日常生活,避免等到發病後再來矯正,效果較佳。後續研究建議可從醫療端進行醫師診療能力、醫院檢驗品質、個管師衛教等,進行金門縣醫療品質對結核病防治的影響做探討。 This study mainly discussed Tuberculosis Prevention in Kinmen County to understand the concept of Tuberculosis Prevention of the people lived there and also to infer the possible spreading way in society and health-promoting lifestyle of Tuberculosis Prevention. Conducting depth interviews and analyzing to find out the implicit danger factors to conclude possible sources of infection. Then, giving some concrete advice of Tuberculosis Prevention and hoping this study will benefit public health and Tuberculosis Prevention. This study judgmental sampling interviewed 16 cases who were made definite diagnosis by central infectious disease system of government in 2013-2014 in Kinmen County and the result as follows: 1.The average amount of Tuberculosis patients in Kinmen County were not obvious increasing or decreasing. The average age of infected people goes down year by year. With the increasing of people for business between mainland China and Kinmen County, not only local people but also people from other cities will be infected. 2.High-risk exposing community of Tuberculosis including who lived with the infected patients and who has been contacted with the patients. Still including sealed place which were not enough fresh air and also high-risk community can include those who don't have regular lifestyle. Most of them can be the high danger factors of infection in the society. 3.All research cases were lack of the concept of health-promoting lifestyle and did not have regular exercise and the right concept of self-protection such as long-term stay up late and lack of sleeping. Therefore, it will have a better effect to teach a right concept of Tuberculosis prevention in daily life before cure after infected. Finally, some of the ideas of the further study such as researching Tuberculosis Prevention from medical part such as conducting the survey of the ability of doctor, the quality of examining disease of hospital and health teaching of Tuberculosis case managers to understand more about Tuberculosis Prevention in Kinmen County. |