41卷4期

• Link 政策論壇 Policy Forum
• 牙周病防治之現況與策略建議Current status and strategies on the management of periodontal disease
• 張博鈞
  Po-Chun Chang
• 牙周病、牙周炎、口腔健康
  periodontal disease, periodontitis, oral health
• 牙周炎除了造成口腔組織破壞，也會透過循環系統影響全身健康，包括引發或加重糖尿病、心血管疾病，甚至與阿茲罕默症及認知障礙發生相關。2017年歐洲、美國、與亞太牙周病醫學會發表的聯合聲明中，呼籲世界各國應從：建立預防保健概念、牙周炎早期診斷、施予正確治療三個層面採取行動，以達到防治牙周炎之目的。而台灣在全民健保開辦之際即將牙周病治療納入給付項目、2003年提出口腔健康促進計畫、2010年推行牙周統合照顧計畫、2022年正式將牙周病科列為部頒專科醫師。筆者建議可透過社區或學校教育加強全民對牙周病的認識、牙周病篩檢納入職場健檢或孕婦產檢項目、經由牙周病篩檢建立縱向資料等措施來健全我國牙周病防治。
  In addition to destroying oral tissues, periodontitis can also affect the whole body through the circulatory system, including causing or aggravating diabetes, cardiovascular disease, and even Alzheimer's disease and cognitive impairment. In 2017, the joint statement issued by learned societies of Periodontology, such as the European Federation of Periodontology and the Asian Pacific Society of Periodontology, called on every country to take action in three aspects: prevention, diagnosis, and treatment to reduce the global burden of periodontal diseases. The treatment of periodontal disease was covered when the National Health Insurance was launched in 1995. Then, an oral health promotion plan was proposed in 2003, and the comprehensive periodontal treatment project was implemented in 2010. Furthermore, the Ministry of Health and Welfare set periodontists officially in 2022. The author suggests that the government can improve the prevention and treatment of periodontal disease through some measures. For example, emphasizing community or school education to strengthen the awareness of periodontal disease, including periodontal disease screening in workplace health examinations or pregnant women's obstetric examinations, establishing longitudinal data through periodontal disease screening, and so on.
• 359-360
• 10.6288/TJPH.202208_41(4).PF04

• Link 公衛論壇 Public Health Forum
• 英國公共衛生專家制度與我國公衛師制度差異之探討The difference between registration public health in England and Public Health Specialists Act in Taiwan
• 王服清、劉姵伶、林展甲、李昱承
  Fu-Ching Wang, Pei-Ling Liu, Chan-Chia Lin, Yu-Cheng Li
• 無none
  無none
• 無none
  無none
• 361-365
• 10.6288/TJPH.202208_41(4).110137

• Link 公衛論壇 Public Health Forum
• 為什麼COVID-19確診者死亡數不等於原死因是COVID-19死亡數?Why the number of deaths with COVID-19 differed from number of deaths from COVID-19?
• 呂宗學
  Tsung-Hsueh Lu
• COVID-19死亡、死因統計、原死因、原死因選擇規則、超額死亡
  COVID-19 death, cause of death statistics, underlying cause of death, selection rules, excess deaths
• 中央疫情指揮中心公告的COVID-19確診者死亡數在2020年與2021年分別是7位與843位。此數據與衛生福利部統計處死因統計中，原死因是COVID-19的死亡數並不相同（2020年7位國內死亡21位國外死亡，2021年839位國內死亡57位國外死亡）。造成此差異的原因包含個案死亡證明書中是否提及COVID-19、COVID-19是否被判定為直接引起死亡的疾病、疾病因果關係鏈是否正確、採用嚴格或寬鬆的COVID-19相關原死因選擇規則等。由於確診個案定義與死亡定義會隨著疫情嚴重度變化而改變，相關標準應說明清楚以便操作分析。若要進行跨國比較，建議使用全死因的超額死亡數比例，較可反映COVID-19的衝擊以及評估不同介入措施的效果。
  The number of deaths with COVID-19 announced by the Central Epidemic Command Center is 7 and 843 in 2020 and 2021, respectively. However, the data is not the same as the number of deaths from COVID-19 in Cause of Death Statistics (7 domestic deaths and 21 foreign deaths in 2020, and 839 domestic deaths and 57 foreign deaths in 2021). The reasons for this difference include whether COVID-19 is mentioned in the death certificate, whether COVID-19 is determined as an immediate cause or underlying cause, whether the causal relationship between immediate cause and underlying causes is reasonable, and whether strict or relaxed COVID-19-related underlying cause of death selection rules are adopted. Since the definition of confirmed cases and death will change with the epidemic's severity, the relevant criteria should be clearly stated for operational analysis. For international comparison of COVID-19 deaths, experts recommend using the proportion of excess deaths from all causes, which better reflects the impact of COVID-19 and assesses the effects of different interventions.
• 366-373
• 10.6288/TJPH.202208_41(4).111053

• Link 綜論 Review Article
• 生理、認知、社會衰弱、及多面向衰弱之文獻回顧Literature review of physical, cognitive, social, and multidimensional frailty
• 劉禮慧、張睿詒
  Li-Huei Liu, Ray-E Chang
• 生理衰弱、認知衰弱、社會衰弱、多面向衰弱、衰弱評估工具
  physical frailty, cognitive frailty, social frailty, multidimensional frailty, frailty assessment tools
• 台灣於2018年正式邁入高齡社會，隨老年人口快速成長，慢性病與功能障礙盛行率急遽上升，失能人口大幅增加，對國家長照體系及財源負擔接帶來很大的挑戰，因此，如何預防長者邁入失能階段、健康老化成為各國關注的議題。衰弱是介於健康與失能之間的連續狀態，具可復原性，可經由有效介入恢復健康狀態，避免長者進入到不可逆的失能期。本文綜覽國內外生理、認知、社會多面向衰弱相關研究，回顧衰弱相關研究的發展現況及提出研究缺口。與國際相較，我國尚缺乏認知、社會、及多面向衰弱相關研究，作者提出三點建議：第一，發展符合台灣民情之社會衰弱量表；第二，增加發展社會衰弱相關研究，如其盛行率、風險因子、與不良健康結果間的關聯等；第三，從多維觀點探討衰弱議題，研析生理、認知、社會衰弱三者互相作用之機轉，並以研究實證多面向衰弱評估量表之信、效度，從更全面的角度評估長者健康，達到預防不良健康結果的作用。
  As the elderly population increases in Taiwan, the prevalence of chronic diseases and functional disability has risen sharply. Consequently, long-term care and financial systems can quickly become overburdened. Therefore, preventing disabilities among older adults and ensuring healthy aging are essential. Older adults often experience frailty, which is a predisability state; however, frailty is reversible, and older adults can return to a normal state through interventions. This review analyzed studies on physical, cognitive, social, and multidimensional frailty and provides an overview of research on frailty in Taiwan and abroad. Because additional studies on cognitive, social, and multidimensional frailty should be conducted in Taiwan, this review offers three suggestions: (a) A Taiwanese social frailty assessment tool should be developed; (b) further research on social frailty and its prevalence, risk factors, and relationship to adverse outcomes should be conducted; and (c) the mechanisms among aspects of frailty should be further investigated. Studies should evaluate the reliability and validity of multidimensional frailty assessment tools to screen for frailty among older adults in Taiwan more effectively.
• 374-382
• 10.6288/TJPH.202208_41(4).111044

• Link 原著 Original Article
• 台灣藥品給付協議實施特性分析Characteristics of the implementation of managed entry agreements for drug reimbursement in Taiwan
• 高雅芝、董鈺琪
  Ya-Chih Kao, Yu-Chi Tung
• 給付協議、藥物給付
  managed entry agreement, drug reimbursement
• 目標：本研究欲由公開資料中，探討國內執行藥品給付「其他協議」政策之現況。方法： 由中央健康保險署官網之公開資料，分析健保署與廠商簽訂之藥品給付其他協議特性。結果： 2018年10月至2021年10月底為止，共要求77件藥品給付協議案例，其中12件仍在協議中，已簽訂的協議中，3件於2021年10月終止，2件重新再議。要求的協議中，以財務結果為基礎之協議有63件（82%），以療效結果為基礎之協議有4件（5%），未說明其他協議類型者有10件（13%）；以藥物治療（Anatomical Therapeutic Chemical, ATC）分類系統分析，案例中多數為抗腫瘤與免疫調節類藥物（ATC-L，約73%），其次為抗感染藥（ATC-J，約12%）。結論：各國支付者對於藥品給付關注的焦點議題各不相同，國內共擬會議中討論的焦點，多半是關注於藥品預算衝擊的問題。實施MEA之後，健保署得以再透過多元的協議內容，與廠商協議機密性價格折扣或療程費用上限等等方式，以多種工具使新藥使用能與國際同步，不但促進病人對於新藥之可近性，同時也管控健保的財務支出。
  Objectives: The study investigated the characteristics of managed entry agreements (MEAs) in Taiwan by using open data. Methods: Data were derived from the official website of the National Health Insurance Administration (NHIA). The MEAs requested during the Pharmaceutical Benefit and Reimbursement Scheme Joint committee (PBRS) meeting to be signed between NHIA and the industry were investigated. Results: Between October 2018 and October 2021, 77 MEAs were requested, 12 of which have not been concluded. Among the signed MEAs, three were agreed to be terminated, and re-discussion was requested for two. Among the required agreements, 63 (82%) were finance-based MEAs, 4 (5%) were performance-based MEAs, and 10 (13%) were unspecified. An analysis of the therapeutic areas of the drugs listed in the MEAs by using the Anatomical Therapeutic Chemical (ATC) classification system revealed that most drugs were antineoplastic and immunomodulating drugs (ATC-L, approximately 73%), followed by anti-infectives for systemic use (ATC-J, approximately 12%). Conclusions: The focus of payers on drug reimbursement varies from country to country; in the local PBRS meeting, focus was identified as the main issue relating to drug budget impact. MEAs allow the NHIA to discuss with the pharmaceutical companies regarding a confidential discount or payment cap of a treatment course to facilitate patient access to new drugs while managing the healthcare expenditure.
• 383-396
• 10.6288/TJPH.202208_41(4).111015

• Link 原著 Original Article
• 醫院評鑑等級與醫療品質相關性之探討—以醫療品質資訊公開指標為例Association between hospital accreditation level and publicly reported indicators of healthcare quality
• 鄭仁翔、陳宛琪、郭年真
  JEN-HSIANG CHENG, Wan-Chi Chen, Raymond N. Kuo
• 醫院評鑑、醫院層級、醫療品質、醫療品質資訊公開
  hospital accreditation, hospital level, healthcare quality, public reporting of quality
• 目標：探討醫院評鑑的醫院分級結果，是否與醫療品質資訊公開指標有顯著的相關性，以及醫院層級的差異與異動是否也符合醫療品質指標的測量結果。方法：採橫斷式研究法，2008 年到2018年間醫療品質資訊公開網中所公布的三類疾病別與處置別：急性心肌梗塞、糖尿病、透析治療、醫院整體性指標，共16項品質指標進行分析。在控制權屬別、健保分區別等醫院特質後，探討醫院層級別在三類疾病別與處置別的品質指標中，是否有顯著差異。另外，比較醫院層級有變動的醫院在13項指標品質的差異。結果：16項指標中有10項指標於醫院層級別呈現顯著差異；其中7項急性心肌梗塞的指標，皆是醫學中心的指標平均值優於區域醫院，區域醫院又優於地區醫院；但在糖尿病與透析治療的相關指標中，則無顯著差異。在研究觀察期間評鑑等級升格的11間醫院中，僅有3間醫院的品質表現是明顯優於原層級同儕醫院，且與新層級醫院群體之品質表現相當。結論：醫院評鑑之結果，未必能反映不同層級醫院在部分常見疾病別與處置別照護品質之品質表現。建議未來應進一步探討品質資訊公開與醫院評鑑標準中對醫療品質的測量，是否能全面性反應個別醫院醫療品質之良窳。使民眾在參考這些資訊時做出更合適的就醫選擇。
  Objectives: This study investigated the association between hospital accreditation level and publicly reported indicators of healthcare quality. Methods: Sixteen quality indicators were derived from the treatment protocols for three conditions: acute myocardial infarction (AMI), diabetes mellitus (DM), and dialysis treatment. Data were obtained from the Hospital Public Quality Reporting website as well as hospital outcome indicators for the period between 2008 to 2018. The quality indicators were examined in the context of the accreditation level, ownership, and location of the hospitals. Further analysis was performed on facilities where the accreditation level has changed, including comparisons of quality before and after the change as well as comparisons with facilities that have not changed. Results: Among the 16 indicators, 10 differed significantly as a function of accreditation level. Note that 7 of the 10 indicators were related to AMI. Note also that in dealing with AMI, medical centers outperformed regional hospitals and district hospitals. We observed no differences in the indicators for DM or dialysis treatment. Among the 11 hospitals that raised their accreditation level, only 3 presented a corresponding improvement in care quality and none of them differed significantly from other hospitals of the same level. Conclusions: This study revealed that hospital accreditation level is not a reliable indicator of the quality of care. This inconsistency demonstrates the need to reassess publicly reported indices of care quality as well as the means by which hospital are assessed in the accreditation process. Only then public will be able to make informed decisions pertaining to their choice of health services.
• 398-410
• 10.6288/TJPH.202208_41(4).111026

• Link 原著 Original Article
• 台灣飲用酒精飲料盛行率與其相關疾病之醫療費用Prevalence of alcohol consumption and medical expenditure related to alcohol-related diseases in Taiwan
• 張雅惠、呂瑾立、徐宇慧、古鯉榕、李中一
  Ya-Hui Chang, Chin-Li Lu, Yuu-Hueih Hsu , Li-Jung Elizabeth Ku, Chung-Yi Li
• 酒精飲料、全民健保資料庫、族群可歸因風險百分比、醫療費用、國民健康訪問調查
  alcohol drink, National Health Insurance, population attributable risk percentage, medical care costs, National Health Interview Survey
• 目標：本研究旨在探討台灣民眾飲酒與其相關疾病所衍生之健保醫療花費。方法：利用2009與2013年國民健康訪問調查資料，依據民眾不同年齡別、性別之飲酒型態，建立酒飲研究世代。利用研究世代串聯健保資料，分別計算各種與飲酒相關疾病之相對風險與族群可歸因風險百分比，再根據2015-2017年全國性全民健保門診與住院酒飲相關疾病之就醫費用，估計可歸因於酒飲所造成之健保年平均就醫費用。結果：本研究發現約43%之民眾過去一年有飲酒。醫療費用部分，若僅以主診斷為主，年健保費用約為28億（95%信賴區間：5-63億元），若以主次診斷為主，年健保費用可達到56億（95%信賴區間：11-126億元）。結論：飲酒造成之醫療花費相當可觀，飲酒造成沈重之醫療經濟負擔應當可避免，倘若酒精所造成健康危害已確立，該如何減少飲酒以降低相關醫療成本支出是未來永續健保的課題之一。
  Objectives: To estimate the medical expenditure associated with alcohol-related diseases in Taiwan. Methods: The age- and sex-specific study cohorts were based on data from the 2009 and 2013 National Health Interview Surveys. We then linked the study cohorts to National Health Insurance (NHI) claims data. This study estimated the relative risk and population attributable risk percent. Using nationwide inpatient and outpatient medical expenditure from 2015 to 2017, we estimated the annual medical expenditure attributable to alcohol consumption. Results: Approximately 43% of the enrollees had drunk alcohol in the preceding year. The estimated average annual medical expenditure attributable to alcohol consumption was NT$2.8 billion (95% confidence interval [CI]: NT$0.50–6.30 billion) when alcohol-related diseases were considered primary diagnoses. The corresponding figures were NT$5.6 billion (95% CI: NT$1.10–12.60) when alcohol-related diseases were considered primary or secondary diagnoses. Conclusions: The medical expenditure associated with alcohol-related diseases is substantial and should be prevented. Given that alcohol consumption is known to lead to adverse health outcomes, action should be taken to decrease alcohol consumption, which will in turn decrease the medical expenditure associated with alcohol-related diseases and reduce the burden on the NHI.
• 411-425
• 10.6288/TJPH.202208_41(4).111025

• Link 原著 Original Article
• 台灣中老年人身心健康及社交參與之潛在類別與長期照護2.0服務認知與使用意願Physical health, mental health, and social engagement in relation to awareness of and willingness to utilize Long-Term Care 2.0 Services among middle-aged and older adults in Taiwan: latent class analysis
• 田維華、田峻吉
  Wei-Hua Tian, Joseph J. Tien
• 長照2.0服務認知與使用意願、身心健康、社交參與、潛在類別分析
  awareness and willingness of LTC 2.0 service utilization, physical and mental health, social engagement, latent class analysis
• 目標：台灣在2018正式邁入高齡社會，如何建立合適且有效率的長期照護制度，是未來重要課題。本研究探討影響台灣中老年人身心健康及社交參與之潛在類別與長照2.0 ABC服務據點及日間照顧、居家服務之認知與使用意願之因子。方法：使用衛福部2017年之老人狀況調查檔，採用55歲以上之樣本以潛在類別分析法將中老年人身心狀況與社交參與之異質性進行潛在類別分組，接著再以logistic迴歸進行分析。結果：相對於潛在類別身心相對健康組，屬於身心相對不健康具輕度日常生活活動障礙與身心不健康具日常生活活動障礙少社交組之個體，較不知道且未來有需要也較不會使用長照2.0等服務。結論：研究結果顯示長照2.0服務推廣之目標族群為具有身心不健康、日常生活活動障礙及少社交等特性，因此可藉由各式媒體及活動的推廣及協助申請相關服務窗口的設立讓對長照服務有需求的族群瞭解並易於申請長照2.0服務，冀望藉由長照2.0服務的推廣與使用對其健康餘命有正面影響，也對其照顧者提供了喘息的機會。
  Objectives: Taiwan officially became an aging society in 2018. Therefore, a context-appropriate and robust long-term care (LTC) system must be established. This study explores physical health, mental health, and social engagement in relation to Taiwanese middle-aged and older adults’ awareness of and willingness to utilize LTC 2.0 services such as the community-based integrated care system (ABC system) and day or home care services. Methods: Analyzing data from the 2017 Senior Citizen Condition Survey, this study applied latent class analysis to identify the latent classes in physical health, mental health, and social engagement and conducted logistic regression to investigate the relationships of each class with LTC 2.0 services. Results: The results indicate that people in the class who have relatively poor physical and mental health, a low level of impaired mobility, and in the class who have poor physical and mental health, impaired mobility, and a low level of social activity are more unaware of and unlikely to use LTC 2.0 services if necessary than people in the class who have favorable physical and mental health. Conclusions: Our results indicated that LTC 2.0 services should be promoted among individuals who have poor physical and mental health, impaired mobility, and a low level of social activity. Uptake and awareness can be increased by promoting LTC 2.0 services through media platforms and by streamlining the care application process. The use of LTC 2.0 services are expected to increase life expectancy and reduce the burden on caregivers.
• 426-437
• 10.6288/TJPH.202208_41(4).110127

• Link 原著 Original Article
• 以字詞分析取向探討台灣新冠肺炎防疫工作主事者之心理特性Applying a linguistic approach to examination of the psychological process of Taiwan’s primary leaders in the fight against Covid-19
• 林瑋芳
  Wei-Fang Lin
• 字詞分析、新冠肺炎、防疫記者會
  Linguistic Inquiry and Word Count (LIWC), Covid-19, press conference
• 目標：介紹語言分析工具（LIWC）在公衛領域的應用實例，以中央疫情指揮中心與北市府在三級警戒期間的防疫記者會為分析文本，描繪台灣領導防疫工作之指標人物的心理特性。方法：採字詞分析研究取向，從思維特性、動機驅力、認知歷程及時態關聯詞彙，比較陳時中和柯文哲的語言使用特性差異。結果：依據職務有別，陳時中在記者會上的表現更明確篤定， 且更關注未來趨勢和因應策略；柯文哲在言談間則有較高的不確定性，且較多是在回應先前發生的事項。在個人風格上，陳時中明顯有較高的分析性思考，較關切如何強化人際社會連結； 柯文哲則較傾向以個人經驗來詮釋問題，更多互動性的直覺反應，且更重視既有制度結構的鞏固。結論：本研究為台灣首篇以字詞分析取向探討新冠疫情防疫工作的應用研究，顯示字詞分析可用於反映防疫工作主事者的心理特性，未來可進一步加入民眾端的資料，更深入探討「如何說」對實質溝通成效的預測效果，以期在公衛議題之溝通宣導上，達到更良好的運作成效。
  Objectives: We used the Linguistic Inquiry and Word Count (LIWC) program to capture the psychological process of Taiwan’s primary leaders in the fight against COVID-19. Methods: We analyzed the word usage of the head of the Central Epidemic Command Center in Taiwan, Chen Shih-Chung, and the mayor of Taipei City, Ko Wen-Je, in daily press conferences during the level 3 epidemic alert in 2021. Results: We found that Chen had greater certainty and confidence and focused more on epidemic projections and response. By contrast, Ko was less certain and focused more on the past. In addition, each leader demonstrated significant differences in thinking style and motivation. Chen exhibited higher-level analytical thinking and was driven by the need for affiliation, whereas Ko exhibited dynamic thinking and was driven by the need for power. Conclusion: Our study indicated that these two major leaders faced the pandemic with different focuses, thinking styles, and motivations. Future studies are encouraged to explore how word usage affects the feeling and behavior of listeners.
• 438-448
• 10.6288/TJPH.202208_41(4).111033

• Link 原著 Original Article
• 疫苗猶豫與風險溝通之必要:對照長者與慢性病族群經驗Vaccine hesitancy and risk communication: experiences among older adults and patients with chronic diseases
• 官晨怡、林正揚、劉政翰
  Chen-I Kuan, Jheng-Yang Lin, Cheng-Han Liu
• 新冠疫苗接種、疫苗猶豫、風險溝通、長者、慢性病社群
  COVID-19 vaccination, vaccine hesitancy, risk communication, elders, patients with chronic diseases
• 目標：本研究探討長者與慢性病族群針對新冠疫苗出現之疫苗猶豫，及其對於風險溝通之需求。方法：資料來自於2021年6月1日至10月31日進行之「台灣新冠疫苗民眾決策態度之快速質性研究調查」，以訪談與焦點團體蒐集資料。結果：基於調查與分析，本研究發現由於年齡與特定病症的身體狀況，長者與慢病族群對於疫情威脅下緊急授權之疫苗持有疑慮，擔憂自身之脆弱性能否承受新冠疫苗之不確定性與副作用，這些疑慮是否被充分回應，成為決策關鍵。本研究對照具相似疑慮，但出現不同決策傾向的長者與慢病族群，當後者在尋得資訊後，多能處理原有疫苗猶豫、轉而接種，前者則因特殊情境下對資訊缺乏控制感，仍陷於困惑、抗拒接種。結論：風險溝通在建立脆弱族群疫苗信心上具有關鍵角色。
  Objectives: This study explored COVID-19 vaccine hesitancy among older adults and patients with chronic diseases and the need for risk communication in these two communities. Methods: The data source was the Rapid Qualitative Investigation on Attitudes and Factors Influencing COVID-19 Vaccination Among People in Taiwan project. Interviews and focus groups were conducted from June 1 to October 31, 2021. Results: Older adults and patients with chronic diseases reported feeling hesitant about COVID-19 vaccination because of their specific health conditions associated with aging and chronic disease. They reported concerns that they were vulnerable to the side effects of COVID-19 vaccines developed under emergency use authorization and that they were unable to tolerate this uncertainty. Most participants with chronic diseases eventually accepted vaccination after acquiring information addressing their concerns. By contrast, because they lacked a sense of control and the ability to adequately assess information, older adult participants remained skeptical and resisted COVID-19 vaccination. Discussions: By comparing the experiences of older adults and participants with chronic diseases, this study demonstrates that, even when two communities report similar concerns about COVID-19 vaccination, targeted strategies must be adopted; these must be developed according to each population’s capacity to assess complex information. Policy initiatives and information campaigns must address their specific concerns to effectively promote COVID-19 vaccination among these two communities. Conclusions: These findings highlight the importance of risk communication for initiatives to enhance COVID-19 vaccine confidence among vulnerable populations.
• 449-466
• 10.6288/TJPH.202208_41(4).111028

• Link 原著 Original Article
• 台灣青少年在COVID-19疫情的孤寂感與情緒困擾現況之調查The investigation of the status quo of loneliness and psychological distress of Taiwanese adolescents during the COVID-19 epidemic
• 林烝增、刑志彬
  Cheng-Tseng Lin, Chih-Pin Hsing
• 孤寂感、青少年、情緒困擾、新冠肺炎
  loneliness, teenagers, psychological distress, COVID-19
• 目標：本研究欲探索青少年在COVID-19流行期間，情緒困擾與孤寂感之間的關聯性，從青少年的人口變項進行相關討論，並建構台灣青少年孤寂感量表工具。方法：研究採用調查研究法，在2021年10月至2022年3月期間，於全國蒐集6,646位中學生之量表數據，進行孤寂感量表工具建構，並蒐集簡式健康量表（The 5-item Brief Symptom Rating Scale, 簡稱BSRS-5）、自殺意念、以及相關人口變項數據。結果：(一)青少年孤寂量表總計六題，具有良好的信效度； (二)在孤寂感與情緒困擾、自殺意念呈現顯著正相關；(三)青少年孤寂感受與同儕關係、照顧者關係呈現顯著負相關；(四)而性別、年級、父母婚姻關係在孤寂感、情緒困擾呈現顯著差異，主要照顧者類型則是與青少年的情緒困擾呈現顯著差異。結論：青少年的孤寂感量表可以作為後疫情時代的評估工具，提供青少年危機族群的篩檢與輔導資源提供之依據，並進一步協助有情緒困擾與自殺意念之青少年，結果發現孤寂感與情緒困擾、自殺意念、關係滿意度、與照顧者關係呈現顯著相關。
  Objectives: The purpose of this study is to investigate the relationship between psychological distress and loneliness in adolescents during the COVID-19 epidemic, make relevant discussions through demographic variables, and construct a Taiwanese Adolescents Loneliness Scale (TALS). Methods: The research adopts the survey research method. The scale data were collected from 6,646 high school students to construct the TALS from Oct 2021 to Mar 2022. And the score of The 5-item Brief Symptom Rating Scale (BSRS-5), suicidal ideation, and demographic variables were also collected. Results: (1) The TALS has a total of six items and with good reliability and validity; (2) The adolescents’ loneliness has significant positive correlations with psychological distress and suicidal ideation; (3) The adolescents’ loneliness has significant negative correlations with peer relationship and caregiver relationship; (4) Both loneliness and psychological distress show significant differences in gender, grades and parental marital relationship; the psychological distress also shows a among different primary caregivers. Conclusions: The TALS can be applied as an assessment tool in the post-pandemic era. It provides the basis for the screening of in-crisis adolescents and the guidance for the following interventions. Furthermore, the TALS can assist the adolescent with psychological distress and suicidal ideation. The adolescents’ loneliness has significant correlations with psychological distress, suicidal ideation, peer relationship and caregiver relationship.
• 467-478
• 10.6288/TJPH.202208_41(4).111036

• Link 評論 Commentary
• 評論：台灣藥品給付協議實施特性分析Commentary: characteristics of the implementation of managed entry agreements for drug reimbursement in Taiwan
• 呂宗學
  Tsung-Hsueh Lu
• 無
  none
• 無
  none
• 397
• 10.6288/TJPH.202208_41(4).11101501