42卷5期

• Link 政策論壇 Policy Forum
• 注意力不足過動症之現況與策略建議Current conditions and health strategy suggestions for Attention-Deficit/Hyperactivity Disorders
• 葉啓斌
  Chin-Bin Yeh
• 無
  none
• 無
  none
• 465-467
• 10.6288/TJPH.202310_42(5).PF05

• Link 公衛今與昔 Public Health Now and Then
• 防疫大將許書刀Dr. Shu-Tao Hsu, the general of epidemic prevention
• 葉宏明
  Horng-Ming Yeh
• 無
  none
• 無
  none
• 468-471
• 10.6288/TJPH.202310_42(5).112083

• Link 公衛論壇 Public Health Forum
• 戰爭、武裝衝突與公共衛生War, armed conflict, and public health
• 葉明叡
  Ming-Jui Yeh
• 無
  none
• 無
  none
• 472-477
• 10.6288/TJPH.202310_42(5).112055

• Link 原著 Original Article
• 以病患與家屬為中心的出院準備工具之開發：以台灣中部某區域醫院為前導測試Development of a patient- and family-centered discharge planning tool: a pilot study at a regional hospital in central Taiwan
• 張郁屏、余養豪、鍾國彪、陳雅美、董鈺琪、蔡欣芸、郭年真、游宗憲、楊名廷、邱琬育、張子晏、林澤宏
  Yu-Ping Chang, Yang-Hao Yu, Kuo-Piao Chung, Ya-Mei Chen, Yu-Chi Tung, Nien-Chen Kuo, Yu Tsung Hsien, Ming-Ting Yang, Wan Yu Chiu, Tzu-Yen Chang, Tse-Hung Lin
• 以病人與家屬為中心、出院準備服務、工具測試
  patient and family-centered, discharge planning, tool test
• 目標：發展與驗證以病患與家屬為中心的出院準備評估問卷（Patient- and family-centered discharge planning tool, PFC-DP）之信效度。方法：以初步發展的PFC-DP問卷，包含自我照顧能力等自評現況與需要更多協助之評估，以台灣中部某家醫院50歲以上的病患進行工具信效度測試，包括出院後一個月的預測效度。結果：共收案200位。本問卷各構面的自評現狀和需要更多協助程度之Cronbach’s α值分別介於0.71-0.95和0.93-0.98。驗證性因素分析困難程度與需要更多協助都呈現良好適配度。工具共有六個構面（身體恢復的資訊需求、衛教資訊、社會支持、個人照護、行動能力、家事活動等），共31題。自評個人照護（p < .01）、行動能力（p < .05）、家事活動（p < .05）越困難，其出院後一個月內急診與再入院次數會越多，其他健康狀況也更差。當自評個人照護越需要更多協助，一個月內再入院次數也增加，行動能力也越差（p < .05）。結論：本工具有良好信效度，可以應用於補足從專業角度的出院準備並提升病患出院後的健康成效。但此研究僅為工具信效度初探，未來可以更大與多元樣本測試與驗證。
  Objectives: In this pilot study, we developed a patient and family-centered discharge planning tool (PFC-DP) for assessing hospital discharge readiness from the perspectives of Taiwanese patients and their families. Methods: From a hospital in central Taiwan, we enrolled patients aged ≥50 years. Their current self-care status and requirement for additional support before discharge were assessed using the newly developed PFC-DP tool. A follow-up assessment was conducted 30 days after discharge to obtain data on relevant health outcomes. Using these data, the validity and reliability of our tool were examined. Results: In total, 200 patients completed pilot surveys. The Cronbach’s alpha values of items on participant characteristics and on the requirement for additional support were 0.71–0.95 and 0.93–0.98, respectively. A confirmatory factor analysis revealed the validity of the tool when it was formulated to have 31 questions across 6 domains (self-care information, health education, self-care ability, mobility, ability to complete household chores, and social support). Patients who had reported more difficulties in self-care ability (p < .01), mobility (p < .05), and ability to complete household chores (p < .05) had more readmissions and worse health outcomes after discharge. Furthermore, patients who had reported requiring more mobility support had more readmissions and worse mobility after discharge (p < .05). Conclusions: The PFC-DP tool is valid and reliable, and it can complement discharge planning and enhance post discharge health outcomes. Large-scale studies involving populations outside of Taiwan are warranted.
• 478-493
• 10.6288/TJPH.202310_42(5).112025

• Link 原著 Original Article
• 中文版SATED睡眠健康評估量表之發展與信效度驗證Development and validation of SATED Sleep Health Assessment Scale - Chinese version (SATED-TW)
• 鄭翔如、陳嬿今、李商琪、黃渝涵、葉淑婷、陳華芬、李中一
  Hsiang-Ju Cheng, Yen-Chin Chen, Shan-Chi Lee, Yu-Han Huang, Shu-Tin Yeh, Hua-Fen Chen, Chung-Yi Li
• 睡眠健康、評估量表、信度、效度、田野調查
  Sleep health, measurement scale, reliability, validity, field work
• 目標：本研究旨在針對英文版SATED睡眠健康評估量表（Satisfaction, Alertness, Timing, Efficiency and Duration Questionnaire）進行中文化，並評估中文版SATED睡眠健康評估量表（SATED-TW）之信效度特徵，該量表包含睡眠健康的五個面向：對睡眠的滿意度、醒著時的警覺程度、入睡時間點、睡眠效率與睡眠時間。方法：本研究利用翻譯-回譯程序進行量表的中文化，經雙語專家小組評估SATED-TW表面效度。於2021年9月至11月期間完成647位20歲以上成年民眾之線上面訪，依此數據評估SATED-TW之內部一致性、再測信度、收斂效度、區別效度等。結果：雙語專家小組會議確認SATED-TW具有表面效度。依田野調查數據所計算之內部一致性係數（Cronbach’s α）為0.570；2周再測信度係數（Intra-class Correlation Coefficient）為0.767。探索性與驗證性因素分析均支持SATED-TW具有單一構面。結論：SATED-TW具有良好的再測信度以及建構效度，加上內容簡要，並有多種語言版本，可適用於較大規模的睡眠健康調查與進行國際比較。
  Objectives: This study translated the English version of the SATED sleep health scale into Chinese (denoted as SATED-TW) and evaluated its reliability and validity. The scale includes five domains of sleep health: satisfaction with sleep, alertness, timing, sleep efficiency, and sleep duration. Methods: A translation–back-translation procedure was used to create the SATED-TW. A bilingual expert group assessed the face validity of the SATED-TW. A field survey involving an online face-to-face interview was then conducted among 647 adults aged 20 years or older between September and November 2021. The scale’s internal consistency, test–retest reliability, convergent validity, discriminant validity, and construct validity were assessed on the basis of the survey data. Results: The bilingual expert group confirmed the face validity of the SATED-TW. The survey data revealed a Cronbach α value of 0.570, and the intraclass correlation coefficient for 2-week test–retest reliability was 0.767. In addition, both exploratory and confirmatory factor analyses suggested a single construct of the SATED-TW. Conclusions: The SATED-TW demonstrated good test–retest reliability and a satisfactory level of construct validity. The scale is brief, has been translated into several languages, and is thus suitable for use in large-scale field surveys of sleep health. Use of the scale can facilitate international comparisons.
• 494-505
• 10.6288/TJPH.202310_42(5).112036

• Link 原著 Original Article
• 身心障礙者罹患大腸直腸癌延遲治療情形及死亡風險Risks of treatment delay and mortality in individuals with disability and colorectal cancer
• 龔佩珍、龔娟玉、王舜睦、邱莉婷、黃秀玲
  Pei-Tseng Kung, Chuan-Yu Kung, Shun-Mu Wang, Li-Ting Chiu, Hsiu-Ling Huang
• 身心障礙者、健保資料庫、大腸直腸癌、延遲治療、死亡風險
  disabled people, National Health Insurance Research Database, colorectal cancer, delayed treatment, mortality risk
• 目標：大腸直腸癌為我國最常見癌症。本研究探討身心障礙者罹患大腸直腸癌延遲治療情形及死亡風險。方法：為回溯性世代研究，利用癌症登記檔資料擷取2008~2015年新登記為大腸直腸癌者，串聯內政部身心障礙者資料及衛福部健保資料庫，篩選出研究對象計11,967人，追蹤至2016年年底，觀察其延遲治療情形及死亡風險。除了描述性統計及雙變項分析外，利用羅吉斯迴歸分析探討是否延遲治療之相關因素，以Cox model探討是否延遲之相對死亡風險。 結果：共計有2,840人延遲治療（佔23.73%），年齡越大、共病嚴重度越高、有其他重大傷病者，延遲治療比率越高（p<0.05）。罹癌以第2期延遲治療比率最高（佔36.53%），其延遲治療風險較第1期高1.31倍。有延遲治療者每千人年死亡率較高（21.19‰ vs. 19.50‰），死亡風險亦較高（HR: 1.09）。結論：在全民健保制度下，身心障者罹患大腸直腸癌延遲治療比率高達23.73%，顯示該族群民眾受限於障礙，會影響其接受治療可近性。本研究結果可供相關單位在癌症防治及身心障礙者健康照護政策擬定之參考。
  Objectives: Colorectal cancer (CRC) is the most prevalent cancer in Taiwan. In this study, we evaluated the incidence rates of treatment delay and mortality among individuals with disability and CRC. Methods: This retrospective cohort study was conducted using data from patients with CRC who were registered in the Taiwan Cancer Registry between 2008 and 2015. The obtained data were cross-referenced with the disability registry data from Taiwan’s Ministry of the Interior and National Health Insurance Research Database. The included patients were followed up until the end of 2016. Descriptive statistics were used and bivariate, logistic regression, and Cox proportional-hazards analyses were performed to identify factors and risks associated with treatment delay and mortality. Results: This study included 11,967 patients; of them, 2,840 patients (23.73%) experienced treatment delay. Older age, elevated Charlson Comorbidity Index scores, and the presence of other catastrophic illnesses were associated with treatment delay (all p < .05). The incidence rate of treatment delay was the highest in individuals with stage 2 CRC (36.53%), with the risk being 1.31 times higher than that in patients with stage 1 CRC. Compared with patients who did not experience treatment delay, those who experienced treatment delay had an elevated mortality rate (19.50‰ vs. 21.19‰, respectively) and an increased (by 1.09 times) mortality risk. Conclusions: According to the universal health insurance system, the incidence rate of treatment delay is high (23.73%) among individuals with disability and CRC. This suggests that disability and other pertinent factors impede the access to timely treatment in this patient population. Our findings may guide health-care policies for individuals with disability and facilitate effective initiatives toward cancer prevention.
• 506-518
• 10.6288/TJPH.202310_42(5).112054

• Link 原著 Original Article
• 建構健康促進友善社區藥局：藥師和顧客的觀點Development of an amiable, health-promoting community pharmacy: perspectives from pharmacists and customers
• 王人杰、蔡馨慧、邱建強、游佩雯、黃彥銘、張雅惠、吳建遠、鍾遠芳、廖宏恩、林香汶
  Jen-Chieh Wang, Hsin-Hui Tsai, Chien-Chiang Chiu, Pei-Wen Yu, Yen-Ming Huang, Elizabeth H. Chang, Chien-Yuan Wu, Yuan-Fang Chung, Hung-En Liao, Hsiang-Wen Lin
• 社區藥局、顧客、健康促進、觀點、藥師
  community pharmacy, customer, health promotion, perspective, pharmacist
• 目標：此研究旨在探索建立健康促進社區藥局的可行性，以讓藥師於社區中可以提供友好和專業的健康促進服務。方法：本計畫進行台灣中部地區連鎖、門前及獨立社區藥局之共六名執業藥師及六名訪客之半結構式訪談及多次專家會議，所獲得的資料經描述性與演繹式主題分析，綜合比較研究結果後，擬出社區藥局執行健康促進（健促）的作業流程及執業藥師的自我檢核表草案，以供日後在實施時參考。結果：社區藥局因型態不同導致服務內容差異甚大，多以調劑為主，其中獨立藥局在藥事照護及其他健促服務的配合度上最高。民眾對藥師的專業服務的認同，藥師提供健促的專業訓練、政府的給付、作業流程及自我評核的建立是推動健促社區藥局的最大挑戰。結論：後疫情時代，建議由獨立藥局或有意願的社區藥局藥師以戒菸諮詢之初始架構，加以政府支持以作為發展健促社區藥局執業模式之參考；在與新冠病毒共存之時，以利於在社區中可以提供高品質的健康促進與用藥安全之健康照護。
  Objectives: This study was conducted to explore a viable model for establishing health-promoting community pharmacies in Taiwan, where pharmacists can provide amiable and professional health promotion services within a community environment. Methods: Semi-structured interviews were conducted with six licensed pharmacists and six customers hailing from chain, non-owner-managed, and independent community pharmacies in central Taiwan. Following these interviews, several expert meetings were scheduled to discuss the collected information. The obtained data were analyzed through deductive content analysis, utilizing descriptive, in vivo, and pattern coding techniques. Drawing upon the insights gleaned from our analysis, we formulated standard operating procedures and a self-assessment performance checklist for pharmacists, with the ultimate goal of enhancing health promotion in community settings. Results: The services, which primarily centered around dispensing medications, exhibited variation across the included community pharmacies. Independent pharmacies demonstrated the highest level of cooperation in delivering pharmaceutical care and other health promotion services. The primary hurdles in the pursuit of health promotion revolved around gaining public recognition, facilitating professional training for pharmacists, securing government funding, and developing pertinent standard operating procedures and self-assessment checklists. Conclusions: We recommend the incorporation of independent pharmacies and pharmacists who are enthusiastic about engaging in community pharmacy initiatives. The proposed model can seamlessly integrate into the current framework of smoking cessation services, provided it receives adequate government support. Given the challenges arising in the post-pandemic period, our study has the potential to advance the delivery of high-quality primary care to community-based patients in Taiwan, with a focus on health promotion and ensuring safe medication use.
• 519-529
• 10.6288/TJPH.202310_42(5).111075

• Link 原著 Original Article
• 中文版「低血糖感知障礙量表」之發展與心理計量特性Development and psychometric properties of the Chinese version of the Impaired Awareness Hypoglycemia Assessment Scale
• 翁修慧、吳嘉玲、鄭翔如、葉淑婷、陳華芬、李中一
  Hsiu-Hui Weng, Jia-Ling Wu, Hsiang-Ju Cheng, Shu-Tin Yeh, Hua-Fen Chen, Chung-Yi Li
• 低血糖感知障礙、Clarke量表、Gold量表、信度、效度
  Impaired Awareness of Hypoglycemia (IAH), Clarke questionnaire, Gold questionnaire, reliability, validity
• 目標：本研究旨在針對英文版Clarke與Gold之低血糖感知障礙（Impaired Awareness of Hypoglycemia, IAH）量表進行中文化（分別稱Clarke-TW與Gold-TW），並評估其信、效度特性。方法：組成雙語專家小組利用翻譯-回譯程序進行量表中文化。於2022年9月至11月完成898位由台南市19家藥局、診所及衛生所針對20歲以上三個月內曾接受胰島素注射或磺醯脲類口服藥物治療之第二型糖尿個案進行方便抽樣與面對面訪談，評估社區糖尿病個案IAH盛行狀況。根據調查數據本研究評估量表之內部一致性信度、再測信度以及建構效度等。結果：本研究由雙語專家小組首先確認中文版量表之內容效度；Clarke-TW內部一致性信度係數Kuder-Richarson-20為0.481，4周再測信度係數Intra-class Correlation Coefficient（ICC）為0.660。Gold-TW也有類似的ICC（0.653）；檢定Clarke與Gold中文版量表IAH狀況與性別（p=0.32、0.70）或受雇狀態（p=0.08、0.29）均無顯著相關；但與規律自我血糖監測與一年內是否有接受視網膜檢查均呈顯著負相關性（p<0.001），前述結果支持兩個中文化量表具有已知族群效度。因素分析也識別Clarke-TW具有2個構面，且主軸因素法顯示模式配適度良好。結論：Clarke-TW與Gold-TW量表具有中等程度的再測信度與良好建構效度；兩個量表呈現的整體IAH盛行率分別為36.1%（95%CI: 32.9%−39.3%）與49.4%（95%CI: 46.1%−52.3%）。因兩個量表題目簡單且方便應用，建議可以考慮於社區調查中使用，用以評估糖尿病個案低血糖認知障礙盛行率。
  Objectives: This study was conducted to translate Clark’s and Gold’s questionnaires on impaired awareness of hypoglycemia (IAH) from English to Chinese (Clarke-TW and Gold-TW, respectively) and evaluate their reliability and validity. Methods: A bilingual expert group translated and back-translated the original questionnaires to develop the Clarke-TW and Gold-TW questionnaires. Convenient sampling was performed across 19 pharmacies, clinics, and public health centers in Tainan between September to November 2022. Thus, we recruited 898 patients (age ≥ 20 years) with type 2 diabetes who had received insulin injection or oral sulfonylureas over the previous 3 months. Face-to-face interviews were conducted with these individuals. IAH prevalence, internal consistency, test–retest reliability, and construct validity were evaluated for both questionnaires. Results: The bilingual expert group confirmed the content validity of the two questionnaires. For Clark-TW, the Kuder–Richarson-20 coefficient was 0.481 and the 4-week test–retest intraclass correlation coefficient was 0.660. The intraclass correlation coefficient for Gold-TW was 0.653. IAH prevalence measured using Clarke-TW and Gold-TW exhibited no association with sex (p = .32 and .70, respectively) or employment status (p = .08 and .29, respectively). However, routine self-monitoring of blood glucose and a retinal examination in the previous year were significantly associated with reduced IAH prevalence regardless of the measurement tool used (p < .001); this finding supports the questionnaires’ known-group validity. Factor analyses identified two factors from Clarke-TW; principal axis factoring indicated that the two-factor model fit was adequate. Conclusions: Both Clarke-TW and Gold-TW have moderate test–retest reliability and satisfactory construct validity. The overall IAH prevalence measured using Clarke-TW and Gold-TW was 36.1% (95% confidence interval: 32.9%-39.3%) and 49.4% (95% confidence interval: 46.1%-52.3%), respectively. Both questionnaires are straightforward and convenient and can be used in community surveys to estimate IAH prevalence among patients with diabetes.
• 530-541
• 10.6288/TJPH.202310_42(5).112068

• Link 原著 Original Article
• 全人工膝關節置換術病人術前共病分群與術後感染之關聯Association between preoperative comorbidity clusters and surgical site infection after total knee arthroplasty
• 許繼澤、溫淑惠
  Ji-Ze Syu, Shu-Hui Wen
• 共病分群、潛在類別分析、術後感染、全人工膝關節置換術、英國生物資料庫
  clusters of comorbidities, latent class analysis, postoperative infection, total knee arthroplasty, UK biobank
• 目標：本研究旨在探討全人工膝關節置換術（total knee arthroplasty，簡稱TKA）病人術前共病分群與術後感染之關聯。方法：採回溯性世代研究並以英國生物資料庫住院檔（採計1980到2020年）判定初次TKA患者（n=20,112），追蹤結果變項術後感染直至2021年止；術前共病以術前所有醫療紀錄之疾病診斷碼定義。以潛在類別分析（latent class analysis，簡稱LCA）法進行共病分群，並用Cox比例風險迴歸模式評估TKA患者之共病分群的短期與長期術後感染之風險。結果：LCA分群最合適的結果為四群，分別命名為低共病（n=10,573, 52.6%）、三高及心血管疾病（n=4,597, 22.9%）、皮膚及感染性疾病（n=3,390, 16.8%）及多共病群（n=1,552, 7.7%）。與低共病群相比，皮膚及感染性疾病群短期術後感染風險較高（風險比（hazard ratio, HR）=1.86, 95%信賴區間（confidence interval, CI: 1.14-3.05）；至於長期術後感染風險，皮膚及感染性疾病群（HR=2.25, 95% CI: 1.52-.35）、三高及心血管疾病群（HR=1.90, 95%CI: 1.25-2.89）與多共病群（HR=2.78, 95% CI: 1.52-5.08）皆比低共病群高。結論：TKA病人術前共病可分成四大分群且與低共病群相比，其他三群都具有長期術後感染風險，其中皮膚及感染性疾病群也有較高的短期術後感染風險，研究發現有助臨床醫師辨別術後感染較高風險病人。
  Objectives: This study was conducted to investigate the association between preoperative comorbidity clusters and surgical site infection after total knee arthroplasty (TKA). Methods: This retrospective cohort study was conducted using the data (from the UK Biobank database) of 20,112 adults who had undergone primary TKA between 1980 and 2020. The primary outcome was postoperative infection. The patients were followed up until the end of 2021. Information on the patients’ preoperative comorbidities was obtained from their pre-TKA medical records. A latent class analysis was performed to cluster patients with TKA according to preoperative comorbidities. A Cox proportional-hazards model was used to estimate the risks of short- and long-term postoperative infection in patients with different comorbidity clusters. Results: The latent class analysis revealed four comorbidity clusters: low comorbidity (10,573 patients [52.6%]); hypertension, hyperglycemia, hyperlipidemia, and cardiovascular disease (4,597 [22.9%]); skin and infectious diseases (3,390 [16.8%]), and multiple comorbidities (1,552 [7.7%]). The risk of short-term postoperative infection was higher in the skin and infectious diseases cluster than that in the low-comorbidity cluster (hazard ratio [HR]: 1.86; 95% confidence interval [CI]: 1.14–3.05). The risk of long-term postoperative infection was elevated in the skin and infectious diseases cluster (HR: 2.25; 95% CI: 1.52–3.35); hypertension, hyperglycemia, hyperlipidemia, and cardiovascular disease cluster (HR: 1.90; 95% CI: 1.25–2.89); and multiple comorbidities cluster (HR: 2.78; 95% CI: 1.52–5.08). Conclusions: We identified four comorbidity clusters in patients who underwent TKA. Compared with the low-comorbidity cluster, the other three clusters had increased risks of long-term postoperative infection; the skin and infectious diseases cluster also had an elevated risk of short-term postoperative infection. Our findings can help clinicians identify patients at an elevated risk of post-TKA infection.
• 542-553
• 10.6288/TJPH.202310_42(5).112072

• Link 原著 Original Article
• 細懸浮微粒與失智症和帕金森氏症惡化之相關性—以嘉義地區為例Effects of ambient fine particulate matter on the exacerbation of dementia and Parkinson’s disease in Chiayi City
• 黃淑倫、林裕清、林玠模、紀妙青
  Su-Lun Hwang, Yu-Ching Lin, Chieh-Mo Lin, Miao-Ching Chi
• 細懸浮微粒、帕金森氏症、急診就醫、都市化
  fine particulate matter, Parkinson’s disease, emergency department visits, urbanization
• 目標：本研究探討大氣細懸浮微粒（fine particulate matter, PM2.5）短期暴露對失智症與帕金森氏症（Parkinson’s disease, PD）惡化影響。方法：分析「長庚醫學研究資料庫」選取嘉義縣市失智症與PD急診就醫個案（2015-2019年），連結環保署空品測站資料。以時間分層病例交叉研究法探討大氣PM2.5對失智症與PD惡化影響。結果：PM2.5每增加10 mg/m3，PD急診就醫風險增加39%（Lag0），且呈現累積效應（Lag0-1至Lag0-3的勝算比[Odds ratio, OR]分別為1.29、1.31、1.36）。女性，PD急診就醫風險增加53%（Lag0），且呈現延遲（Lag1，OR = 1.31）與累積效應（Lag0-1至Lag0-5，OR分別為1.45、1.51、1.61、1.58、1.60）。特定鄉鎮（高齡 化、農業與偏遠），PD急診就醫風險增加46% （Lag0）；一般鄉鎮，PD急診就醫風險則呈現延遲（Lag2，OR = 1.49）與累積效應（Lag0-2與Lag0-3，OR分別為1.63、1.90）。急診就醫年齡（> 75歲），PD急診就醫風險增加32% （Lag0）；≤75歲，PD急診就醫風險呈現累積效應（Lag0-3至Lag0-5，OR分別為2.13、2.28、2.40）。失智症則無顯著增加現象。結論：大氣 PM2.5短期暴露可能提高PD急診就醫風險。
  Objectives: This study investigated the effects of short-term exposure to ambient fine particulate matter (PM2.5) on the worsening of dementia and Parkinson’s disease (PD). Methods: Data regarding emergency department visits (EDVs) for dementia and PD and air pollutant levels in Chiayi City from 2015 to 2019 were obtained from the Chang Gung Research Database and Taiwan’s Environmental Protection Administration, respectively. A time-stratified case–crossover design was adopted to estimate the risks of EDVs for dementia and PD patients associated with short-term exposure to PM2.5. Results: Increased exposure to PM2.5 was associated with a 39% increase in EDVs for PD patients following a 10 mg/m3 increase at Lag 0. Moreover, cumulative effects were observed, with odds ratios (ORs) of 1.29, 1.31, and 1.36 for Lag 0–1 to Lag 0–3, respectively. Among women, PD-related EDVs increased by 53% at Lag 0, and delayed and cumulative effects were evident, with ORs of 1.31, 1.45, 1.51, 1.61, 1.58, and 1.60 for Lag 1, Lag 0–1 to Lag 0–5, respectively. In specific towns (aged, agricultural, and rural), a 46% increase in EDVs was noted for PD at Lag 0. In general towns, PM2.5 exhibited delayed and cumulative effects, with ORs of 1.49, 1.63, and 1.90 for Lag 2, Lag 0–2 to Lag 0–3, respectively. Among individuals aged ≥75 years, PM2.5 had cumulative effects, with ORs of 2.13, 2.28, and 2.40 for Lag 0–3 to Lag 0–5, respectively. However, no significant association was observed between PM2.5 exposure and an increase in EDVs for dementia patients. Conclusions: Short-term PM2.5 exposure increased the risk of PD exacerbation and demonstrated delayed effects.
• 554-563
• 10.6288/TJPH.202310_42(5).112078

• Link 原著 Original Article
• 空氣清淨機技術介入對工業區室內空氣污染物與氣喘患者健康改善之評估Effects of air purifiers on indoor air pollutants and health in patients with asthma in industrial areas
• 李宛宸、陳培詩
  Wan-Chen Li, Pei-Shih Chen
• 空氣清淨機、光觸媒、室內空氣污染物、健康效應、肺功能
  air purifier, photocatalyst, indoor air pollutants, health effects, lung function
• 目標：探討以光觸媒氧化及過濾空氣清淨技術移除工業區室內空氣污染物及改善氣喘患者介入後之健康效應。方法：對居住在重工業區之58名氣喘病患進行雙盲交叉設計研究，將受試者隨機分為PCO組與附加濾網之PCO+filter組。PCO+filter組在第一階段介入PCO+filter空氣清淨機兩週；經過兩週的效應排除重置期（washout period），將濾網移除進入第二階段之PCO空氣清淨機介入兩週。PCO組與PCO+filter組的第一階段與第二階段互為相對。介入期間測量清淨機介入前後之室內粒狀（PM1, PM2.5, PM4, PM10, TSP, UFPs）和氣狀（CO, SO2, NO2, CO2, TVOC）等空氣污染物移除及健康效應（肺功能、血壓、FeNO、ACT score、Symptom score）。結果：污染物部分，PCO組中觀察到室內SO2、TVOC等氣狀污染物顯著下降；PCO+filter組中觀察到PM、CO、NO2、TVOC等污染物顯著下降。健康效應部分，肺功能在第7天就觀察到上升，血壓在第13天觀察到顯著下降，問卷分數在兩組皆觀察到改善，且症狀具臨床顯著改善。結論：居住在高污染工業地區之敏感族群，可藉由介入空氣清淨機技術的方式來減緩空污對健康的不良影響。
  Objectives: This study investigated the effectiveness of photocatalytic oxidation (PCO) and air filtration technology for removing indoor air pollutants and improving the health of patients with asthma. Methods: A double-blind crossover study was conducted. In total, 58 patients with asthma residing in a heavily industrialized area were recruited. The patients were randomly assigned to two groups: a PCO group and a PCO+filter group. The PCO+filter group underwent an intervention that consisted of a 2-week period using a PCO and a filter, a 2-week washout period, and a 2-week period using only a PCO. The PCO group followed the same sequence, with interventions reversed. During the intervention period, measurements were taken to assess the removal of indoor particulate matter (PM1, PM2.5, PM4, PM10, TSP, and UFPs), gaseous pollutants (CO, SO2, NO2, CO2, and TVOC), and their effect on health outcomes, including lung function, blood pressure, FeNO levels, ACT score, and symptoms. Results: Significant reductions in indoor gaseous pollutants, such as SO2 and TVOC, were observed in the PCO group. Significant reductions in PM, CO, NO2, and TVOC were observed in the PCO+filter group. Improvements in lung function were observed after only 7 days, and significant reductions in blood pressure were observed after 13 days. Both groups reported improvements in symptoms. Conclusions: Individuals living in highly polluted industrial areas can mitigate the adverse health effects of air pollution by adopting air purifier technology.
• 564-574
• 10.6288/TJPH.202310_42(5).112073

• Link 評論 Commentary
• 評論：空氣清淨機技術介入對工業區室內空氣污染物與氣喘患者健康改善之評估評論：空氣清淨機技術介入對工業區室內空氣污染物與氣喘患者健康改善之評估
• 黃彬芳
  黃彬芳
• 無
  none
• 無
  none
• 575
• 10.6288/TJPH.202310_42(5).11207301

• Link 原著 Original Article
• 跨國震災救難人員創傷後壓力症候群因應策略之研究Post-traumatic stress disorder response strategies in cross-national earthquake rescue workers
• 李燕青、吳政倫
  Yen-Ching Lee, Cheng-Lun Wu
• 地震、救難人員、創傷後壓力症候群、休假因應、因應策略
  earthquakes, rescue workers, post-traumatic stress disorder, taking a vacation coping style, coping strategies
• 目標：探討跨國救災後救難人員創傷後壓力症候群之因應策略，達到確切有效的處理措施。方法：本研究對象為因應2023年2月6日土耳其發生規模7.8地震死傷慘重而支援震災之國際搜救隊之救難人員，有效樣本共計121人。研究工具為結構性問卷，內容包括個人基本資料、簡式健康量表、中文版戴氏創傷量表及自填因應方式。結果：在Logistic迴歸分析中，僅有「休假因應方式」對創傷後壓力症候群有顯著預測效果（OR=0.332；95%CI=0.114-0.964；p=0.043）。結論：充足的訓練或相關災難演練能夠提升救難人員自信心，並掌握團隊能力減少PTSD風險，雖然本次研究過程中有進行的專業諮商服務，文獻也持肯定態度，但在本次統計分析中專業諮商服務並不顯著，反而讓我們發現「休假因應方式」能使救難人員達到心身的修復狀態，因此，期望在本研究中提出適切有效的因應策略建議，強化「事前教育、救災中預防對策及災後照顧」等三大面向，讓未來跨國救災人員能夠得到合適的因應作為，避免創傷後壓力症候群的發生。
  Objectives: This study aims to explore strategies for dealing with post-traumatic stress disorder (PTSD) in rescue workers after providing multinational disaster relief and identify effective management measures. Methods: A valid sample of 121 international search and rescue team members who supported rescue efforts following the 7.8-magnitude earthquake in Turkey on February 6, 2023, was considered for this study. The study instrument was a structured questionnaire comprising basic demographic information, the five-item Brief Symptom Rating Scale, the Chinese version of the Davidson Trauma Scale, and a self-rated coping style. Results: In the logistic regression analysis, the only coping style that was a significant predictor of PTSD was that of taking a vacation (OR = 0.332; 95%CI = 0.114–0.964; p = 0.043). Conclusions: Adequate training or relevant disaster drills can improve workers’ self-confidence and the team’s ability to reduce the risk of PTSD. Taking vacations can allow the rescue worker to physically and mentally recover, and the provision of professional counseling services can further enhance social support for rescue workers. Therefore, the study proposes three major strategies, namely, pre-education, prevention during disaster relief, and post-disaster care, for dealing with PTSD in rescue workers.
• 576-586
• 10.6288/TJPH.202310_42(5).112052