40卷1期

• Link 政策論壇 Policy Forum
• 台灣2025年C肝消除的策略與進度Eliminating hepatitis C in Taiwan by 2025: strategies and progress
• 吳慧敏、楊雯雯、劉嘉玲、鄭國本、陳時中、陳建仁、蒲若芳
  Grace Hui-Min Wu, Wen-Wen Yang, Chia-Ling Liu, Kuo-Pen Cheng, Shih-Chung Chen, Chien-Jen Chen, Raoh-Fang Pwu
• 慢性C型肝炎、台灣、2025、C型肝炎口服新藥、消除C型肝炎
  chronic hepatitis C, HCV, Taiwan, 2025, direct-acting antiviral agent, DAA, elimination of hepatitis c
• 為消除C型肝炎，台灣設立國家消除C肝辦公室、制定《國家消除C型肝炎政策綱領2018-2025》訂下2025年C肝口服新藥（direct-acting antiviral agent, DAA）治療人數達25萬人的目標。目前推估台灣有40萬名慢性C型肝炎病人，70%以上為早期醫療資源匱乏的醫源性感染，近期新感染個案以靜脈注射藥癮者等高風險個案為主。我國C肝消除策略採「以治療引領預防、以篩檢支持治療、以預防鞏固成效」，推廣DAA治療消除感染源並於2019年健保放寬給付條件、2011年8月起推行成人預防保健肝炎篩檢找出潛在慢性C肝病患、提供高危險族群衛教諮詢等預防措施。自2017年將DAA納入給付後，包含過去干擾素治療至今整體治療涵蓋率約達50%，未來如何藉由各種管道及策略，有效率且便利地找出待篩檢民眾進行C肝篩檢並加以治療，將成為能否達成2025消除C肝的最大關鍵。
  To eliminate hepatitis C, Taiwan established the National Hepatitis C Program Office, formulated the "National Hepatitis C Elimination Policy Program 2018-2025," and stipulated that the number of direct-acting antiviral agent (DAA) treatments for hepatitis C reached 250,000 in 2025. Currently, it is estimated that there are 400,000 chronic hepatitis C patients in Taiwan, and more than 70% are iatrogenic infections with insufficient early medical resources. Recent infections are mainly high-risk cases, such as intravenous drug addicts. Taiwan's hepatitis C elimination strategy follows the principle: "treatment to lead prevention, screening to support treatment, and prevention to consolidate effectiveness." Practical actions include promoting DAA treatment to eliminate the source of infection and relaxing payment conditions for health insurance in 2019, implementing adult preventive hepatitis screening in August 2011 to find potential patients, and providing health education consultations for high-risk groups. Since DAA was in the payment in 2017, the overall treatment coverage rate, including interferon treatment, has reached about 50%. In the future, how to use various channels and strategies to efficiently and conveniently identify people needed screening and treatment will become the biggest key to the elimination of liver C by 2025.
• 1-4
• 10.6288/TJPH.202102_40(1).PF01

• Link 公衛論壇 Public Health Forum
• 負壓隔離病房是醫院的標準配置嗎？Are negative pressure isolation wards essential standard settings in hospitals?
• 蕭世槐、廖茂宏
  Shih Huai Hsiao, Mao Hung Liao
• 負壓隔離病房、醫院配置、隔離治療
  negative pressure isolation ward, hospital configuration, isolation treatment
• COVID-19疫情爆發後，各界開始關注國內是否有充足的負壓隔離病房收治需隔離治療的病患。依我國醫療法第27條，重大災害發生時，醫療機構不得規避、妨礙或拒絕協助辦理公共衛生業務。然而若醫院未設有負壓隔離病房，恐無法收容或診治，故負壓隔離病房應為醫院之標準配置或選擇性配置值得討論與深究。
  After the outbreak of the COVID-19, people began to pay attention to whether there are enough negative pressure isolation wards in Taiwan to treat patients who need isolation treatment. According to Article 27 of Medical Law, when a severe disaster occurs, medical institutions shall not evade, hinder or refuse to assist with public health services. However, suppose the hospital does not have a negative pressure isolation ward. In that case, it may not be able to accommodate or diagnose and treat, so the negative pressure isolation ward should be the standard configuration or optional hospital configuration, which is worth discussing and studying.
• 5-7
• 10.6288/TJPH.202102_40(1).109075

• Link 綜論 Review Article
• 急診壅塞的原因與改善策略Emergency department overcrowding: an overview of critical issues and improvement strategies
• 蔡哲宏、蔡耀德、翁紹仁、劉士嘉
  Jeffrey Che-Hung Tsai, Yao-Te Tsai, Shao-Jen Weng, Shih-Chia Liu
• 急診、壅塞、醫療品質、病人安全
  emergency department, crowding, medical quality, patient safety
• 本文以文獻回顧方式，就急診壅塞概況（包含台灣現況）、原因與機轉、對醫療品質之衝擊及相關的改善策略等各面向進行討論。作者搜尋1999至2019年急診壅塞的相關文獻，再挑選較具代表性的文章加以整理。文獻整理的結果發現輸入-處理效能-輸出的概念模型可用來分析急診壅塞的原因、所造成的影響及可能的解決辦法。作者另提出急診病人與其他類型的病人會共同競爭醫院的一般病床資源的生態，且以水庫的「水位」來說明急診壅塞如何形成的機轉。造成急診壅塞的成因非常複雜，主要發生在輸出端、醫院系統的問題、以及背後醫療體系與給付制度的生態等多重因素所造成。急診的壅塞的相關指標可由等候時間的延長及空間的擁擠情形分別來定義，其中急診留滯病人數能間接反應急診佔床率的概念。改善急診室壅塞的策略可以由急診流程、醫院管理、社區面等方面來討論。已經造成急診壅塞的醫院，必須注意維持照護品質與病人安全。急診壅塞未來將面臨新的挑戰，包含醫療環境的變化與急診生態與作業模式的改變，所以必須以新的思維面對急診壅塞的情形。醫院管理在處理急診壅塞時可能面臨財務上的阻力，因此政策的介入以提高誘因將更形重要。本文所整理急診壅塞各種相關問題的重要文獻，應對國內有志於進行急診壅塞相關研究的學者有所助益，進一步或可引導未來有效的政策之建議。
  This study reviews emergency department (ED) crowding by focusing on the current situation in Taiwan, causes and mechanisms of ED, the impact of ED on health care quality, and improvement strategies. We searched studies addressing ED crowding between 1999 and 2019 and summarized the most representative articles. We found that the input–throughput–output model can help analyze the causes and effects of ED crowding and reveal potential solutions. ED patients must compete for medical resources, such as patient beds, with non-ED patients, and reservoir level has been used to explain the mechanism of ED crowding. ED crowding stems from multiple complex factors, mainly including output factors, hospital operation systems, and the health care system overall. The indicators of ED crowding are prolonged waiting time and a crowded space. Strategies to solve ED crowding include changes in ED operations and hospital management and the use of a community network. The number of patients in the ED is indirectly correlated with the ED occupancy rate. We also discuss the topics of the number of ED visits, number of discharged/transferred and admitted patients, and ED flow efficiency to address common improvement strategies. ED crowding has been a critical issue for hospitals, and changes in the health care environment and operations have exacerbated this problem; every staff member has to expend considerable effort in dealing with it. Financial pressure might prevent decisionmakers from implementing potential solutions; therefore, incentives and government support may be required. We hope that this study provides a useful overview for researchers and policymakers and guides them to make effective policies for addressing ED crowding.
• 8-29
• 10.6288/TJPH.202102_40(1).109124

• Link 綜論 Review Article
• 輕度身體活動的健康價值被低估了嗎？Are health benefits of light-intensity physical activity underestimated?
• 古博文、陳俐蓉、孫繼光、薛名淳
  Po-Wen Ku, Li-Jung Chen, Chi-Kuang Sun, Ming-Chun Hsueh
• 文獻回顧、規律運動、成年人、老年人、中高強度
  review, regular exercise, adult, elderly, moderate-to-vigorous
• 國際身體活動指引建議成年人每週應進行至少150分鐘的中強度有氧運動，或至少75分鐘高強度有氧運動，或以相等活動量進行中高強度組合活動。但這易讓人感到輕度身體活動（如：散步、遛狗、逛街購物、輕度家務勞動等）似乎沒有健康益處。近年逐漸有研究指出：輕度身體活動可為成年人（含老年人）帶來健康效益。本篇綜論檢視了以儀器測量輕度身體活動和其健康有關研究的重要議題，並討論輕度活動對18歲以上成年人的健康益處是否被低估。首先，描述國際間有關客觀測量輕度身體活動的現況。其次，分析以儀器測量身體活動相關研究的系統性文獻回顧及統合分析等證據，探討輕度身體活動與死亡率、罹病率及其他健康狀態之關係。最後，討論輕度身體活動的健康效益是否被低估的議題。整體而言，系統性文獻回顧及統合分析均支持輕度身體活動可提供成年人健康益處，且此效益獨立於中高強度身體活動的影響。部分研究建議成年人每天至少從事6小時的輕度身體活動以獲得健康效益，但須更多研究加以驗證。
  International physical activity guidelines suggest that adults should engage in at least 150 min of moderate-intensity aerobic physical activity per week, at least 75 min of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity. This seems to imply that little or no health benefits can be reaped from light-intensity physical activity (LPA; e.g., walking slowly, shopping, walking a dog, lifting lightweight objects, and doing household chores). However, an increasing body of evidence indicates that LPA may provide health benefits for adults and older adults. This review examined several crucial aspects of LPA and health and assessed whether the health benefits of LPA for adults aged 18 or older are underestimated. The following procedures were implemented to review the evidence of device-based measurements of LPA and health. First, the country profiles of adults performing LPA were described. Second, evidence obtained through systematic reviews and meta-analyses was examined to explore how LPA relates to mortality, morbidity, and other health outcomes. Finally, research topics regarding whether the health benefits of LPA for adults are underestimated were evaluated. In summary, evidence from systematic reviews and metaanalyses based on device-based assessment of LPA supports the health benefits of LPA for adults, which are independent of the effects of moderate-to-vigorous-intensity physical activity. Although some studies have suggested that adults can achieve health benefits by engaging in LPA for at least 6 hours per day, further research is needed to confirm this finding.
• 30-40
• 10.6288/TJPH.202102_40(1).109130

• Link 綜論 Review Article
• 探討日本照顧工作專業化演進歷程對我國之借鏡The Japanese care work vocational process as a reference for Taiwan
• 徐明仿
  Ming-Fang Hsu
• 介護福祉士、照顧工作、專門職業、專業能力、自立支援
  certified care worker, care work, vocational, professional, self-reliance support
• 1987年5月日本立法通過介護福祉士制度（Certified Care Worker），1988年實施日本學校專業教育養成機制與國考證照機制，培育從事第一線照顧工作之專業人才，於法源依據下，日本將照顧工作定位是一份專門職業工作。本文以概念性文獻回顧探討日本從事第一線之照顧工作朝向專門職業化演進之歷程，搜尋國內外資料庫檢索系統CiNii、NDL、華藝線上圖書館、台灣期刊論文索引系統，篩選納入12篇（1990-2020年）日文研究。本文歸納出有六項因素交錯 影響阻礙日本探討照顧工作專業性，此六項因素亦正是臺灣現今面臨的阻因。再者，本文歸納出日本照顧工作朝向專門職業演進的條件有五項，可供我國未來規劃提升照顧工作專業性之參考。
  Japan passed the Certified Care Worker Act in May 1987 and initiated a dual-track approach to specialized nursing care education and national qualification in 1988 to cultivate and certify care professionals; in the act, a “caregiver” is defined as a certified care worker. This study adopted a conceptual review methodology to explore the historical evolution of the care work professionalization process in Japan. Domestic and foreign databases, including CiNii, NDL, Ariti Library, and TPLS, were searched to identify official historical Japanese policy documents from 1990 to 2020, and 12 studies were obtained. This study concludes that 6 major factors that hindered Japan’s progress in professionalization are also the challenges faced in Taiwan. Moreover, this study summarizes 5 principles of the Japanese care work professionalization process that Taiwan can refer to for planning the future development of care work professionalization.
• 41-54
• 10.6288/TJPH.202102_40(1).109129

• Link 原著 Original Article
• 一項大學安全衛生課程對大學生的影響評估The impacts of an occupational health and safety course on college students
• 董育蕙、陳富莉、陳志傑、林瑜雯
  Yu-Huei Tong, Fu-Li Chen, Chih-Chieh Chen, Yu-Wen Lin
• 職業危害、職業安全衛生教育、職業安全衛生態度、職業安全衛生自我效能、職業安全衛生行為意向
  occupational hazards, occupational health and safety education, OHS attitude, OHS self-efficacy, OHS behavioral-intentions
• 目標：本研究係評估一項在大學開設之安全衛生通識課程，對大學生的安全衛生知識、態度、自我效能與行為意向的影響研究。方法：本項研究共有2所大學總計198位大學生參與（實驗組107位：對照組91位），並採準實驗設計之前測－後測－5週後後測設計進行課程介入成效評估。以T檢定分析前測、後測、後後測間之差異，並使用廣義估計方程式迴歸模式評估該項介入課程的成效分析。結果：顯示課程在介入組學生的安全衛生知識、態度及行為意向都有顯著正向影響，且該項正向影響可持續到介入課程結束5週後。此外，廣義估計方程式迴歸模式分析結果顯示在控制學生個人因素後，該項安全衛生介入課程對大學生「安全衛生知識」及「安全衛生態度─安全行為」有顯著正向影響。結論：由於該項安全衛生課程介入顯示了對大學生安全衛生知識、態度與行為意向的正向效應，建議持續於學校提供安全衛生課程予學生學習，對於提升學生安全衛生意識會有相當助益。
  Objectives: The impacts of an occupational health and safety (OHS) course on undergraduates’ knowledge, attitudes, self-efficacy and behaviorial intentions were evaluated. Methods: Participants included 198 college students (107 receiving intervention and 91 controls) from two universities. This study was a quasi-experimental, nonequivalent control group design with pre-post- and five week follow-up tests. We assessed the differences in mean scores using T-tests. Significant associations between the intervention and outcomes were identified by generalized estimating equation (GEE) regression models. Results: Statistically higher mean scores in knowledge (from 0.49 to 0.65, p<0.001), attitudes (from 2.83 to 3.00, p<0.001), and behavioral intentions (from 3.01 to 3.06, p=0.02) were observed in the intervention group, and significant improvements were maintained until follow-up. The regression models indicated that the intervention positively changed OHS knowledge and safety practices among college students. Conclusions: Consistently offering OHS courses in colleges is recommended, as shown by the positive impact demonstrated in this study.
• 55-70
• 10.6288/TJPH.202102_40(1).109048

• Link 原著 Original Article
• ABCDE bundle介入對加護病房病人譫妄之成效─系統性回顧暨統合分析Effects of ABCDE bundle on incidence of delirium among critically ill patients in intensive care unit: a systematic review and meta-analysis
• 劉芝妤、王琤、郭素娥、劉靜如、周芳如、黃秋雯
  Chih-Yu Liu, Jeng Wang, Su-Er Guo, Ching-Ju Liu, Fang-Lu Chou, Chiu-Wen Huang
• ABCDE組合照護模式、譫妄、系統性文獻回顧、統合分析
  ABCDE bundle, delirium, systematic review, meta-analysis
• 目標：譫妄為加護病房病人常見的合併症，發生率高達八成。國外自2014開始實施ABCDE組合照護（ABCDE bundle）預防譫妄，但歐、亞及國內較少相關研究，也缺乏系統性文獻整合與回顧其成效，本文旨在探討ABCDE bundle介入對加護病房病人譫妄之成效。方法：此研究於PubMed Clinical Queries、CINAHL、The Cochrane Library、Trip、Web of Science、ProQuest和華藝線上圖書館等7種電子文獻資料庫設定關鍵字，搜尋2020年12月以前出版之中、英文文獻，依據納入及排除條件後共納入4篇文獻。依JBI類實驗法評讀工具評價文章品質，發現效果明確超過不良效果，具備充足品質的證據支持，給予“強”建議，並使用Review Manager軟體（RevMan）5.3版本進行統合分析。結果：統合分析顯示ABCDE bundle介入可有效地降低譫妄發生率（RR: 0.63; CI: 0.45~0.90），並可提高13%的28天存活率（RR: 1.13; CI: 1.04~1.23）。結論：ABCDE bundle對加護病房的譫妄預防及存活率具實證基礎。此結果可提供醫療人員給予加護病房病人多元整合照護之參酌；但受限於研究多為類實驗設計且較少歐亞研究，建議未來投入更多及更嚴謹的在地臨床隨機控制研究。
  Objectives: Delirium is a common complication in patients in the intensive care unit, with a high incidence of up to 80%. The ABCDE (Awakening, Breathing, Coordination, Delirium monitoring/management, and Early exercise/mobility) bundle care model has been implemented to prevent delirium in the United States since 2014, but only few relevant studies have been conducted in Europe, Asian countries and Taiwan. Moreover, a systematic literature review and meta-analysis of its efficacy is lacking. Methods: This meta-analysis used defined keywords to search for quantitative studies published in Chinese or English before December 2020 in seven electronic literature databases. Four articles were included after applying the inclusion and exclusion criteria. The Joanna Briggs Institute (JBI) quasi-experiment appraisal tools were used to evaluate the quality of these articles. Data were analyzed using the RevMan version 5.3 software. Results: The JBI appraisal was level of evidence 2c, indicating strong evidence. The meta-analysis revealed that the ABCDE bundle could effectively lower the incidence of delirium (relative risk [RR], 95% confidence interval [CI]: 0.63, 0.45–0.90) and incidental benefit increase the 28-day survival rate by 13% (1.13, 1.04–1.23). Conclusions: The use of the ABCDE bundle to prevent delirium and improve survival in patients in the critical care unit is supported by evidence. The results may serve as a reference for health-care professionals who provide interdisciplinary care. However, this study is limited by its quasi-experimental design and the lack of studies in Eurasia and Taiwan. Further studies with a stringent design (RCT) are recommended to investigate this topic in depth.
• 71-82
• 10.6288/TJPH.202102_40(1).109104

• Link 原著 Original Article
• 台灣公民面對新冠肺炎疫情初期之焦慮症狀與防疫作為之趨勢Trends of anxiety and performance of preventive measures among Taiwanese citizens during COVID-19 pandemic
• 趙恩、陳國緯、李思賢
  En Chao, Kuo-Wei Chen, Tony Szu-Hsien Lee
• 新冠肺炎、焦慮症狀、大流行病、防疫行為、趨勢分析
  COVID-19, anxiety symptoms, pandemic, preventive measures, trend analysis
• 目標：面對新冠肺炎疫情，民眾若覺知有病毒感染的嚴重性與易感性，可能引發過度焦慮，導致出現過度反應或不理性行為。本研究是分析台灣在新冠肺炎疫情發展初期，成年公民面對疫情威脅時的焦慮症狀與採取防疫作為之趨勢。方法：本研究採用匿名網路調查台灣成年公民面對疫情之焦慮症狀及採取之防疫作為。焦慮症狀是採用STAI-6量表，詢問民眾因為疫情經驗到的緊張、沮喪、擔心、平靜、放輕鬆及滿足，共計6種情緒；防疫行為包含三個構面：洗手與戴口罩之個人防護、咳嗽禮儀、保持社交距離與自願檢疫，共計12題。資料分成三個期間，分別為中國武漢實施封城（1月23日至2月7日）、台灣實施強化邊境防疫、口罩購買實名制與首例無症狀高病毒感染者（2月8日至2月16日宣布第一位死亡案例）以及台灣發生第1例新冠肺炎死亡案例10天後（2月27日至3月9日）。統計方法使用Cochran-Armitage Trend Test及Jonckheere’s Trend Test檢視疫情發展不同時段之民眾焦慮程度，以及採取防疫作為之趨勢變化，並進一步檢視性別、年齡、教育程度與收入在焦慮程度與防疫行為關聯性之差異。不同時期之焦慮程度均與防疫行為關聯程度是採用共變數分析。結果：分析結果顯示，研究參與者出現高度焦慮程度之比率在三個時段分別為45%、50%及55%，上升趨勢達統計顯著。能經常或總是落實防疫作為者之比率在三個時段分別為46%、58%及66%，上升趨勢達統計顯著，但與性別、年齡、教育程度與收入之相關未達顯著，表示不同時期之焦慮程度與防疫行為關聯性斜率均一致。共變數分析顯示不同時期之焦慮程度均與防疫行為有顯著關聯。結論：本研究結果顯示隨著COVID-19疫情發展，民眾焦慮症狀及防疫作為，不分性別、年齡與教育程度，都呈現上升趨勢。
  Objectives: Citizens who perceive SARS-CoV-2 as a threat may experience heightened anxiety of the severe illness caused by COVID-19. This study investigated the trends in anxiety and performance of preventive measures among Taiwanese citizens during the early stages of the COVID-19 pandemic. Methods: This study employed an anonymous online survey to investigate anxiety and preventive behavior practice in adults during the early stages of the COVID-19 pandemic. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to measure symptoms of anxiety. The preventive measures consisted of 12 items divided into three categories: personal protection, cough etiquette, and social distance and voluntary quarantine. The three time periods studied were the lockdown in Wuhan, China (from January 23 to February 7), the week when enhanced border protections and in-person mask purchase systems were introduced and the first citizen tested positive for SARS-CoV-2 without symptoms (from February 8 to February 16), and the 10 days following the first death from COVID-19 in Taiwan (from February 27 to March 9). The Cochran–Armitage trend test and the Jonckheere trend test were used to analyze changes in the degree of anxiety and the adoption of preventive measures in the early stages of the epidemic. An analysis of covariance was performed to examine the relationship between changes in anxiety and engagement in preventive behaviors after control for sex, age, education, and income. Results: The percentages of the participants with moderate to high levels of anxiety during the three time periods were 45%, 50%, and 55%, respectively. The percentages of those who practiced preventive measures often or always during the three time periods were 46%, 58%, and 66%, respectively. Significant increases were found both in levels of anxiety and in performance of preventive measures over the three time periods, but no differences across sex, age, education, or income groups were found. Changes in anxiety and performance of preventive behaviors were significantly associated during the three periods. Conclusions: The results revealed that as the pandemic spread, citizens’ anxiety, and performance of preventive measures increased significantly for each sex, age, education level, and income group.
• 83-96
• 10.6288/TJPH.202102_40(1).109115

• Link 原著 Original Article
• 社區成年民眾身體活動量、年齡與自評生理心理健康之關聯性 Relationships between physical activity, age, and self-rated physical and psychological health in community-dwelling adults
• 翁成傑、陳煒、王政偉、楊惠斐、王建宇、黃琬婷、范聖育
  Cheng-Chie Weng, Wei Chen, Cheng-Wei Wang, Hui-Fei Yang, Jian-Yu Wang, Wan-Ting Huang, Sheng-Yu Fan
• 年齡、身體活動量、自評生理健康、自評心理健康
  age, physical activity, self-rated physical health, self-rated psychological health
• 目標：研究欲探索：(1)社區成年民眾身體活動量與自評生理與心理健康的關聯性；以及(2)在不同層級的身體活動量中，年齡與自評健康為線性或U型曲線之關係。方法：研究參與者為社區成年民眾，於教育部體育署舉辦之國民體適能檢測站進行資料收集，包括人口學資料、身體活動量、以及自評生理與心理健康。使用階層迴歸進行統計分析。結果：研究共招募2,212位研究參與者，依照身體活動量區分為高中低三組。控制人口學變項後，高度與中度身體活動量的研究參與者在自評健康（高度Beta = 0.12，中度Beta = 0.20，p值皆小於0.001）、自評生理健康（高度Beta = 0.09，中度Beta = 0.17，p值皆小於0.001）、自評心理健康（高度Beta =0.12，中度Beta = 0.19，p值皆小於0.001）皆顯著高於低度身體活動量者。在三組身體活動量，年齡皆與自評健康為線性正相關，年齡越大分數越高。結論：身體活動與年齡越高，社區成年民眾的自評生理與心理健康越佳。
  Objectives: The aims of this study were to investigate whether (1) physical activity is significantly associated with self-rated physical and psychological health in community-dwelling adults and (2) associations between age and self-rated physical and psychological health are linear or U-shaped for various physical activity levels. Methods: The participants were community-dwelling adults, and data were collected from physical fitness exam stations operated by the Sports Administration, Ministry of Education. Demographic characteristics, physical activity, and self-rated physical and psychological health statuses were collected. Hierarchical regression was used for statistical analysis. Results: In total, 2,212 adults were recruited and divided into high, moderate, and low physical activity groups. After controlling demographic characteristics, adults in high and moderate physical activity groups had significantly higher self-rated health (high: β = .12; moderate: β = .20, both p < .001), self-rated physical health (high: β = .09; moderate: β = .17, both p < .001), and self-rated psychological health (high: β = .12; moderate: β = .19, both p < .001) than those in the low physical activity group. In addition, linear and positive relationships were observed between age and self-rated physical and psychological health in the three physical activity groups. Conclusions: Elderly adults with high physical activity tended to have good selfrated physical and psychological health.
• 100-110
• 10.6288/TJPH.202102_40(1).109092

• Link 實務 Public Health Practice
• 客觀測量青少年在校期間身體活動量之研究Objectively measured school-based physical activity among adolescents
• 王文宜、李美賢、薛名淳、周建智
  Wen-Yi Wang, Mei-Hsien Lee, Ming-Chun Hsueh, Chien-Chih Chou
• SH150政策、中等至費力身體活動、客觀測量
  SH150 program; moderate-to-vigorous physical activity; objective measurement
• 目標：本研究旨在透過客觀測驗工具了解SH150政策推動下國中生在校期間身體活動量之狀況。方法：本研究對象為北部地區418位國中生，透過在校期間配戴五日加速規，蒐集有體育課日、無體育課日、體育課期間以及扣除體育課後在校期間之輕度身體活動（light physical activity, LPA）及中等至費力身體活動（moderate-to-vigorous physical activity, MVPA）時間；並記錄其性別、年級與體位程度等相關因子。結果：不同性別因子下LPA並未有所顯著差異，但MVPA各時間段男生都顯著高於女生；不同年級因子下，LPA與MVPA皆呈現年級越高身體活動量越低，與國際趨勢相同；而體位程度則與以往研究不同，體位適中組達標率為5.74，低於整體學生平均達標率，僅次於體位過重組的學生，可見學生即便體位適中，其身體活動量也是亟需關注的族群。結論：本研究透過客觀測量身體活動量檢視SH150達成率偏低，整體學生僅7.65%達150分鐘以上MVPA，建議可考量國際認可之消耗強度進行規劃，並研議學校執行面之推動策略。
  Objectives: This aim of the study was to objectively measure students’ levels of schoolday physical activity at junior high schools in Taipei that had implemented the Sport and Health 150 (SH150) program. Methods: The participants in this study were 418 students from junior high schools in northern Taiwan. Participants were asked to wear accelerometers for 5 days to measure their time spent performing light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). The average amount of time was subdivided into days with and without physical education (PE) class, the duration of the PE class, and the amount of time spent on physical activity on weekdays outside of PE class. In addition, data on participants’ gender, grade, and body mass index (BMI) were recorded. Results: No significant differences in the level of LPA were found across genders. However, in terms of MVPA, boys scored significantly higher than girls for all periods. Our results were consistent with those of other international studies suggesting that the higher the grade, the lower the level of LPA and MVPA. However, our findings on BMI differed from those of previous studies. Only 5.74% of students with normal BMI met the SH150 requirements, which was a lower percentage than the overall average and higher only than the overweight group. This result suggests that future studies should focus on students with normal BMIs but low levels of physical activity. Conclusions: International standards on energy consumption intensity should be considered when creating school-day physical activity programs. Strategies for implementing a physical activity programs should also be reviewed.
• 111-121
• 10.6288/TJPH.202102_40(1).109097

• Link 評論 Commentary
• 評論：新冠疫情、心理健康與防疫行為Commentary: COVID-19 pandemic, mental health, and preventive behaviors
• 張書森
  Shu-Sen Chang
• 無
  none
• 無
  none
• 97-98
• 10.6288/TJPH.202102_40(1).10911501

• Link 作者回覆 Authors' response to commentary
• 作者回覆：愛情還是麵包：代表性vs.時效性與研究倫理Authors' response to commentary: love or bread: representativeness vs. timeliness and research ethics
• 趙恩、陳國緯、李思賢
  En Chao, Kuo-Wei Chen, Tony Szu-Hsien Lee
• 無
  none
• 無
  none
• 99
• 10.6288/TJPH.202102_40(1).10911502