40卷3期

• Link 政策論壇 Policy Forum
• 新冠肺炎大流行對C肝消除計畫的挑戰：隱藏性感染人口的診斷與治療Impact of coronavirus disease 2019 pandemic on hepatitis C virus elimination: diagnosis and treatment in the hidden population with HCV infection
• 陳為堅
  Wei J. Chen
• C型肝炎、新冠肺炎、消除C型肝炎、C肝隱藏性感染人口
  hepatitis C, HCV, COVID-19, hepatitis C virus elimination, the hidden population with HCV infection
• 美國疾病中心曾分析過45個高收入國家能否達成WHO的2030年前消除C肝的目標，大多數國家皆不如預期。如今再加上新冠肺炎疫情，許多國家都因為將醫療資源用在新冠肺炎的預防跟診治上，使C肝的醫療照護提供減少，可能造成消滅C肝計畫達標的延遲。台灣C肝感染者的主要來源為靜脈注射藥癮者，此族群易成為隱藏性感染人口，目前已加設了39個衛星藥癮治療站，來因應疫情期間的移動管制可能降低美沙冬治療的可近性。除此之外，仍應再採取其他新的策略，如一步式的診斷與篩檢，以望如期達成消除C肝的目標。
  The US Center for Diseases has analyzed whether 45 high-income countries can achieve the WHO's goal of eliminating hepatitis C by 2030. Many countries were thought of incapable of reaching the goal. Since the outbreak of COVID-19, many countries have spent lots of medical resources for the prevention, diagnosis, and treatment of COVID-19, which has reduced the provision of medical care for hepatitis C. This may cause delays in the hepatitis C elimination plan. The primary source of patients with hepatitis C infection in Taiwan is intravenous drug addicts, who are prone to become a hidden infection population. At present, 39 satellite drug addiction treatment centers (DATC) have been established to cope with the movement control during the epidemic and improve the accessibility of Methadone Maintenance Therapy. In addition, new strategies should be adopted, such as one-step screening and diagnosis, in order to achieve the goal of eliminating hepatitis C on schedule.
• 241-244
• 10.6288/TJPH.202106_40(3).PF03

• Link 公衛論壇 Public Health Forum
• 全球流行傳染病疫情期間使用個人資料科技防疫措施之法律反省與建議A critical evaluation of public health policies that utilize personal data for pandemic control in Taiwan
• 吳倚晴、陳建煒
  Yi Ching Wu, K. Arnold Chan
• 全球大流行、個人資料、公共衛生政策、台灣、反省與建議
  pandemic, personal data, public health policies, Taiwan, critical evaluation
• 此次COVID-19疫情台灣使用全民健保資料庫、手機定位資訊等個人資料進行標記、追蹤與聯繫，這些科技防疫措施增進傳染病防治的效果與效率。然而，個人資料的取得與應用存在著授權法源依據不明確、隱私權界線不清、有產生歧視之虞、受不當侵害缺乏救濟管道等法律爭議。政府應建立個人資料使用於科技防疫之信任機制，如成立獨立審查委員會授權及監督個資使用、建構稽核制度，以避免以公眾利益為名，不當侵害人民權利。
  In the COVID-19 epidemic, Taiwan used personal data such as the National Health Insurance database and mobile phone location information for marking, tracking, and contacting. These public health policies that utilize personal data for pandemic control have improved the effectiveness and efficiency of infectious disease prevention and control. However, the acquisition and application of personal data are subject to legal disputes such as unclear sources of authorization, the blurring of privacy boundaries, the potential for causing discrimination, and the lack of remedies for improper infringements. Therefore, the government should establish a trust mechanism for the use of personal data in scientific and technological epidemic prevention, such as establishing an independent review committee to authorize and supervise the use of personal data and an audit system. Improper infringement of people’s rights in the name of public interest should be avoided.
• 245-255
• 10.6288/TJPH.202106_40(3).110018

• Link 原著 Original Article
• 老人社會資本對健康生活品質的影響：以台中市老人為例Effects of social capital on health-related quality of life among older adults in Taichung City
• 梁亞文、唐婷菱、王佑芸、蘇侰寧
  Yia-Wun Liang, Ting-Ling Tang, You-Yun Wang, Chun-Ning Su
• 老人、社會資本、健康生活品質
  seniors, social capital, health-related quality of life
• 目標：本研究旨在探討老人社會資本及健康生活品質的現況，進一步探討老人社會資本對健康生活品質的影響。方法：本研究為一探索性的橫斷式研究，以結構式問卷調查台中市12個C據點的212位居住在家中的老人。社會資本包含社區參與、信任與安全感、鄰居的連結三個構面、共計15題，健康生活品質則以EQ-5D5個面向(行動能力、自我照顧、一般活動、疼痛/不適與焦慮/沮喪）共5道題項進行測量，各題項計分介於1分至3分之間，3分代表沒有問題、1分代表無法自理/有極度問題。統計分析方法包含描述性統計及推論性統計，多變項分析則以等級機率迴歸探討老人社會資本對健康生活品質的影響。結果：鄉區老人增加一等級EQ-5D的勝算比為2.052（95% C.I.=1.070; 3.939）；高社會資本老人增加一等級EQ-5D的勝算比為低社會資本老人的3.662倍（95% C.I.=1.917; 7.001）；老人年齡每增加1歲增加一等級EQ-5D的勝算比下降6.9%（OR=0.931, 95% CI=0.889; 0.977）；有慢性病的老人增加一等級EQ-5D的勝算比下降62.8%（OR=0.372, 95% CI=0.165; 0.840）；衰弱前期的老人（OR=0.261, 95% CI=0.129; 0.530）與衰弱期的老人（OR=0.121, 95% CI=0.050; 0.289）增加一等級EQ-5D的勝算比分別下降73.9%及87.9%。結論：老人的社會資本對老人健康生活品質具有顯著影響，建議政府提出各項面對超高齡社會政策時，應納入如何提高老人社會資本的相關措施。
  Objectives: This study explored the effects of social capital on health-related quality of life among older adults in Taiwan. Methods: This exploratory cross-sectional study used a self-administered structured questionnaire to collect data from 212 older adults from 12 community care centers in Taichung City. Social capital was measured using a 15-item scale, which included items on community participation, trust/safety, and neighborhood linkage. The EQ-5D descriptive system is a preference-based health-related quality of life measure with one question for each of its five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The responses are coded from 1 to 3, with 3 indicating “no problems,” 2 indicating “some problems,” and 1 indicating “many problems.” Ordered probit regression was used to explore the effect of social capital on health-related quality of life. Results: The results of ordered probit regression revealed that living in rural areas (odds ratio [OR] = 2.0052, 95% confidence interval [CI] = 1.070–3.939) and having high social capital (OR = 3.662, 95% CI = 1.917–7.001) supported high self-rated health-related quality of life. Low assessment of health-related quality of life increased with age (OR = 0.931, 95% CI = 0.889–0.977), growing number of chronic diseases (OR = 0.372, 95% CI = 0.165–0.840), and Study of Osteoporotic Fractures frailty index (OR = 0.261, 95% CI = 0.129–0.530 vs. OR = 0.121, 95% CI = 0.050–0.289). Conclusions: Social capital played a relatively strong role in determining the health-related quality of life of older adults in Taichung City. Policymakers should implement social capital–related policies when facing a super-aged society.
• 256-267
• 10.6288/TJPH.202106_40(3).110035

• Link 原著 Original Article
• 不同背景特徵的手術室護理人員對手術煙霧自覺症狀、知識、態度、自我防護行為及阻力因素之比較Comparing different background characteristics in self-perceived symptoms, knowledge, attitude, self-protection behavior, and resistance factors for surgical smoke among operating room nurses
• 游景蘭、林麗虹、謝素英、紀夙芬、王琦
  Ching-Lan Yu, Li-Hung Lin, Suh-Ing Hsieh, Shu-Fen Chi, Chi Wang
• 手術煙霧、知識、態度、自我防護行為、阻力因素
  surgical smoke, knowledge, attitude, self-protection behaviors, barrier
• 目標：描述手術室護理人員所經驗過的手術煙霧症狀頻率與嚴重度；及其手術煙霧的知識、態度、自我防護行為及阻力因素，並比較不同背景特徵的手術煙霧症狀頻率與嚴重度、知識、態度、自我防護行為及阻力因素差異。方法：採描述性與比較性研究，方便取樣兩院區手術室護理人員，使用自擬結構式問卷，資料分析採描述性及單因子變異數分析。結果：症狀頻率與嚴重度前三高為想睡覺、流鼻水或其他鼻子不適、頭痛與咳嗽；不同年齡、護理及手術室工作總年資與每日平均工作時數的症狀頻率與嚴重度有顯著差異。知識答對率53.3%；態度平均數3.58分，而不同年齡、職稱、臨床工作職級、臨床工作科別、護理及手術室工作總年資的手術煙霧態度有顯著差異。自我防護行為平均數為1.47分，僅不同臨床工作科別有顯著差異，阻力因素平均數1.03分僅不同職稱有顯著差異。結論：期望此結果可提高手術室護理人員與醫療機構對手術煙霧職業傷害及相關防護方法的重視，並向人員宣導暴露之可能危害與加強自我防護行為。
  Objectives: To describe the frequency and severity of symptoms of exposure to surgical smoke experienced by operating room nurses and to assess and compare the knowledge of, attitude toward, protective measures for, and resistance factors for surgical smoke among operating room nurses with different background characteristics. Methods: This descriptive and comparative study used a convenience sample of nurses at two operating rooms at a medical institute and asked the nurses to fill a structured self-report questionnaire. The data were analyzed using descriptive statistics and one-way analysis of variance. Results: The three most frequent and severe symptoms were sleepiness, runny nose or other nasal discomfort, and headache and cough. Significant differences in symptom frequency and severity were noted with respect to age, years of nursing/operating room experience, and daily working hours. The knowledge test on surgical smoke was answered correctly by 53.3% of the nurses. The mean score of attitude toward handling surgical smoke was 3.58 and was significantly different with respect to age, work title, clinical nursing ladder, clinical unit, and years of nursing/operating room experience. The mean score for self-protective behavior was 1.47 and significantly differed between different clinical units. The mean score for resistance factor was 1.03 and significantly differed between different work titles. Conclusions: These findings may increase the awareness of the hazards of exposure to surgical smoke and highlight the importance of implementing relevant protection measures, educating medical personnel on the potential risk of and injury after exposure, and improving self-protective behaviors.
• 268-282
• 10.6288/TJPH.202106_40(3).110025

• Link 原著 Original Article
• 照顧新型冠狀病毒性感染病人護理師之心路歷程Psychological process of caring for patients with Coronavirus infections by nurses
• 梅襔、丘周萍
  Man Mei, Chou-Ping Chiou
• 新型冠狀病毒性肺炎、質性研究、護理經驗
  Coronavirus infections, qualitative research, experience of nursing
• 目標：新冠肺炎的爆發，於全球各地帶來了衝擊，世界各地進行大規模的防疫措施，造成醫護人員大規模的離職，產生人力的不足、職業生涯的變化、造成了莫大的壓力及因應等問題。確診率上升及醫療資源耗盡，促使研究人員對護理師照護此類病人的經驗進行訪談及分析，期望此經驗能協助日後之醫療人員的壓力及不確定感得到因應及調適。方法：本研究為質性研究深度訪談十位照護新冠肺炎病人的護理師，採內容分析法，透過與研究對象的互動及行為、語言及非語言之意義，以探討護理師照護此類病人之經驗。結果：根據受訪者之心路歷程，歸納出四個主題「過去累積的經驗，只為了蓄勢待發，對抗疾病的下一刻」、「同儕的鼓勵和支持，困苦中仍然堅守崗位，永不放棄」、「面對醫療資源缺乏，環境的艱難，仍堅持到底」、「川流不息的確診人數，陪伴病人的橫亙旅程」。結論：藉由護理師之經驗及心路歷程，提供給臨床護理師照護此類病人之經驗做為參考，同時提供相關主管單位瞭解現況以輔導協助。
  Objectives: The outbreak of the novel coronavirus pneumonia has caused economic turmoil and social unrest worldwide. Large-scale epidemic prevention measures have been implemented globally, and in-house isolation and quarantine strategies have resulted in the large-scale resignation of medical staff, thereby leading to a shortage of human resources. The change of career has caused great pressure and coping problems with the pandemic. With the increase in the diagnosis rate and the exhaustion of medical resources, researchers are encouraged to analyze the burden and experience of nursing staff caring for infected patients. We hope that this report will help in responding and adapting to the pressure and uncertainty faced by medical staff in the future. Methods: In this research, qualitative in-depth interviews were conducted. We collected the experiences of 10 nurses caring for patients infected with the coronavirus; analyzed the interview responses; and evaluated the nurses’ behavior, language, and nonverbal cues through interaction with them. Results: Based on a literature review and the interviewees’ experiences and feelings, four themes were identified as follows: “the past accumulated experience helps to gain momentum and fight the next course of the disease,” “colleague encouragement and support help medical staff to be persistent in their work,” “lack of medical resources and the difficulties faced by staff in the medical environment, stick to the end,” and “the changing number of confirmed cases encountered through a patient’s care journey.” Conclusions: The study findings can help nursing staff caring for patients infected with the novel coronavirus by providing a basis for understanding psychological pressure among nurses and adjusting the response protocol.
• 283-292
• 10.6288/TJPH.202106_40(3).110001

• Link 原著 Original Article
• 台灣版慢性病照護評估問卷之發展與驗證Development and validation of the Taiwanese Version of the Assessment of Chronic Illness Care questionnaire
• 黃紀諺、周盈邑、楊銘欽、董鈺琪
  Chi-Yen Huang, Ying-Yi Chou, Ming-Chin Yang, Yu-Chi Tung
• 慢性病照護評估、效度、信度、慢性病照護模式
  assessment of chronic illness care, validity, reliability, chronic care model
• 目標：慢性病照護評估（Assessment of Chronic Illness Care, ACIC）問卷為國際上常用於評估醫療機構慢性病照護之品質或整合程度，但尚未使用於台灣，故本研究目的為翻譯慢性病照護評估問卷，並驗證台灣版ACIC問卷，作為測量台灣慢性病照護品質之評估工具。方法：依世界衛生組織建議之問卷發展流程進行問卷翻譯，我們於2019年7月至2020年2月之間完成ACIC問卷翻譯，郵寄ACIC問卷給56家診所之所有377位醫療人員，並以內容效度指標值（content validity index, CVI）、驗證性因素分析（confirmatory factor analysis, CFA）及Cronbach's α進行信效度檢定。結果：有效問卷共251份，回收率66.6%。經檢測專家效度全數題目之CVI均達0.8以上，刪除原量表其中13題後，配適度指標為0.89，卡方自由度比為1.78，標準化均方根殘差值為0.04，及近似均方根誤差為0.06，驗證性因素分析結果為一可接受之模型。內在一致性檢定之Cronbach's α值為0.897-0.946，顯示題目間有內在一致性。結論：21題台灣版ACIC問卷具有效度和信度，可以作為評估台灣慢性病照護品質的工具。
  Objectives: The Assessment of Chronic Illness Care (ACIC) questionnaire is widely used to assess the quality or integration of services in medical institutions. However, it has not yet been used in Taiwan. Thus, this study translated the ACIC questionnaire and validated the Taiwanese version of this questionnaire to measure the quality of chronic care in Taiwan. Methods: The translation process was based on the World Health Organization’s “Process of Translation and Adaptation of Instruments.” We translated the ACIC questionnaire between July 2019 and February 2020 and distributed it by mail to 377 medical personnel employed at 56 clinics. The content validity index (CVI), confirmatory factor analysis (CFA), and Cronbach's α values were used to assess its reliability and validity. Results: The number of valid questionnaires returned was 251, and the response rate was 66.6%; the CVI was 0.8 or higher for all questions. After 13 items were eliminated, CFA revealed a favorable index of fit (0.89), with a chi-square to degree of freedom ratio, standardized root mean square residual, and root mean square error of approximation of= 1.78, 0.04, and 0.06, respectively. The Cronbach’s α values (0.897–0.946) indicated acceptable internal consistency. Conclusions: The 21-item Taiwanese version of the ACIC questionnaire has satisfactory validity and reliability and can be used to evaluate the quality of chronic care in Taiwan.
• 294-305
• 10.6288/TJPH.202106_40(3).109098

• Link 原著 Original Article
• 衛生所第二型糖尿病患加入糖尿病共同照護計畫後代謝指標的變化分析Changes to metabolic indices of patients who have type 2 diabetes and are included in the Diabetes Shared Care Program administered in a public health center in Taiwan
• 楊雅惠、王俊毅
  Ya-Hui Yang, Jiun-Yi Wang
• 糖尿病共同照護計畫、衛生所、第二型糖尿病、糖化血色素
  Diabetes Shared Care Program, public health center, type 2 diabetes mellitus, glycated hemoglobin (HbA1c)
• 目標：糖尿病醫療給付改善方案自2001年實施至今，文獻中探討衛生所執行糖尿病共同照護計畫的研究相當少。本研究以中部某衛生所的糖尿病共照計畫個案資料，分析患者加入糖尿病共照計畫後，代謝指標的長期變化。方法：以回溯性世代研究法進行資料收集及分析，擷取台灣某衛生所「糖尿病共同照護服務管理系統」2002年5月至2008年12月加入共照計畫的個案為研究對象，每位個案自初診後追蹤至多8年，平均追蹤6.2年。使用廣義估計方程式，分析患者加入糖尿病共照計畫後各項代謝指標的變化。結果：共133位納入分析。在前二年分析中，糖化血色素以第4季下降幅度最大（β=-0.41, p=0.003）；在長期8年的分析中，糖化血色素≥9%的比率，自初收案的28.6%，至第1年底及其後各年度均維持在20%以下。舒張壓在短期有顯著下降；長期而言，血壓控制良好的比率有逐年上升的趨勢。結論：衛生所推動糖尿病共照計畫，使就診病患能獲得良好的照護。加入共照計畫的患者，血糖及血壓的控制整體而言可獲得逐步改善。建議未來能持續招募糖尿病患加入共照計畫，以提升整體照護率及代謝指標之改善。
  Objectives: Taiwan established the Diabetes Shared Care Program (DSCP) in 2001, but few studies have discussed the DSCP’s implementation by public health centers (PHCs) in the community. Thus, this study aimed to analyze the changes to the metabolic indices of patients who had type 2 diabetes and joined the DSCP through a PHC in Central Taiwan. Methods: Participants were enrolled retrospectively from a database of outpatients who had diabetes mellitus and visited a PHC in Central Taiwan at any period between May 2002 and December 2008. After enrollment, the participants were tracked for up to 8 years, with the average follow-up period being 6.2 years. Due to the use of repeated measurements, generalized estimating equations were applied to evaluate the changes to the examined indices over time. Results: The data of 133 patients were analyzed. In the first 2 years of follow-up, HbA1c significantly decreased in the fourth quarter (β = −0.41, p = 0.003). For the 8-year long-term follow-up, the percentage of patients with HbA1c ≥ 9% decreased from 28.6% to 20% or lower in the years following DSCP intervention. The patients’ diastolic blood pressure significantly decreased in the short term. The percentage of patients with well-controlled blood pressure increased gradually in the long term. Conclusions: The DSCP implemented by PHCs provides a good quality of care, and it can help patients to continually improve their HbA1c and blood pressure. The DSCP should be promoted among patients with diabetes to improve their metabolic indices.
• 306-318
• 10.6288/TJPH.202106_40(3).110010

• Link 原著 Original Article
• 國人飲用含糖飲料盛行率與其相關疾病之全民健保醫療費用估計Prevalence of sugar-sweetened beverage consumption and estimated National Health Insurance–related medical expenditures among Taiwanese people
• 張雅惠、呂瑾立、徐宇慧、李岳蓁、黃乙芹、巫岑希、古鯉榕、李中一
  Ya-Hui Chang, Chin-Li Lu, Yuu-Hueih Hsu, Yueh-Chen Li, Yi-Chin Huang, Cherl Cy Moo, Li-Jung Elizabeth Ku, Chung-Yi Li
• 含糖飲料、全民健保資料庫、族群可歸因風險百分比、醫療費用、國民營養健康狀況變遷調查
  sugar-sweetened beverages, National Health Insurance, population attributable risk percentage, medical care costs, Taiwan Nutrition and Health Survey
• 目標：本研究旨在分析台灣民眾含糖飲料飲用盛行率，並計算族群可歸因風險百分比以估計民眾喝含糖飲料造成相關疾病醫療負擔情形。方法：本研究利用2013-2016年「國民營養健康狀況變遷調查」區分年齡別與性別，呈現含糖飲料飲用盛行率，並採用國外文獻中含糖飲料相關疾病之相對風險數值，計算族群可歸因風險百分比，爾後相乘2015-2017年全民健保資料庫中門診與住院健保相關疾病就醫費用，獲得我國民眾飲用含糖飲料所造成之醫療負擔。結果：10,443位民眾調查顯示，3-12歲有近4成的幼學童於最近一個月有喝市售含糖蔬果汁，而13-35歲的民眾9成7於最近一個月都有喝含糖飲料，36歲以上之民眾則約7成，且普遍男性喝含糖飲的比例比女性高。含糖飲料飲用造成相關疾病風險的部分，健保主診斷疾病醫療費用年均約為87億元（95%信賴區間為49-124億元），而主次診斷醫療費用年均約233億元（95%信賴區間為138-324億元）。結論：含糖飲料飲用盛行率有明顯的年齡差異，其中年輕世代含糖飲料飲用盛行率明顯較高。不過，因為本研究進行分析時所使用的部分參數援用國外數據，同時也未將含糖飲品與疾病之劑量反應關係納入計算，這對本研究結果的推論增加一些限制。但如何減少含糖飲料飲用過量，以降低民眾健康危害與相關醫療成本支出，仍是未來重要且迫切的健康政策課題。
  Objectives: To analyze the prevalence of sugar-sweetened beverage (SSB) consumption in Taiwan and estimate the population attributable risk percentage (PAR%) to evaluate the medical care burden of SSB consumption. Methods: The prevalence of SSB consumption was calculated by age and sex according to data from the Taiwan Nutrition and Health Survey collected between 2013 and 2016. The disease-specific relative risks of SSB consumption were determined by reviewing the literature. The medical care costs of diseases attributable to SSB intake were estimated by multiplying PAR% by average annual medical expenditures from 2015 to 2017 according to data in the National Health Insurance Research Database. Results: Among the 10,443 enrollees in this study, 40% of children aged 3–12 years reported consuming sugar-sweetened juice in the preceding month; for adults aged 13–35 and ≥36 years, who had consumed SSB, the relevant percentages were 97% and 70%, respectively. Men reported higher SSB consumption than women did. The average annual health insurance medical expenditure attributable this SSB overconsumption was NT$8.7–23.3 billion (95% confidence interval: NT$4.9–32.4 billion). Conclusions: We identified a distinct and elevated pattern in the prevalence of SSB consumption among young people. Although we extracted the disease risk from the literature and did not consider the dose–response relationship between SSB consumption and disease, the results clearly indicate that SSB overconsumption is related to disease incidence; the corresponding increase in medical care burden is a critical health policy concern.
• 319-331
• 10.6288/TJPH.202106_40(3).110023

• Link 實務 Public Health Practice
• 新型冠狀肺炎（COVID-19）「數位接觸者追蹤」之法律與倫理議題初探Legal and ethical issues of COVID-19 “Digital Contact Tracing” measures in Taiwan
• 黃于玲、羅承宗
  Yu-Ling Huang, Cheng-Chung Lo
• 新冠肺炎、數位接觸者追蹤、公衛監控、法律與倫理議題
  COVID-19, digital contact tracing, public health surveillance, legal and ethical issues
• 目標：新冠肺炎大流行為全世界帶來前所未有的挑戰。在有效治療藥物與疫苗研發成功之前，非藥物的介入方式（non-pharmaceutical interventions, NPIs）格外重要；其中，數位接觸者追蹤成為2020年全球重要防疫科技之一，台灣疫情指揮中心也使用多種接觸者追蹤措施，本文探究此新興公衛科技的執行、相關法律與倫理議題。方法：透過檢視衛福部官網、新聞報導、研究論文、法規、國際組織指引，本文類型化地呈現數位接觸者追蹤措施使用狀況以及其引發的法律與倫理議題、各方討論與回應。結果：台灣社會在此次疫情中確診、死亡人數皆遠低於其他國家，顯示合併使用多種防疫措施之成效，但也付出法律與倫理代價：電子藩籬、健保系統勾稽、電子足跡資料、簡訊措施皆欠缺法律明確性，也引發公私機構以超前部署之名，進行具倫理與科學有效性疑義的介入，並欠缺監督機制與公眾討論。結論：隱私、自由與防疫監控並非相互衝突的兩難選擇，讓新興數位技術成為防疫與公衛科技一環，除了資訊與生醫專業，也需要納入流行病學、公共衛生、法律、生醫科技倫理、社會科學等不同領域的專業，與相關公民團體，參與數位防疫科技的設計、使用、評估與監督。
  Objectives: COVID-19 has posed unprecedented challenges to governments and civil society worldwide. Before effective treatments and vaccines become available, nonpharmaceutical interventions (NPIs), including digital contact tracing technologies, are critical for delaying or controlling the spread of COVID-19. This paper investigates the practices, discussions, and legal and ethical issues of the contact tracing measures imposed in Taiwan during the COVID-19 pandemic. Methods: By analyzing official documents from the Ministry of Health and Welfare website, media reports, legal regulations, international organizations’ ethical guidelines, and research on contact tracing measures, this paper categorically presents the applications, effectiveness, and legal and ethical concerns of these measures in Taiwan. Results: Although the rates of confirmed cases and deaths from COVID-19 are low in Taiwan, the Electronic Fence of Surveillance, a digital contact tracing measure implemented by the National Health Command Center, was found to lack legal certainty. Some proactive deployments by public and private organizations that have used location-based services, the National Health Insurance system, and the center’s data on of the digital footprints of confirmed cases do not meet ethical and scientific validity standards. Oversight mechanisms have not been established, and public reflection has not been addressed. Conclusions: This paper argues that the choice of upholding individual privacy rights versus performing digital contact tracing is not binary. To make digital technologies part of measures against COVID-19, and future public health crises, it is crucial to include diverse experts not only of information technology and biomedicine, but also of epidemiology, public health, law, ethics, and social sciences, as well as civil organizations in the design, application, oversight, and evaluation of new public health technologies.
• 332-345
• 10.6288/TJPH.202106_40(3).109085

• Link 評論 Commentary
• 評論：照顧新型冠狀病毒性感染病人護理師之心路歷程 Commentary: Psychological process of caring for patients with Coronavirus infections by nurses
• 白香菊
  Hsiang-Chu Pai
• 無
  none
• 無
  none
• 293
• 10.6288/TJPH.202106_40(3).11000101