19卷1期

• Link 公衛論壇 Public Health Forum
• 全球化趨勢下台灣公共衛生的挑戰與轉機全球化趨勢下台灣公共衛生的挑戰與轉機
• 石曜堂
  Yaw-Tang Shih
• 無
  none
• 無
  none
• 1-2
• 10.6288/CJPH2000-19-01-01

• Link 公衛論壇 Public Health Forum
• 全球化趨勢下台灣公衛的挑戰與轉機：政治經濟與健康全球化趨勢下台灣公衛的挑戰與轉機：政治經濟與健康
• 胡勝正
  Sheng-Cheng Hu
• 無
  none
• 無
  none
• 3-4
• 10.6288/CJPH2000-19-01-02

• Link 公衛論壇 Public Health Forum
• 全球化趨勢與婦女健康全球化趨勢與婦女健康
• 張玨
  Chueh Chang
• 無
  none
• 無
  none
• 5-9
• 10.6288/CJPH2000-19-01-03

• Link 公衛論壇 Public Health Forum
• 全球化趨勢台灣公共衛生界所面臨的問題與挑戰－傳染病的防制全球化趨勢台灣公共衛生界所面臨的問題與挑戰－傳染病的防制
• 何美鄉
  Mei-Shang Ho
• 無
  none
• 無
  none
• 10-11
• 10.6288/CJPH2000-19-01-04

• Link 公衛論壇 Public Health Forum
• 全球化與公共衛生界的自省全球化與公共衛生界的自省
• 陳美霞
  Meei-Shia Chen
• 無
  none
• 無
  none
• 12-15
• 10.6288/CJPH2000-19-01-05

• Link 公衛論壇 Public Health Forum
• 高血壓才是第一大死因高血壓才是第一大死因
• 宋鴻樟
  Fung-Chang Sung
• 無
  none
• 無
  none
• 16-19
• 10.6288/CJPH2000-19-01-06

• Link 綜論 Review Article
• 全球環境變遷對公共衛生衝擊之評析Assessment of Vulnerability of Public Health to the Impact of Global Environmental Change
• 萬國華、王根樹、李芝珊、王秋森
  Gow-Hwa Wan, Gen-Shuh Wang, Chih-Shan Li, Chiu-Sen Wang
• 全球環境變遷 ； 氣候變遷 ； 公共衛生
  Global change ; Public health ; Vulnerability
• 本研究主要目的在透過文獻回顧之形式蒐集相關文獻，探討全球環境變遷與氣候變遷對公共衛生可能造成之衝擊，並嘗試提出因應對策以供政府施政之參考。針對全球氣候變遷及環境變遷對公共衛生之衝擊，由於無法以實證之方式探討相關效應，僅能以文獻回顧之方式探討氣候及環境變遷對人體健康所產生之影響。文獻顯示環境變遷之直接衝擊主要在熱危，間接衝擊則涵蓋病媒導致之傳染病、紫外線導致之皮膚病變、環境污染導致之過敏、氣喘等疾病盛行率之增加等。但由於生態系受環境及氣候影響所產生之效應不易確定，加上目前相關領域之研究成果無法針對未來五十年生態系之變化作一預測，以致無法確實評估氣候及環境變遷對人體健康所可能產生之影響。
  Critical literature review was used in this study to collect the information concerning the potential ompact of global environmental changes on public health. Although the potential influence of global warming on public health has been a subject of study for decades, no clear conclusions have been made. The vulnerability of public health to environmental changes is hypothetical until the degree of changes is known. The global environment changes may have direct or indirect effects on public health. The main direct effects are heat stroke and heat exhaustion. The indirect effects from global changes include changes in the pattern and trends of vectorborne diseases from unusual distribution of vectors, increased skin diseases from ultraviolet light, and increased cases of allerty and asthma from environmental pollution. However, due to uncertainty concerning the impact of global climate changes on public health, it will be difficult to justify trends and correlation between observed health changes and environmental changes.
• 20 - 32
• 10.6288/CJPH2000-19-01-07

• Link 原著 Original Article
• 青少年體型意識與節制飲食行為之研究Study of Body Image and Dietary Restraint in Adolescence
• 林宜親、林薇
  Yi-Chin Lin, Wei Lin
• 青少年 ； 體型 ； 體型意識 ； 節制飲食行為
  adolescence ; body figure ; body image ; dietary restraint
• 本研究主要在瞭解青少年體型意識與節制飲食行為。方法：研究對象為8所國小六年級及19所國中一、二、三年級學生，共822人。結果：不論實際體型為何，多數青少男期望正常體型，多數青少女期望較瘦體型。影響青少年體型意識主要因素為體型受嘲笑經驗、是否崇拜偶像身材、未來想從事與體型有關之活動。實際體型過重、自覺變「瘦」壓力越大者、會崇拜偶像身材者，特別是青少女，越容易有體型意識困擾。個人對過重關注之程度為青少年是否採取節制飲食行為之重要因素。結論：當青少年實際過重且自覺過重、希望減少體重越多、體型嘲笑經驗越多者，傾向高度節制飲食。過度外表取向、自覺體重過重、期望體型變瘦之青少女，會藉高度節制飲食來降低或維持體重，以達到理想體型；她們較可能發生飲食失控，並可能發展為異常飲食行為者。
  The purpose of this study is to understand adolescents’body image and dietary restraint. Methods: A total of 822 students from 19 Junior high schools and 8 elementary schools completed a self-administered questionnaire. Results: In spite of actual body figure, the majority of adolescent boys expected a normal body figure, and adolescent girls expected a slim body figure. Being teased, admiring the figure of models, and interest in a career related to the figure had significant influences on adolescents’body image. Body image disturbances were more likely to occur in overweight adolescents, especially girls and those who perceived pressure to be thin on who admired an idol’s body figure. A preoccupation with being overweight was a significant factor in dietary restraint. Conclusions: Overweight adolescents who perceived themselves as fat, wanted to lose more weight or had experienced more teasing, had a higher degree of restrained eating. Adolescent girls who were overconcerned with body shape and weight perceived them selves as fat, and expected to be thin tended to have a higher degree of dietary restraint in order to maintain or achieve the ideal figure. They are at risk of disinhibition and more likely to become eating disorders in the future.
• 33 - 41
• 10.6288/CJPH2000-19-01-08

• Link 原著 Original Article
• 台灣地區在校青少年嚼檳榔的流行病學研究Epidemiology of Betel Nut Chewing among Adolescent Students in Taiwan
• 劉美媛、周碧瑟
  Meei-Yuan Liou, Pesus Chou
• 嚼檳榔；抽菸；飲酒
  betel nut chewing ; cigarette smoking ; alcohol drinking
• 近年來隨著種植檳榔的高獲利誘惑，嚼檳榔者大幅增加，危健康。本研究的主要目的在探討台灣地區在校青少年的嚼檳榔盛行率，以及嚼檳榔與學校、家庭狀況、親人不良衛生習慣等的相關情形。方法：本研究以結構性問卷進行資料收集，以二階段隨機抽樣方法抽取研究樣本。第一階段依台灣地區國中、高中、高職、專校（五專的一至三年級）等學校類別，按學生人數比例，抽出51所國中、12所高中、27所高職、10所專科學校共100所校，第二階段再於每校各年級隨機抽取一個班級，全班列入研究對象，共計12,703位學生，完成問卷數12,222份，完成率為96.2%。結果：在校青少年的嚼檳榔盛行率為11.5%，男生19.1%，女生3.7%，年齡越大，盛行率越高。其中高職生最高15.5%，高中生最低6.7%。5.7%的受測者同時有嚼檳榔、抽菸，飲酒的行為。學校因素上的課業情形、出席情形、工作打工狀況、在校曾經被體罰過、參加幫派等，家庭因素中之單親家庭結構型態，以及父母、兄弟姊妹嚼檳榔，和玩電動、飆車等，都是與嚼檳榔有關的因素。結論：瞭解嚼檳榔的性別、年齡差異及其他相關因素，將可作為青少年的檳榔防治教育之參考。
  Objectives: The purposes of this study were (1) to estimate the prevalence of betel nut chewing among adolescents in Taiwan, (2) to survey the possible related factors for betel nut chewing. Methods: Subjects were selected through a two-stage random sampling procedure. In the first stage, the strata were based on the type of school: middle school, high school vocational school and junior college (first 3 years only). A total of 100 schools were sampled. In the second stage, the strata were based on grade: on class each representing the first , second, and third grades were randomly selected from each type of school. Of the 12,703 eligible students, 12,222 participated (96.2%). Results: The prevalence of betel nut chewing was 11.5%, and it was much higher in male than in female students (19.1% vs. 3.7%). The prevalence was highest in vocational schools (15.5%), followed by junior colleges (12.7%), junior high schools(10.2%), and high schools (6.7%). Of the students, 5.7% had the habits of cigarette smoking, alcohol drinking, and betel nut chewing. Factors considered possibly related to betel-nut chewing included (1) school factors: academic performance, absenteeism, working part-time while as a student, corporal punishment at school, and gang membership; (2)family factors: family structure and cigarette, alcohol, and betel-nut use by parents, brothers, and sisters, and (3)other factors, such as playing video games and car motorcycle racing. Conclusions: An understanding of gender and age differences and other factors of betel nut chewing can provide guidelines for effective interventions.
• 42 - 49
• 10.6288/CJPH2000-19-01-09

• Link 原著 Original Article
• 南部社區老人憂鬱症狀盛行率及相關因素研究Prevalence and Correlates of Depressive Symptoms Among Community-dwelling Elderly in Southern Taiwan
• 呂淑妤、林宗義
  Shu-Yu Lyu, Tsung-Yi Lin
• 老人 ； 憂鬱症狀 ； 家庭支持
  the elderly ; depressive symptoms ; family support
• 憂鬱為老人常見之心理衛生問題.本研究之目的在於調查南部社區老人之憂鬱症狀盛行率及相關因素.方法：研究對象係以1994年高雄市某一社區長期照護研究[1]之樣本群（N=1,221）中，依樣本之心理衛生狀況良好與否，分層隨機抽樣210位老人（n1=n2=105）進行面對面之問卷訪視；研究期間為1995年1月至3月。憂鬱症狀之測量主要依據美國流行病學研究中心之憂鬱量表（Center for Epidemiologic Studies Depression Scale, CES-D）。結果：研究結果顯示，如以CES-D量表得分大於或等於16做為具有憂鬱症狀之標準，則樣本之憂鬱症狀盛行率為31.3%，CES-D量表平均得分為13.21，標準差10.74。在男性和女性方面的盛行率分別為22.0%與39.6%；而在心理衛生狀況較佳及較差的兩組樣本，其盛行率分別為23.0%與65.3%。另依據邏輯迴歸分析的結果，憂鬱症狀之相關因素包括：年齡、性別、受訪前一年心理衛生狀況、身體健康狀況，以及家庭支持。結論：本研究確認人口學因素、社會因素與身體健康狀況都是影響憂鬱症狀的相關因素。
  Depression is recognized as one of the major mental health problems among the elderly. The purpose of this study was to investigate the prevalence and correlates of depressive symptoms among community-dwelling elderly in southern Taiwan. Methods: This study involved selecting subjects from a group of elderly who participated in a long-term care survey (N=1,221) in 1994[1]. In total, 210 subjects (n1=n2=105) were recruited according to their mental health status. Data for this study were collected by face-to-face interviews between January and March 1995. The symptoms of depression were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: The mean score of the CES-D was 13.21 with a standard deviation 10.74. Using a cut-off point of greater than or equal to 16 on the CES-D score yielded a depression rate of 39.6% for women and 22.0% for men, with an overall depression rate in this study population of 31.3%. The prevalence of depressive symptoms was 23.0% from the group with “good” mental health status, and 65.3% from those with “poor” mental health status. Results of the logistic regression analysis showed that age, gender, prior mental health status, physical health status, and family support were significant correlates for depressive symptoms. Conclusions: This study confirmed that demographic factors, social factors, and physical health were correlated with depression.
• 50 - 60
• 10.6288/CJPH2000-19-01-10