2卷1期

• Link 原著 Original Article
• 健康是由什麽造成的健康是由什麽造成的
• 金高德、楊志良
  金高德、楊志良
• 無
  none
• 無
  none
• 2 - 5
• 10.6288/JNPHARC1983-02-01-01

• Link 原著 Original Article
• 理想的醫療保健制度之我見理想的醫療保健制度之我見
• 江東亮
  江東亮
• 無
  none
• 無
  none
• 6 - 12
• 10.6288/JNPHARC1983-02-01-02

• Link 原著 Original Article
• 垂死病人問題之探討 垂死病人問題之探討
• 王國裕
  王國裕
• 無
  none
• 無
  none
• 13 - 21
• 10.6288/JNPHARC1983-02-01-03

• Link 原著 Original Article
• 衛生人力供需分析常用變數之探討衛生人力供需分析常用變數之探討
• 藍忠孚 、李玉春
  藍忠孚 、李玉春
• 無
  none
• 無
  none
• 22 - 33
• 10.6288/JNPHARC1983-02-01-04

• Link 原著 Original Article
• 區域醫療計劃之概念與架構區域醫療計劃之概念與架構
• 藍忠孚、李玉春
  藍忠孚、李玉春
• 無
  none
• 為徹底解決當前的醫療保健問題，政府曾提出區域性醫療網的構想，其目的在透過分級的醫療、轉診制度以改善醫療品質、降低醫療成本，增加醫療的可近性(accessibility)，避免醫療設備的重覆投資和浪費，促進醫療設施經營的合理化，以期提供民?繼續性、綜合性的醫療服務(Continuous Comprehensive Care)。 區域性醫療網的基本架構在行政院衛生署「公立醫院業務改革設計」研究報告中已有初步的規劃?，但由於區域性醫療網涉及廣泛，必須搜集許多實際的背景資料，才可能做進一步的規劃。本文音在闡述區域計劃之概念與架構，以哄學者和行政人員在規劃時，作為參考。
  無none
• 34 - 41
• 10.6288/JNPHARC1983-02-01-05

• Link 原著 Original Article
• 嬰兒猝死症之流行病學Epidemiology of Sudden Infant Death Syndrome
• Marilyn Farber ； 張森和
  Marilyn Farber, Shen-Ho Chang
• 無
  none
• 美國全年每一千新生嬰兒約有兩位死於猝死症，或稱「搖籃死」，該症狀之死亡原因仍然未知。雖然我國每年出生嬰兒中死於該症狀之新生兒，尚無確實統計資料，但此症狀之發生率無地域之分，任何嬰兒對該症狀也無免疫作用，而且嬰兒死亡之前，無顯著的致命病徵或異常，因此，嬰兒往往在母親懷抱中、搖籃裡，或前往醫院途中意外地死亡。最重要的是此症狀多發生在一歲以下的新生嬰兒，其發生亦甚?意外突然，根本無法事先預防。 如果照美國千分之二的發生率推算，民國七十年我國四十萬新生幼兒中，估計約有800人死於嬰兒猝死症。因此，本篇報告就流行病學方法對此症狀之定義、發生率、其在嬰兒死亡率中所佔之份量，以及導致嬰兒死亡之危險因素加以分析探討，並就其他國家現有資料予以分析比較，希望藉本篇論文揭發之事實，喚起民?與衛生人員的認識及警惕，進而減少此不幸事件之發生。
  Although about' 2 per 1,000 live births die of the sudden infant death syndrome (SIDS) or ”cost death” in the United States, its etiology remains unknown. No data show the number of such deaths which occur anually among the newborns in Taiwan, but SIDS takes place everywhere in the world. No baby is immune from SIDS. Nevertheless, no fatal symptoms or disorders are detected before its .death. There fore, unexpected death occurs occasionally while the baby is held in the arms of its mother, in cribs, or on the way to hospitals. First of all, death occurs under one year of age and ' is hardly prevented because of its unexpected and inexplicable nature. If an incidence rate of SIDS, 2 per 1,000 live births in the United States, is applied to the 1981 newborns of about 400,000, it is estimated thaat nearly 800 deaths from SIDS occur annually in Taiwan. Therefore, this paper will be used to describe epidemiologically the definition, incidence, the significance of the problem, and the risk factors related to SIDS. Moreover, a comparison is made among SIDS data from various countries. The purpose of this ' paper is to inform the public and health workers of SIDS and possibly prevent the occurrence of the tragic event.
• 42 - 62
• 10.6288/JNPHARC1983-02-01-06

• Link 原著 Original Article
• 四湖鄕民衆對小兒痲痺預防接種知識態度實行之調查研究A Study of Knowledge, Attitude and Practice of Shuhu Residents on Poliomyelitis Vaccination
• 江昭興、季瑋珠、陳建仁、楊志良
  Chao-Hsing Chiang, Wei-Chu Chi, Chien-Jen Chen, Chih-Liang Yaung
• 無
  none
• 為了探討民?在預防接種的知識態度與實行上造成預防接種率降低的因素，在民國七十二年二月初調查了四湖鄉139位孩童照顧者，進行了各項影響預防接種接受率因素統計分析。發現空戶率甚高，一般社會經濟地位甚低。「孩童照顧者對小兒痳痹的預防知識」顯然受「孩童照顧者之教育程度」、「家庭執會經濟地位」及「鄰居是否有人羅病」三者影響。「接種是否完全」顯然受「照顧者教育程度」、「家庭文化程度」及「家庭求醫偏好」三者影響。民?對預防接種通知方式的建議，顯示「社區執會經濟地位」愈高愈易使用「衛生所通知或手冊」的文字方式。反之，農漁民社區較依賴衛生所人員深入社區的口頭通知。民?對於通知次數的建議顯示「照顧都預防知識」愈低、「社區社會經濟地位」愈低、「照顧者年齡」愈高，愈需要衛生所每一次的通知。「社區社會經濟地位」愈低、「照顧者教育程度」愈低，愈傾向於建議「深入社區」的服務。本研究顯示因地制宜的衛生服務，始可奏效。
  In order to investigate the factors which determined the knowledge, attitude and practice of poliomyelitis vaccination, a study was conducted on 139 baby caretakers in Fefruary 1983. The data was analyzed with multivariate regression and correlation techniques, The absent rate, the proportion of population who do not live on the address they have registered, is rather high. In addition, the socioeconomic status of the population is generally low. Both of the factors resulted in a low vaccination rate. The vaccination knowledge of baby caretakers is highly correlated with their educational levels, socioeconomic status and the morbidity of poliomyelitis among neighbors. Vaccination rate is strongly correlated with the baby caretaker's educational status, cultural background of the family and the pat tern of seeking medical services in that paticular family. Results also indicated that people with higher socioeconomic status prefer to have a formal literal vaccination notification rather than a verbal, face to face communication which is required by those less privileged. The baby caretakers with poorer vaccination knowledge, lower socioeconomic status and older age prefer to be noticed each time of vaccination arid to be vaccinated at the front of their doors instead of going to health stations.
• 63 - 83
• 10.6288/JNPHARC1983-02-01-07

• Link 原著 Original Article
• 黃豆製品及肉乾類微生物汚染之調查研究Amicrobiological Study of Processed Bean Food and Dried Meat
• 陳小梨、趙秀雄、曾惠中、林春蓮
  Shou-Li Chen, Shiu-Hsiung Chao, Huei-Chung Tsen, Chuen-Lian Lin
• 無
  none
• 本研究之微生物檢查，指示菌部份以檢查總生菌數及糞生大腸菌群；致病菌則為凝固?正反應之金黃色葡萄球菌及沙門氏捍菌。檢體共計296件，分別由台北市六個市場採樣。其中111件其總生菌數大於10^6/克，佔37.5%。107件檢體其糞生大腸菌群為正反應，佔36.14%。致病菌中凝固酸正反應的金黃色葡萄球菌及沙門氏捍菌的檢查，在本研究中均未發現。 我們的結果均未發現含有引人生病的致病菌，但約有30~40%樣本其指示菌含量較高，表示衛生情況欠佳。故希望衛生當局，販賣商及消費者大眾重視食品販賣方式，謀求改進，藉以提高食品的品質。
  A total of 296 food samples were examined by microbiological technique including total bacterial counts, total Coli form, Fungi & Yeasts, Coagulase positive for Staphylococcus aureus and Salmonella. Of the 296 sample s examined, 111 had total bacterial counts over 10' cells per gram (37.5%). Fecal Coliform were present in 107 samples (36.14%). Neither Staphylococcus aureus nor Salmonella was found in the samples examined. Our results indicated that there were no pathogenic bacteria being detected in this study but relatively high bacterial counts in 30-40 % of the samples examined. It appeared that the microbial quality control of food selling especially in sanitary condition was not good at all. In order to have good food for human beings, health authorities, food sellers and consumers should pay an attention to the methods for the management for food selling.
• 84 - 94
• 10.6288/JNPHARC1983-02-01-08

• Link 原著 Original Article
• 烏腳病地區居民醫療行爲之研究A Study on Illness Behauior in Black Foot Disease Area
• 蔡淑芬
  Su-Fen Tsai
• 無
  none
• 為探討民?之醫療需要及需求，明瞭影響醫療行為之因素，以台南學甲及嘉義布袋為研究對象展開調查。先以立意取樣抽出烏?病最多之里，再以系統抽樣抽出所需之戶數。訪視完成率為76.56 %，共訪視898戶，調查4315人“所得到之結果為： 一、受訪區之醫療需要平均每人每年自覺患病1.4次。傷病罹患率女性高於男性，且在六歲以下及六十五歲以上產生兩個高峰。自覺症狀以呼吸系疾病者為最多。 二、受訪區之醫療需求乎均每人每年求醫3次，其中，以西醫最多，其次是自行至西藥房購藥。 三、利用路徑分新方法求得影響醫療行為之最重要因素，其中：不考慮價格及距離因素、考慮效果是否較佳、認為社區民?最常利用西醫以及傷病者年齡較小者比較傾向利用西醫；而考慮價錢是否較低及距離是否較近，且不考慮效果是否較佳者比較傾向利用西藥房。
  In order to understand the need and the demand of medical care, and the determinants of the illness behavior in the black foot disease areas a systematic sample of 898 households or 4315 persons in Hsuechia Chen of Tainan Hsein and Putai Chen of Chiayi Hsein were interviewed. The main findings are as following: 1. The self-councious health need was 1.4 times per person per year by average, and that of female was higher than that of male. The illness of respiratory system were most common. 2. The demand of medical care was 3 times per person per year by average. When those people were sick, to go to modern physicians for medical care was the most popular way; to go to drug stores was the second. 3. By the method of path analysis, the results indicate that that the first choice of medical care from modern physician or drug store when those people were sick was determined by such factors as the cost, the effectiveness and the distance to medical resources.
• 95 - 113
• 10.6288/JNPHARC1983-02-01-09