| 研究生: |
王月伶 Wang, Yueh-Ling |
|---|---|
| 論文名稱: |
台灣地區青少年住院主要健康問題之長期趨勢分析 The trend analysis of the major health problems among hospitalized Taiwanese adolescents |
| 指導教授: |
王琪珍
Wang, Chin-Jean 王文玲 Wang, Wenling |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 護理學系 Department of Nursing |
| 論文出版年: | 2003 |
| 畢業學年度: | 91 |
| 語文別: | 中文 |
| 論文頁數: | 117 |
| 中文關鍵詞: | 全民健康保險研究資料庫 、健康問題 、青少年 |
| 外文關鍵詞: | National Health Insurance Database, health problem, adolescence |
| 相關次數: | 點閱:153 下載:25 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
本研究旨在探討民國85-90年台灣地區10-19歲青少年住院主要健康問題與其長期趨勢,資料源自「全民健康保險研究資料庫」之「住院醫療費用清單明細檔」,為經國家衛生研究院5%之系統抽樣樣本。應用SPSS 10.0中文版進行資料處理及分析,藉由相對危險性的計算瞭解主要健康問題各年趨勢變化,並藉由Extended Mantel-Haenszel test進行趨勢檢定。
研究發現,不同年齡層青少年男女住院之主要健康問題具有差異。10-14歲青少年男女與15-19歲男性青少年住院主要健康問題,集中於損傷中毒、消化系統疾病與呼吸系統疾病三診斷類別;而15-19歲青少女則為妊娠生產產褥期併發症、損傷中毒與消化系統疾病。其中,損傷中毒與妊娠生產產褥期併發症各年住院之相對危險性,隨時間增加而逐年下降;呼吸系統疾病住院者,則具上升趨勢。機動車交通事故,為青少年損傷中毒類別住院主要外因;自然生產、懷孕與分娩其它照護適應症,為青少年妊娠生產產褥期併發症類別之住院主要診斷細項。此外,急性呼吸道感染與闌尾炎,則分別為青少年呼吸系統疾病及消化系統疾病住院主要診斷項目。
鑑於本研究結果發現青少年住院之診斷特性,具有性別及年齡層分布之差異。建議學校健康工作之防治重點,必須納入呼吸系統疾病與消化系統疾病的防範;創新青少年損傷中毒與妊娠生產產褥期併發症的介入措施並且落實成果評量,以作為未來青少年健康服務、教學、研究與政策擬定參考。
Purpose:To analyze the major health problems and trends among hospitalized Taiwanese adolescents, aged 10-19 years, from 1996 to 2001.
Methods: A retrospective study was used. Samples were selected from the files of “Inpatient expenditures by admissions” in the “National Health Insurance Research Database.” Systematic sampling was utilized. The sample was comprised of 5% of the hospitalized population as determined by the National Health Research Institutes in their data collection. The software of SPSSâ 10.1 for Windows was used for data management and statistics. Proportional rates were presented in ranking the diagnoses categories for each year. The rate ratio showed the relative risks of the major diagnosis categories of hospitalization from 1996 to 2001, and the extended Mantel-Haenszel test was used to examine the relative risk trend of each major diagnosis.
Findings:Adolescents had age and gender differences among hospitalized diagnoses categories. Injury and poisoning; digestive system diseases; and respiratory system diseases were the top three hospitalized diagnoses categories in male and female adolescents (aged 10-14); as well as in male adolescents, aged 15-19. Pregnancy related diagnoses were the major diagnoses category in female adolescents, aged 15-19. The relative risk of injury and poisoning and Pregnancy related diagnoses declined each year, while the relative risk of the respiratory system diseases and digestive system diseases significantly increased each year. The majority of injury and poisoning were due to motor vehicle traffic accidents and the majority of pregnancy related diagnoses were due to normal delivery & other indications for care in pregnancy, labor, and delivery. Appendicitis was the top diagnosis of digestive system diseases and acute respiratory infections were the leading diagnoses of respiratory system diseases.
Conclusions: The characteristics of major health problems were different among both age and gender variables in hospitalized adolescents. Adolescent health promotion programs and policies toward adolescent male, aged 10-19, should focus on injury and poisoning. Respective programs for females, aged 15-19, should emphasis on injury and poisoning as well as pregnancy related diagnoses. All health promotion programs and policies should effectively provide the respective services and measure the outcome efficiently.
中文參考資料
刁冠宇、朱志純(1997)•兒童闌尾炎•國防醫學,25(1),78-83。
中央健康保險局(2002,8月25日)‧醫事機構專區‧台灣衛生網路‧取自http://www.nhi.gov.tw/02hospital/hospital 7.htm
尹長生、李耀泰、趙德彰、詹景全(1999)‧花蓮少女懷孕之身心問題探討‧Chinese Medical Journal(Taipei),62(7),430-429。
內政部兒童局(2002,4月4日)‧法規查詢‧內政部網站‧取自http://www.cbi.gov.tw/law/law.asp
王文玲(2000)‧台灣安全帽立法後對頭部外傷的成效評估‧未發表的碩士論文,台北:台北醫學院。
王國川(1997).應用健康信念模式預測青少年搭機車戴安全帽之行為意向與行為•衛生教育雜誌,17,37-49。
王國川(1998)‧台灣地區青少年非致命性事故傷害之流行病學調查‧高雄醫學科學雜誌,14(6),348-356。
王國川(1999).青少年搭機車戴安全帽行為之預測—理性行動理論之應用與延伸•教育與心理研究,22,41-60。
交通部(2002,8月8日)‧法規檢索,電子公路監理網‧取自http://www.mvdis.gov.tw/index.htm
交通部統計處(2003,01月8日)‧台閩地區道路交通事故特性分析,統計專題分析‧取自 www.motc.gov.tw/service/index.htm
江淑娥(1997)‧青少年騎機車之冒險行為‧未發表的碩士論文,台北:國防醫學院。
行政院內政部(2002,8月8日)‧統計資料查詢,戶役政為民服務公用資料庫‧取自http://www.ris.gov.tw/
行政院婦幼衛生研究所(2000)‧婦幼衛生之主要統計‧台北:作者。
行政院衛生署(2002a,4月4日)‧衛生統計資訊網‧台灣衛生網路‧取自http://www.doh.gov.tw/statistic/index.htm
行政院衛生署(2002b)•民國89年全民健康保險醫療統計年報,台北:作者。
吳玉萍(1998a)‧氣喘學生與健康學生之生活適應研究-以宜蘭縣礁溪鄉為例‧未發表的碩士論文,台北:台灣師範大學。
吳肖琪(1998b)‧青少年的健康與安全‧於行政院青年輔導委員會編著,青少年白皮書(pp.67-106)‧台北:行政院青年輔導委員會。
呂育凱(1998)‧低齡孕婦不良生育結果之研究—配合懷孕週數,探討低出生體重與妊娠低出生體重‧未發表的碩士論文,台北:國立陽明大學。
李孟智(1998)‧青少女之生育問題.中華衛誌,17(5),381-387。
李俊德(2001)•台灣地區青少年保健門診病例之分析及其健康問題改善之相關因素•未發表的碩士論文,台中:中山醫學院。
李燕鳴(1994).花蓮地區機動車傷害事故描述性流行病學調查.慈濟醫學,10(3),211-219。
李燕鳴(1998b).花蓮市高中生之性知識、態度和行為調查.慈濟醫學,4(2),63-72。
周書正(1999).台中二中學生之肥胖程度與血壓狀況之分析.中二中學報,3,164-179。
林正介、賴明美、劉秋松、李采娟(1998).台中市學童肥胖盛行率之分析:不同篩選指標的比較.中華民國家庭醫學雜誌,8(3),134-143。
林宇璿、林惠生(2002,10月26日)•疾病狀態與疾病盛行率•台灣衛生網路‧取自http://www.bhp.doh.gov.tw/people/people-index.htm
林惠生(2002,12月12日)‧台灣地區未成年生育婦女保健狀況初探‧台灣衛生網路‧取自http://www.young.gov.tw/index2.htm
林惠生、林淑慧(1997)‧台灣地區縣市別在校未成年青少年性知識、態度與行為城鄉間之比較‧台中:台灣省家庭計畫研究所。
林齊宣、陳哲雄(1994)•急性闌尾炎—427例報導•中華民國外科醫學會雜誌,27(3),2366-2372。
林蕓蕓(1993).大學生騎摩托車者的特性、意外事故與意外險.公共衛生19(4),404-415。
胡淑貞、林坤松(2001)‧青少年校園暴力盛行率及危險因素研究:以台南市國中為例‧學校衛生,38,32-55。
唐維良、袁至仁(1991)‧兒童之消化性潰瘍‧國防醫學,13(4),394-396。
宴涵文、林燕卿、張利中(1998)‧青少年婚前性行為及其趨勢之探討‧台灣性學學刊,4(2),1-14。
國民健康局(2002,6月10日)‧青少年保健業務工作‧台灣衛生網路‧取自http://www.bhp.doh.gov.tw/index-children.htm
國家衛生研究院(2001)‧全民健康保險學術資料庫譯碼簿‧台北:作者。
國家衛生研究院(2002,3月5日)‧全民健康保險研究資料庫,台灣衛生網路‧取自 http://www.nhri.org.tw/nhird/
張富琴(2001)‧台北市高中生危害健康行為之研究‧未發表的碩士論文,台北:台灣師範大學。
教育部(2002,8月8日)‧健康服務‧台灣教育學術網路‧取自http://www.edu.tw
郭家英(1998)‧台灣地區強制騎乘機車戴安全帽支立法對機車事故頭部外傷防制之影響‧未發表的碩士論文,台北:台北醫學院。
陳哲喜、林惠生、劉怡文(2002,10月26日)•國人健康行為初探•台灣衛生網路‧取自http://www.bhp.doh.gov.tw/people/people-index.htm
陳靜敏(1997)‧北市某國中學生脊柱側彎盛行率之調查研究‧醫學研究,18(3),171-181。
傅瓊瑤、陸振翮、吳欣梅、王銘賢、陳淑貞(1999)‧青少女懷孕發生低出生體重與早產的危險性探討‧中華公共衛生雜誌,18(3),228-234。
楊浩然(2002)‧青少年憂鬱疾患及憂鬱症狀之追蹤研究‧未發表的碩士論文,台北:台灣大學。
廖梅珍、夏萍 回(1999)‧青少年產婦母性角色的經驗‧護理研究,7(5),435-444。
劉秋松、施浤彰、賴世偉、賴明美、李采娟、林正介(1998).台中市學齡兒童及青少年心血管疾病危險因素之流行病學研究.中台灣醫學雜誌,3,237-244。
劉貴雲(1994)‧機動車事故傷害流行病學之探討.學校衛生,24,38-49。
Arlene & Suzanne(1996/1999). Luckmann’s Core Principles and Practice of Medical-Surgical Nursing. 鄭素月譯‧胃部疾病病人之護理‧載於盧美秀總校閱,拉克曼內外科護理學(頁1331-1332)‧台北:華杏。
鍾蝶起、嚴建藏、吳慧美、王月珠(1996)‧高雄市青少年保健門診個案性知識與醫療需求之調查研究‧高雄醫學雜誌,12,174-182。
魏榮男(2002)‧台灣兒童與青少年糖尿病流行病學研究‧未發表的碩士論文,台北:台灣大學。
西文參考資料
Billingham, K. A. (1982). Adolescent development. In K. A. Billingham (Ed.), Developmental psychology for the health care professions: Part 1--Prenatal through adolescent development (pp. 107-142). Colorado: Westview Press.
Blum, R. W., McNeely, C., & Nonnemaker, J. (2002). Vulnerability, risk, and protection. Journal of Adolescenct Health, 31(1S), 28-39.
Chie, W. C. (2000). Height and weight change across menarche of school girls with early menarche. Arch Pediatric Adolescent Medicine, 154(9), 880-884.
Cronau, H., & Brown, R. T. (1998). Growth and development: Physical, mental, and social aspects. Adolescent Medicine, 25(1), 23-47.
English, A., Kapphahn, C., Perkins, J., & Wibbelsman, C. J. (1998). Meeting the health care needs of adolescents in managed care: A background paper. Journal of Adolescent Health, 22(4), 278-292.
Fischhoff, B., & Willis, H. (2002). Adolescent vulnerability: Measurement and priority setting. Journal of Adolescenct Health, 31(Suppl. 1), 58-75.
Kao, C. C., See, L. C., Yan, D. C., Ou, L. C., & Haung, J. L. (2001). Time trends and seasonal variations in hospital admissions for childhood asthma in Taiwan from 1990 to 1998. Asian Pacific Journal of Allergy and Immunology, 19, 63-68.
Kipke, M. D. (1999). Synthesis of studies on Adolescence. Washington, D. C.: National Academy Press.
Lee, M. C., Suhng, L. A., Lu, T. H., & Chou, M. C. (1998). Association of parental characteristics with adverse outcomes of adolescent pregnancy. Family Practice, 15(4), 336-342.
Lee, M. C., Liao, C. F., Lee, S. H., Lu, T. H., & Chou, M. C. (1997). Characteristics of adolescent patients and their health problems at an adolescent health clinic. Kaohsiung Journal of Medical Sciences, 13(9), 548-555.
Lin, M. R., Hwang, H. F., & Kuo, N. W. (2001). Crash severity, injury patterns, and helmet use in adolescent motorcycle riders. The Journal of Trauma: Injury, Infection, and Critical Care, 50(1), 24-30.
Lin, R. S., Sung, F. C., Huang, S. L., Gou, Y. L., Ko, Y. C., Gou, H. W., & Shaw, C. K. (2001). Role of urbanization and air pollution in adolescent asthma: A mass screening in Taiwan. Journal of the Formosan Medical Association, 100(10), 649-655.
Schlesselman, J. J. (1982). Basic methods of analysis. In J. J. Schlesselman (Ed.), Case-control Studues: Design, Conduct, Analysis (pp. 201-207). New York: Oxford University Press.
Senderowitz, J. (1995). Adolescent Health: Reassessing the Passage to Adulthood. Washington, D. C.: World Bank.
Wang, H. H., & Shieh, C. (2001). Concept analysis of well-being. Kaohsiung Journal of Medical Science, 17, 286-293.
Wang, C. S., & Chou, P. (1999). Charcateristics and outcomes of adolescent pregnancies in Kaohsiung county, Taiwan. Journal of Formosa Medical Association, 98(6), 415-421.
Wei, M. C., Wu, M. H., Huang, Y. C., Wang, S. T., & Hsu, C. C. (2001). Adolescent pregnancy and postpartum contraception--Hospital cases in Tainan city. Tzu Chu Medical Journal, 13(1), 23-29.
World Health Organization(1993). The Health of Young People: A Challenge and a Promise. Genava: WHO.
World Health Organizatio(1999a). Programming for adolescent health and development. Report of a WHO/UNFPA/UNICEF study group on programming for adolescent health. Genava: WHO.
World Health Organization(1999b). International Classification of Disease, Nighth Revision Clinical Modification. Genava: WHO.
WHOSIS(2002, July 5). Causes of death. Online version of the World Health Statistics Annual. Available http://www3.who.ch/whosis/menu.cfm?path=whosis&language=english.
Yang, C. Y., Yeh, Y. C., Cheng, M. F., & Lin, M. C. (1998). The incidence of school-related injuries among adolescents in Kaohsiung, Taiwan. American Journal of Preventive Medicine, 15(3), 172-177.
Ziglio, E. (2000). Preface. In C. Currie, Hurrelmann, K., Settertobulte, W., Rebecca, S., & Todd, J. (Ed.), Health and Health Behavior amoung Youth People. Denmark: World Health Organization Reginal Office for Europe.