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台灣急重症跨區就醫之變化情形:2001-2010年 台湾急重症跨区就医之变化情形:2001-2010年
Q4 Medicine Pub Date : 2014-02-01 DOI: 10.6288/TJPH201433102055
李虹映, 黃信忠, 許怡欣, 林文德
目標:本研究以急重症就醫流向為基礎,探討過去10年間民眾急重症跨區就醫流向的變化情形。方法:本研究利用全民健康保險資料庫約200萬人的就醫及承保資料做為分析的主要檔案,首先利用保險對象基層醫療利用次數最多地區及投保地區定義其居住地,接著採美國紐約大學急診緊急分類規則將門診之急診案件依其診斷判定急重症,而住院之急診案件則直接視為急重症;接著利用50個醫療次區域做為地區單位,計算各地區在2001及2010年的急重症跨區就醫比例,並以配對t檢定比較此10年間的急重症跨區就醫比例差異,最後將跨區就醫分為低、中、高三組,分別檢定其10年間的急重症跨區就醫比例及急診能量的差異。結果:整體之急重症跨區就醫比例自2001年的43.4%降至2010年的41.2%,但差異未達顯著,而第三個四分位數和第一個四分位數的比值則由2.19降為2.13。急重症跨區就醫比例較高地區10年間的跨區就醫比例有顯著的下降,但平均仍達57.7%。地區的急重症跨區就醫比例愈高,其急診能量有愈小的趨勢。結論:整體而言,我國2001年至2010年急重症跨區就醫比例並沒有顯著的下降,區域間的跨區就醫差異亦未大幅縮小,但急重症跨區就醫比例較高地區的急診能量有顯著的改善,其跨區就醫比例亦有顯著降低,未來應將緊急醫療資源優先分配至跨區就醫比例較高的地區。
目标:本研究以急重症就医流向为基础,探讨过去10年间民众急重症跨区就医流向的变化情形。方法:本研究利用全民健康保险资料库约200万人的就医及承保资料做为分析的主要档案,首先利用保险对象基层医疗利用次数最多地区及投保地区定义其居住地,接著采美国纽约大学急诊紧急分类规则将门诊之急诊案件依其诊断判定急重症,而住院之急诊案件则直接视为急重症;接著利用50个医疗次区域做为地区单位,计算各地区在2001及2010年的急重症跨区就医比例,并以配对t检定比较此10年间的急重症跨区就医比例差异,最后将跨区就医分为低、中、高三组,分别检定其10年间的急重症跨区就医比例及急诊能量的差异。结果:整体之急重症跨区就医比例自2001年的43.4%降至2010年的41.2%,但差异未达显著,而第三个四分位数和第一个四分位数的比值则由2.19降为2.13。急重症跨区就医比例较高地区10年间的跨区就医比例有显著的下降,但平均仍达57.7%。地区的急重症跨区就医比例愈高,其急诊能量有愈小的趋势。结论:整体而言,我国2001年至2010年急重症跨区就医比例并没有显著的下降,区域间的跨区就医差异亦未大幅缩小,但急重症跨区就医比例较高地区的急诊能量有显著的改善,其跨区就医比例亦有显著降低,未来应将紧急医疗资源优先分配至跨区就医比例较高的地区。
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引用次数: 0
Influential factors of school involvement in family partnership of health-promoting primary schools in Taiwan 台湾健康促进小学家庭伙伴关系中学校参与的影响因素
Q4 Medicine Pub Date : 2014-01-01 DOI: 10.6288/TJPH201433103022
Y. Niu, Chieh-Hsing Liu, S. Chiou, C. Chen
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引用次数: 0
The effects of individual and neighborhood socioeconomic status on early nephrology referral for hemodialysis patients 个体和社区社会经济状况对血液透析患者早期肾病转诊的影响
Q4 Medicine Pub Date : 2014-01-01 DOI: 10.6288/TJPH201433102058
C. Chang, Shiao-Chi Wu, Y. Hung, Y. Ng, Hui-Shan Chen
1 Institute of Health and Welfare Policy, National Yang-Ming University, No. 155, Sec. 2, Linong St., Beitou Dist., Taipei, Taiwan, R.O.C. 2 School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan, R.O.C. 3 Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C. * Correspondence author. E-mail: scwu@ym.edu.tw Received: Jul 8, 2013 Accepted: Jan 15, 2014 DDOI: 10.6288/TJPH201433102058 The effects of individual and neighborhood socioeconomic status on early nephrology referral for hemodialysis patients
1台北市北投区利农街2段155号国立阳明大学卫生福利政策研究所2台北市台北医科大学护理学院老年健康管理学院3台北市台北荣民总医院内科肾内科*通讯作者。E-mail: scwu@ym.edu.tw收稿日期:2013年7月8日收稿日期:2014年1月15日doi: 10.6288/TJPH201433102058个体和社区社会经济状况对血液透析患者早期肾病转诊的影响
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引用次数: 1
An exploratory study of the use of blogs as a means of communication for breast cancer patients 一项关于使用博客作为乳腺癌患者交流手段的探索性研究
Q4 Medicine Pub Date : 2014-01-01 DOI: 10.6288/TJPH201433103055
S. Kuo, Hsieh-Hua Yang, Yi Chun Chen
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引用次数: 0
Readmission and risk factors among community rehabilitation users with psychiatric diseases 精神疾病社区康复患者的再入院及危险因素
Q4 Medicine Pub Date : 2013-12-01 DOI: 10.6288/TJPH201332102057
Ya Hsuan Li, P. Hsieh, Chung‐Yi Li, H. Su
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引用次数: 1
Application of the modified health belief model for undergoing oral mucosal examination: Comparison of different health risk groups 改良健康信念模型在口腔黏膜检查中的应用:不同健康风险人群的比较
Q4 Medicine Pub Date : 2013-08-15 DOI: 10.6288/TJPH2013-32-04-06
M. Y. Wu, Jong-Long Guo, Ming-Shinn Lee, Wang-Ping Shen
Objectives: Oral mucosal examination (OME) is an effective measure for detecting oral cancer, which is the fourth leading cause of cancer deaths among males in Taiwan. Despite this fact, there is a lack of literature concerning the likelihood of undergoing an OME among different health risk groups based on individuals’ habits of drinking alcohol, chewing betel quid, and smoking cigarettes. Methods: We applied a modified form of the Health Belief Model (HBM) to explore the likelihood that a sample of individuals participating in a ”Community Free from Betel Quid Chewing” campaign would undergo an OME. Eight-hundred and sixty-six participants completed questionnaires measuring demographic characteristics, alcohol drinking, betel quid chewing, cigarette smoking, health beliefs, cues to action, self-efficacy, and likelihood of undergoing an OME. We used structural equation modeling (SEM) to investigate the direct and indirect paths, to predict the likelihood of undergoing an OME, in three different health risk groups. Classification of participants into groups of high, moderate, and low risk of developing oral cancer was based on the whether or not the participants drank alcohol, chewed betel quid, or smoked cigarettes. Results: The modified HBM demonstrated a good fit among the high, moderate, and low-risk groups, and explained 50%, 37%, and 30% of the variance of undergoing an OME, respectively. The direct and indirect paths influencing the likelihood of undergoing an OME varied significantly among the three groups. Conclusions: Based on the findings, care must be taken when selecting responsive health education for provision to participants with different health beliefs and levels of risks.
目的:口腔黏膜检查(OME)是检测口腔癌的有效措施,口腔癌是台湾男性癌症死亡的第四大原因。尽管如此,关于不同健康风险群体中因个人饮酒、咀嚼槟榔液和吸烟习惯而发生OME的可能性,目前还缺乏相关文献。方法:我们应用一种改进形式的健康信念模型(HBM)来探讨参与“社区不嚼槟榔”运动的个体样本发生OME的可能性。866名参与者完成了调查问卷,测量了人口统计学特征、饮酒、嚼槟榔液、吸烟、健康信念、行动线索、自我效能感和经历OME的可能性。我们使用结构方程模型(SEM)来研究直接和间接途径,以预测三个不同健康风险组发生OME的可能性。根据参与者是否饮酒、咀嚼槟榔液或吸烟,将参与者分为患口腔癌的高、中、低风险组。结果:改进的HBM在高、中、低风险组中表现出良好的拟合性,分别解释了50%、37%和30%的接受OME的方差。影响OME可能性的直接和间接途径在三组之间差异显著。结论:根据研究结果,在选择向具有不同健康信念和风险水平的参与者提供响应性健康教育时必须谨慎。
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引用次数: 2
台灣工時規範之法規執行度-從法律規範之「應然」到「實然」 台湾工时规范之法规执行度-从法律规范之「应然」到「实然」
Q4 Medicine Pub Date : 2013-06-15 DOI: 10.6288/TJPH2013-32-03-02
蔡奉真
Objectives: This study was conducted to evaluate the average yearly working hours of workers, the Statutory-hour Strictness, the Observance Degree, and the Effective Regulatory Index for working-hours in Taiwan. Methods: The Effective Regulation Index was defined as the average of Statutory-hour Strictness and the Observance Degree. The dataset of the Human Resource Survey from 1978 to 2010 compiled by the Directorate-General of Budget, Accounting and Statistics, Executive Yuan was used in the study. The changes in regulations for working hours in Taiwan were determined. Then the average yearly working hours of workers, the Statutory-hour Strictness, the Observance Degree and the Effective Regulation Index for working hours in Taiwan were calculated. Information from 2004 was further analyzed for comparison with other countries. Results: The average working hours of workers in Taiwan were comparatively high. Before 2000, the average working hours per week were above 46. After 2000, average working hours per week were still above 44, except for 43 hours in 2009. The Statutory-hour Strictness rose from 0 to 4.6 in 2000. The Observance Degree slowly increased from 6.4 in 1978 to 8.64 in 1999; although it dropped to 1.6 in 2000, it remained stable around 5 after 2000. The Effective Regulation Index for working hours in Taiwan was between 2.9 and 4.3 before 2000, but remained between 4.7 and 5.3 in the 21st century. In 2004, the Observance Degree of the working regulations was 5.2, and the Effective Regulation Index was 4.9. Conclusions: The huge gap between regulations and reality in working hours in Taiwan showed the ineffectiveness of working-hours regulation. We suggest increasing workers' awareness of regulations and strengthening enforcement of the working regulations by improving the labor inspection system in Taiwan.
摘要目的:本研究旨在评估台湾地区劳工年平均工时、法定工时严格程度、遵守程度及有效工时监管指数。方法:将有效监管指数定义为法定小时严格程度与遵守程度的平均值。本研究采用行政院预算会计统计总司编制的1978 - 2010年人力资源调查数据集。台湾工作时间规定的变更已确定。进而计算台湾地区劳工年平均工时、法定工时严格度、遵守程度及工时有效规管指数。2004年的信息进一步分析,以便与其他国家进行比较。结果:台湾工人的平均工作时间较高。2000年以前,平均每周工作时数超过46小时。2000年后,除了2009年的43小时外,平均每周工作时间仍在44小时以上。法定小时严格度从0上升到2000年的4.6。遵守度从1978年的6.4缓慢上升到1999年的8.64;虽然在2000年下降到1.6,但2000年以后一直稳定在5左右。2000年以前,台湾工作时数的有效管制指数在2.9 ~ 4.3之间,进入21世纪后则维持在4.7 ~ 5.3之间。2004年,工作法规的遵守程度为5.2,有效法规指数为4.9。结论:台湾工作时间法规与实际存在巨大差距,说明工作时间法规的有效性不足。我们建议透过改善台湾的劳动监察制度,提高劳工的法规意识,并加强劳动法规的执行。
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引用次数: 0
Gender Differences in Occupational Stress and Health among Legal Professionals in Taiwan 台湾法律专业人员职业压力与健康之性别差异
Q4 Medicine Pub Date : 2011-10-15 DOI: 10.6288/TJPH2011-30-05-09
Feng-Jen Tsai, Chang-Chuan Chan
This study sought to determine gender differences in occupational stress and health and to compare the strength of association between two occupational stress models, demand-control-support (DCS) and effort-reward imbalance (ERI), on poor health among male and female legal professionals. Methods: This cross-sectional study included 193 male and 170 female legal professionals from 6 district courts, 1 appeals court, 3 District Procurators Offices and 26 law firms. The Chinese versions of Karasek job content questionnaire (C-JCQ) and Siegrist effort-reward imbalance questionnaire (C-ERI) were used to evaluate occupational stress, and the International Quality of Life Assessment Short Form-36 (IQOLA SF-36) questionnaire to evaluate health. Multivariate logistic regression analysis was used to calculate the odds ratio of poor health among female legal professionals versus male legal professionals, and the gender-specific association between DCS and ERI models and poor health adjusted for age, marital status, job content, years of work experience, and working hours per day. Results: Male legal professionals scored significantly higher on job control (70.54 vs. 66.46) and job satisfaction (59.99 vs. 57.45) than did female legal professionals. Females scored significantly lower on physical function (90.23 vs. 93.80), bodily pain (72.73 vs. 77.68), social function (66.25 vs. 72.85) and mental health (58.02 vs. 62.41) than did males. There was a significant gender difference in the association between occupational stress and poor health. We found that men’s poor health was more significantly related to job strain while effort-reward imbalance was associated equally with poor health in both males and females. Conclusions: Gender differences exist in occupational stress, health and the strength of association between occupational stress models and poor health among legal professionals in Taiwan.
本研究旨在确定职业压力和健康方面的性别差异,并比较两种职业压力模型——需求-控制-支持(DCS)和努力-回报不平衡(ERI)——对男性和女性法律专业人员健康状况不佳的相关性。方法:对来自6个地方法院、1个上诉法院、3个地方检察院和26家律师事务所的193名男性和170名女性法律专业人员进行横断面研究。职业压力评估采用中文版Karasek工作内容问卷(C-JCQ)和Siegrist努力-回报失衡问卷(C-ERI),健康评估采用国际生活质量评估简表-36 (IQOLA SF-36)。采用多变量logistic回归分析计算女性法律专业人员与男性法律专业人员健康状况不佳的比值比,以及DCS和ERI模型与年龄、婚姻状况、工作内容、工作经验年数和每天工作时间调整后的健康状况不佳的性别相关性。结果:男性法律专业人员在工作控制(70.54比66.46)和工作满意度(59.99比57.45)得分显著高于女性法律专业人员。女性在身体机能(90.23比93.80)、身体疼痛(72.73比77.68)、社会功能(66.25比72.85)和心理健康(58.02比62.41)方面的得分明显低于男性。职业压力与健康状况不佳之间存在显著的性别差异。我们发现,男性的健康状况不佳与工作压力的关系更为显著,而努力-回报失衡与男性和女性的健康状况不佳的关系相同。结论:台湾法律专业人员的职业压力、健康状况及职业压力模式与健康状况的关联程度均存在性别差异。
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引用次数: 0
Factors influencing the adoption of the release of prescription information system and the separation of drug prescribing and dispensing 影响处方信息发布系统采用和药品开配分离的因素
Q4 Medicine Pub Date : 2010-12-01 DOI: 10.6288/TJPH2010-29-06-05
Pei-Chen Sung, C. Ku, Wen-Huai Hsieh, Fu Howe Chen, Y. Yang
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引用次数: 1
健康促進學校推動團隊領導方式、集體效能與團體效果之現況及關係模式驗證-以台灣小學為例 健康促进学校推动团队领导方式、集体效能与团体效果之现况及关系模式验证-以台湾小学为例
Q4 Medicine Pub Date : 2010-06-01 DOI: 10.6288/TJPH2010-29-03-08
牛玉珍, 劉潔心, 邱詩揚, 晏涵文
Objectives: The aim of this study was to examine the relationship between the leadership style and collective efficacy on the effectiveness of health promotion work teams in Taiwanese elementary schools. Methods: The study design was cross-sectional. According to the size of the districts and individual schools, a stratified random sample was used to select subjects from 518 health promotion work teams approved by the Ministry of Education in 2007. Four hundred and ninety-seven subjects were recruited and the response rate was 86.32% (n=429). Structured questionnaires including demographics, leadership style, collective efficacy and group effectiveness were used to collect data. The data were analyzed using descriptive statistics, regression and SEM. p<.05 was considered as statistically significant. Results: The leadership style had. 49 direct effect and. 32 indirect effect on Group Effectiveness through collective efficacy. The total effect of leadership style on Group Effectiveness was .81. Leadership style and collective efficacy were the major predictors as they accounted for 53.9% of the total variance for Group Effectiveness. Conclusions: Better leadership style will have direct and indirect effects on group effectiveness.
摘要目的:本研究旨在探讨领导风格与集体效能对台湾小学健康促进工作团队效能的影响。方法:采用横断面设计。根据各区和个别学校的规模,采用分层随机抽样的方法,从2007年教育部批准的518个健康促进工作队中选择受试者。共招募497名受试者,应答率为86.32% (n=429)。采用人口统计、领导风格、集体效能和群体效能等结构化问卷收集数据。采用描述性统计、回归和扫描电镜对数据进行分析。p <。0.05认为有统计学意义。结果:领导风格有。直接影响和。32 .集体效能对群体效能的间接影响。领导风格对团队效能的总影响为0.81。领导风格和集体效能是主要的预测因子,占群体效能总方差的53.9%。结论:良好的领导风格对团队效能有直接和间接的影响。
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引用次数: 0
期刊
Taiwan Journal of Public Health
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