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研究生: 郭鐘隆
Guo, Jong-Long
論文名稱: 臺灣地區國民小學學生健康檢查實施現況及其相關問題研究
A Study on Student Health Examination and Its Related Problems of Elementary Schools in Taiwan, For the Sake of Providing Future Reference, the Republic of China
指導教授: 黃松元
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
畢業學年度: 82
語文別: 中文
論文頁數: 146
中文關鍵詞: 國小學生健康檢查
論文種類: 學術論文
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  • 本研究主要目的為針對臺灣地區國民小學學生健康檢查實施現況及困難問題做一調查,以供未來有效落實學生健康檢查工作之參考。此外,本研究亦探討臺灣地區國民小學、教育行政單位、衛生行政單位對未來學生健康檢查期望實施情形之意見,以做為未來規劃取向之依據。
    研究對象為臺灣地區2470所國民小學、臺灣省21縣市及北高兩市教育局、衛生局學生健康檢查業務負責人。抽取830所國民小學及全體教育局、衛生局負責人為樣本,共獲得有效問卷國小部份607份、教育局17份、衛生局22份。
    研究結果發現有96.4%的學校無校醫、80.9%的學校無牙醫、20.1%的學校無護士或保健員、75.6%的學校未設學校衛生委員會,僅16.3%的學校編列學生健康檢查經費。主要檢查項目為:身高(99.7%)、體重(99.3%)、視力(97.9%)、寄生蟲(93.4%)、頭蝨(1.0%)、胸圍(81.0%)。不同都市化程度、學生人數、班級數、教職員人數、牙醫聘請、護理工作人員聘請狀況對學生健康檢查實施情形加權指數有顯著差異。學生健康檢查工作負責人的資格證照、學校衛生專業素養、健康檢查工作講習會參加之有無,也對學生健康檢查實施情形之加權指數有顯著差異。
    教育行政單位及衛生行政單位均認為可由學校護士執行身高、體重、胸圍、視力、辨色力、頭蝨、頭癬等項目的檢查;並認為檢查間隔為一學期一次。其餘項目之檢查,教育行政單位認為主要應由衛生行政單位支援;衛生行政單位除願意在寄生蟲及尿液篩檢項目上繼續支援外,其他項目均希望另外尋求方法解決。
    綜合而言,目前臺灣地區學生健康檢查遭遇的主要困難依次為:
    1.缺乏相關醫護人員支援;
    2.家長、學校、教師的不配合和不重視;
    3.檢查經費、設備、人力不足;
    4.教師缺乏專業知識、本身工作又相當繁重;
    5.巡迴檢查時間的安排未必能配合學校作業等。
    依據研究結果,建議仿效北、高兩市行之多年的巡迴健檢制度、改善學校健康檢查人力及工作狀況、各校尋找可利用之社區資源、將學生健康檢查工作列入學校評鑑項目、並每年定期舉辦講習會。未來研究應擴大對象、探討健康檢查工作「質」的內涵,採取世代(追蹤)研究法,評估推行學生健康檢查工作之實際效益;採取學生及家長的配對研究,以更了解其對學生健康檢查和缺點矯治的實質影響。

    The main purpose of the study was to investigate the current stantus and its related problems on student health examination of the elementary schools in Taiwan. Study also explored the opinions of the elementary schools, education bureaus and health bureaus in Taiwan, regarding health examination for the students.
    The sample was selected from the persons who was reponsible for student health examination among 2470 elementary schools, 21 education & health bureaus in Taiwan province as well in Taipei and Kaohsiung City.
    Among 607 respondents, 96.4% of the schools had no school physicians, 80.9% had no school dentists, 20.1% had no school nurses, 75.6% had no school health committee, and 16.3% had budget for student health examination. Besides, the six major health examination items were: body-height (99.7%), body-weight (99.3%), vision (97.9%), parasite (93.4%), head louse (91.0%), measurement of chest circumstance (81.0%). Level of urbanizatiion number of students, number of classes, number of school staffs ,number of school dentists and number of school nurses of the sample schools made significant difference on the implementation of student health professional training and experience of attend in health seminar of the respondents have also made significant difference.
    Respondents of education & health bureaus both suggested that school nurses should be responsible for examining the students' body-height, body-weight, measurement of chest circumstance, vision, color blindness, head louse and head ringworm. They also suggested that these items shoule be examined once every semester
    To sum up, the main difficulties of student health examination were:
    1. Without enough physicans and nurses to carry out the examination.
    2. Lack of support from parents, schools and teachers.
    3. Lack of financial sources, facilities, and manpower.
    4. Lack of professional knowledge, regarding health examination among the teachers.
    5. The schedule of mobile examination could not fit to school administration.
    Based on the results of the study, several recommendations were drawn as follows:
    1. To follow Taipei and Kaohsiung City's pattern of student health examination.
    2. To increase human resources for health examination.
    3. To seek for community resources and support.
    4. To supervise student health examination regularly.
    5. To conduct seminars on health examination for health coordinators per year.
    In advance, the following issues should be condsidered as the focuses of future studies:
    1. To increse the number of subjects.
    2. To emphasize the qualitative aspect of healt examination.
    3. To use cohort study for the sake of appraising the effectiveness of health examination.
    4.To conduct paired-study of parents and students in order to realize its potential influence on health examination and correction of physical defects for the students.

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