本研究目的在於發展國中舞蹈班女學生飲食障礙初級預防教育課程，並評估其成效。應用批判社會觀點之理論，採取批判教育之教學策略設計課程，計八單元，每單元45分鐘。第一階段先以飲食障礙傾向高風險者（EAT-26≧20）為蒐集飲食障礙問題影響因素之訪談對象，根據訪談結果據以設計國中舞蹈班女生飲食障礙初級預防教育介入方案。第二階段則以國中二年級舞蹈班女生為研究對象（實驗組21人、控制組43人），進行介入成效評估，包括問卷與焦點訪談，量性資料收集後以SPSS12.0進行描述性統計、卡方檢定、單因子與二因子共變數分析。結果發現具有飲食障礙傾向的舞蹈班女生受到社會文化中對舞者體型的制約影響著舞者自己的體型意識（包括對於體重與身材的認知與關注、身體自尊與身體不滿意），更進而影響其飲食行為；而缺乏對健康的正確態度、飲食營養的知識與觀念，使得自己可能產生危害健康的行為而不自知。因此課程內容涵蓋二個面向：（1）提供飲食障礙與營養相關知識，讓同學瞭解青春期正常的生理發育、飲食障礙的嚴重性、適當的飲食與體重控制方式等，並且反思自己的飲食態度與行為。（2）培養批判思考的能力，能分析大眾媒體、同儕與教練所傳遞有關體型與飲食的訊息，並建立對體型的正確看法。在教育介入成效方面，從量化的研究結果來看，本課程對於國中舞蹈班二年級女生具有降低暴食/食物關注行為與提昇追求纖瘦體型對健康的不良影響之正向態度；而不同背景變項在部分評量項目成效不同，對於現代舞專長者降低內在知覺感受的教育成效較佳，對於學業表現在全班排名前十名者提昇追求纖瘦體型對健康不良影響的正向態度成效較佳，對於「不會」崇拜舞蹈家身材者之自尊與身體滿意度的教育成效較佳。從質性訪談結果顯示，國中舞蹈班女生健康意識提昇並降低其對食物關注的現象、舞蹈體型觀點改變、且批判思考能力與改變社會的心已悄悄萌芽；但未來要繼續跳舞、舞展/舞衣的壓力、舞蹈教師對身材的要求、與社會文化對纖瘦體型讚美等仍對其體型意識與飲食行為有相當大的制約，使其無法拒絕追求纖瘦體型；此外，同學提出四點質疑與反思：『體型評量採均一標準合適嗎？』、『體重的標準男女有別』、『瘦就能贏得掌聲嗎？』、『為了達到目標付出健康值得嗎？』，顯見舞蹈班女生對於生活環境中存在的舞者體型看法產生了批判性思考。整體而言，量化評量之成效有限，其可能受到量表敏感度的影響，建議未來應發展更適當的教育介入評量工具。此外，學校應正視舞蹈班學生異常飲食行為，父母、教師與學校應為飲食障礙預防計畫的一環，大眾媒體應負起傳遞正向體型意識的社會責任。

The purpose of this study was to develop the primary prevention program of eating disorders for Taiwanese dance students and to assess the effects of primary prevention of eating disorders. The program was based on the concept of Critical Social Perspective. Seven ninth-grade students were study subjects screened by Eating Attitude Test (EAT-26≧20) for collecting influencing factors of eating disorders and then to develop the curriculum at first step. Secondly, sixty-four eighth-graders (intervention group N=21；control group N=43) were study subjects for evaluation of intervention program. The outcomes of the intervention were measured by quantitative and qualitative methods: questionnaires administered one week before (pre-test) and a week after (post-test) the intervention, and then focus group was held after the questionnaires. Descriptive analyses, Chi-square test, one-way and two-way ANCOVA were used to analyze the quantitative data. The results indicated that characteristics of most students with high risk (EAT-26≧20) reported their body image and disordered eating behaviors were highly controlled by social norm toward thinness. The knowledge of health and nutrition was insufficient and inadequate. According to these results, the curriculum of primary prevention of eating disorders was included two dimensions: (1) Knowledge about development of adolescence, eating disorders, diet and weight management as well as self-examination their eating behaviors; (2) Critical thinking of the message from peer, teacher, and media mass. From the results of quantitative measures on intervention indicated the intervention group’s bulimia/food preoccupation benefits decreased, as the positive attitudes toward the perceived unhealthy of thinness increased. The results of qualitative approach and focus group revealed the conscious of health increased, as the food preoccupation behaviors decreased at the intervention group. The cognition of dance body changed from thinness to normal. Students of intervention group developed their critical thinking skill and the thinking of wanting to change the society. But the future work as a dancer, the pressures from dancers’ clothes and performance, the body requirement from dance teachers, and the praise of thinness in society still strongly controlled the cognition of body image among dance students after intervention. However, the effects of intervention were limited from quantitative measures. A further research should concern on developing an effective tool for evaluation of a primary prevention of eating disorders. Moreover, educators at school should pay attention to the disordered eating problems among dance students. For more effective of intervention, parents, dance teachers, and school should involve in primary prevention program of eating disorders. Also, mass media are responsible for delivering positive attitude toward a female body.

一、中文部分
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