跨領域健康教育介入對降低社區居民代謝症候群盛行率之成效探討－以北台灣四鄉鎮為例

Effectiveness of an Interdisciplinary Health Education Intervention on Metabolic Syndrome in Community Residents: A Study of Four Towns in Northern Taiwan

10.6224/JN.201808_65(4).07

林晶晶(Ching-Ching LIN)；陳淑賢(Sue-Hsien CHEN)；黃莉媛(Li-Yuan HUANG)

代謝症候群 ； 跨領域健康教育 ； 代謝症候群指標 ； metabolic syndrome ； metabolic syndrome of interdisciplinary health education ； index of metabolic syndrome

護理雜誌

65卷4期（2018 / 08 / 01）

36 - 48

繁體中文

背景：代謝症候群是盛行於台灣地區的慢性疾病，易增加罹患心血管疾病的風險。由於心血管疾病已成為台灣十大死因之第二位，非常接近首位惡性腫瘤的死亡率，是值得被正視的健康問題。目的：探討跨領域代謝症候群健康教育方案介入措施對降低社區居民代謝症候群盛行率之成效。方法：以2014-2015年北台灣四鄉鎮30歲以上民眾為研究對象，採分層隨機抽樣，完成全程試驗共計661人。資料收集分二階段，第一階段：研究對象須接受採血、體位測量及填寫前測問卷，血液檢查與體位測量結果於上課前由醫師個別對研究對象說明；第二階段：經跨領域健康教育介入後，預約研究對象採血日期、體位測量與後測問卷填寫，前、後測間隔一年。結果：（1）年齡越高者越容易發生代謝症候群，性別、婚姻狀況與代謝症候群盛行率並未具顯著相關，教育程度越高者代謝症候群盛行率越低。（2）健康教育介入前、後研究對象的代謝症候群認知具有顯著差異性（p ＜ .05）。「前測」平均數由2.30分提升至「後測」平均數5.65分。（3）研究對象診斷為代謝症候群者由215人（32.5%）減少至170人（25.7%），代謝症候群盛行率改善具顯著性（p ＜ .05）。（4）健康教育介入與研究對象戒菸、戒食檳榔的相關性具顯著性（p ＜ .05）。結論：跨領域代謝症候群健康教育介入，能減少研究對象吸菸、嚼食檳榔比例，進而減少罹患代謝症候群危險因子，降低代謝症候群盛行率；因此，若能將代謝症候群健康教育積極在各社區推廣與落實，應能有效降低國人代謝症候群盛行率。此外，基於高齡者易發生代謝症候群，因此建議衛教策略宜注意淺顯易懂及生活化，而戒嚼檳榔也應列為代謝症候群防治工作的重點項目。

Background: Metabolic syndrome, a widespread condition in Taiwan, increases the risks of cardiovascular diseases. Cardiovascular disease is the second leading cause of death in Taiwan after cancer. Thus, this health problem is a priority issue of concern. Purpose: To study the effects of active intervention of interdisciplinary health education on the prevalence of metabolic syndrome in community residents. Method: This longitudinal study was conducted from 2014 to 2015 on 661 participants who were all over 30 years old and living in four towns in northern Taiwan. The data were collected into two steps. In the first step, participants completed a blood study, body measurement, and pretest questionnaires and participated in the entire course of metabolic syndrome health education. The results of the blood test and body measurement were blinded to the experienced metabolic physicians before and after the education courses. In the second step, one year after administering the interdisciplinary health education course, the participants repeated the blood study, body measurement, and posttest questionnaires. Result: 1. The participants had a higher incidence of metabolic syndrome. However, gender and marital status had no significant correlation with metabolic syndrome. Higher education levels were associated with a lower prevalence of metabolic syndrome. 2. The average scores for literacy rose from 2.30 pretest to 5.65 posttest. There were significant correlations (p ＜ .05) between pretest and posttest health education. 3. The diagnosis of metabolic syndrome in this study changed from 215 participants (32.5%) to 170 participants (25.7%) between pretest and posttest (p ＜ .05). 4. active health education had significant and positive effects on the cessation of smoking and chewing betel nut (p ＜ .05). Conclusion: The active interdisciplinary health education intervention used in this study significantly decreased the smoking and betel-nut chewing habits and decreased the overall risk of metabolic syndrome in participants. Therefore, providing active health education on metabolic syndrome holds the potential to significantly decrease the prevalence of metabolic syndrome in at-risk populations. In addition, healthcare providers should make appropriately targeted health education more accessible to elderly patients who are prone to metabolic syndrome. Finally, the cessation of chewing betel nut should be seen as a major factor in the prevention and alleviation of metabolic syndrome.

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