社區幼童居家事故傷害預防介入研究

Community Home Injury Prevention for Children under Five

10.6288/TJPH2002-21-01-07

李玲玲(Ling-Ling Lee)；白璐(Lu Pai)；盛培珠(Pei-Chu Shen)

幼童 ； 居家事故傷害 ； 社區 ； 居家環境安全 ； 介入措施 ； 平衡控制實驗研究 ； children ； home injury ； community ； home environment safety ； parallel controlled experiment study

台灣公共衛生雜誌

21卷1期（2002 / 02 / 01）

61 - 72

繁體中文

目標：事故傷害為國內外兒童主要死因，五歲以下兒童事故傷害主要發生於家中，居家環境安全對幼童事故傷害的防制扮演重要角色。本研究採用以社區為基礎之介入方式進行幼童居家事故傷害預防，並評價介入措施之效果。方法：以『含對照組、前後測設計』之平衡控制實驗研究，於台北市某國宅社區進行幼童居家事故傷害防制介入活動。內容包括：「安全的家」居家事故傷害防制活動、寄送防制手冊及定期以電話與幼童母親聯繫。活動介入前後由訪員針對五歲以下幼童之家戶收集「居家環境安全改善情形」、「幼童母親之居家事故傷害預防認知程度」、「幼童母親居家事故傷害預防行為」及幼童母親考慮改善居家環境之主要考量因素等，以評價兩組前後測是否有顯著差異。結果：經由重複量數二因子變異數分析顯示，活動前後，實驗組與對照組「客餐廳」、「浴室」、「主臥室」、「書房」、「樓梯間」、「玩具」等居家環境安全改善幅度及幼童母親居家事故傷害預防行為達顯著差異；實驗組後測時，幼童母親考慮改善居家環境時之主要考量因素，亦部分由幼童安全直接相關之因素取代間接之因素；幼童母親拘居家事故傷害預防認知則無顯著差異。結論：本研究跨越傳統幼童居家事故傷害防制單一宣導方式之窠臼，以多元化、動態之活動設計，提昇訊息、資源可近性，呈現居家環境安全改善及幼童母親居家事故傷害預防行為提昇之活動效果，可提供未來規劃以社區為基礎相關介入措施之參考。

Objectives: Injury ranks as one of the most crucial health problems for children. Most of children’s injuries occur at home and are the result of environmental hazards. A safe home environment, therefore, plays a leading role in preventing home-related injuries for children. This paper performed and evaluated a set of community-based interventions designed to prevent related injuries. Methods: A parallel controlled experiment and pre-post test study design is applied to evaluate the implementation of interventions aimed to reduce the childhood home hazard in two of Taipei’s communities. The interventions consist of “Safe Home” injury prevention activities in the community, distributing pamphlets and materials showing how to improve home safety, and keeping in contact with mothers by telephone to reinforce their safety behavior execution. Trained home visitors collected data with a home inspection instrument and questionnaire at pre- and post visiting to assess rectification of injury-related home hazard, mothers’ perceptions of home safety and injury preventive behavior, and their considerations before the decision to improve home safety. Results: The results analyzed by repeated measures two-way ANOVA showed that the interventions of multifarious design led to significant differences in the safety of several home environments, including the ”living room”, ”dining room”, ”bath room”, ”chief bedroom”, ”room for children”, ”study room”, ”staircase”, and ”toys”, and mothers’ behavior between the intervention and control homes. Some of the mothers in the intervention group began to be aware of factors related to the safety of their children when they considered modifying their home environment. Mothers’ perception of home-related injury did not show significant differences. Conclusions: The community based intervention design of home-related injury prevention could serve as a model for children under 5 in the urban community.

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