COVID-19疫情對民眾參與社區式整合性預防保健之影響

Impact of COVID-19 on Community Participation in Integrated Cancer Screening Program

10.29442/HPRP.202312_6(1_2).0002

許齡尹(Lin-Ying Hsu)；顏采如(Connie Cai Ru Gan)；賴怡伶(Yi-Ling Lai)；陳慶元(Ching-Yuan Chen)；王耀進(Yao-Jin Wang)

COVID-19 ； 社區篩檢 ； 預防保健 ； 宣傳方式 ； COVID-19 ； community-based integrated screening ； preventive health checkups

健康促進研究與實務

6卷1&2期（2023 / 12 / 01）

10 - 19

繁體中文;英文

目的：COVID-19從2020年起全球大流行，防疫政策以保持社交距離、不認意外出或參與集會等，造成健康照護模式的改變。社區式整合篩檢活動採暫停或需依照防疫規定辦理，本研究探討COVID-19疫情對與社區式整合篩檢活動之影響。方法：採用橫斷式調查納入2018年－2023年臺中市某區域醫院辦理之社區式整合篩檢活動，排除篩檢人數小於50人之場次。利用場次分析表及Microsoft Excel 2016版本，以描述性統計分析疫情前、中、後期，民眾參與之情況。結果：疫情中期因禁止集會活動，致2021年執行率為43%與2022年執行率為67%；辦理場次數較少，但總平均人數較疫情前增加；成人預防保健與乳房X光攝影人數，相較其他篩檢項目較明顯提升。疫情後期各類篩檢人數，除口腔黏膜檢查外均下降，但較疫情前期稍高；女性在疫情中期與後期，參與平均人數分別是2022年126人及2023年的104人為歷年之最。男性參與活動平均人數在2019疫情前達最高共60位參與。郵簡寄發、宣傳單發送及海報為本案宣傳管道，而民眾從通知單（郵簡）獲得訊息於各年度均為最高，另，親朋好友告知則有漸漸增加的趨勢。結論：COVID-19疫情中期篩檢量達最高，疫情後期則有下降的情形。國際及國內傳染病防治政策，影響民眾參與公共衛生早期診斷與適切治療。又，因衛生行政規定及民眾收訊息管道改變，致未來宣傳管道及大型傳染病流行時之因應措施必須調整。如何提升社區民眾預防保健之參與及兼顧醫療機構成本效益，為政策制定者或業務負責人所需面臨的新挑戰。

Objectives: The COVID-19 pandemic has resulted in the implementation of various epidemic control measures, including social distancing, restrictions on public gatherings, and reductions in medical operations to ensure the capacity of health services prioritizing Covid-19 responses. Community-based screening activities have been suspended or are being conducted in accordance with epidemic prevention regulations. This study aims to explore the impact of participating in community-based integrated screening events before and after the COVID-19 epidemic. Methods: A cross-sectional survey was conducted to include the community-based integrated screening events organized by a regional hospital in Taichung City from 2018 to 2023. Events with less than 50 participants were excluded. Descriptive statistical analysis using session analysis tables and Microsoft Excel 2016 version was used to analyze the participation of the public in the pre, middle, and post-epidemic periods. Results: Due to the implementation of epidemic prevention policies, the implementation rate of community-based integrated screening activities in 2021 was 43%, while in 2022, it increased to 67%. The number of community-based screening activities decreased due to epidemic prevention policies. However, the average number of people participating in the activities was lower than that of the epidemic. During the middle stage of the epidemic, the number of adult preventive health checkups and mammography examinations increased significantly compared to other screening items. The number of screenings in the later stage of the epidemic decreased, except for oral mucosal examinations, which were slightly higher than in the early stage of the epidemic. The average number of women participating in activities during the middle and late stages of the epidemic was 126 in 2022 and 104 in 2023, respectively, which were the top two over the years. The average number of men participating in activities was highest in the 2019 epidemic, with a total of 60 people participating. Mailing, leaflets, and posters were necessary items for this case. The rate of people getting event information from the notices was the highest in each year, and the notification from relatives and friends gradually increased. Conclusions: The amount of screening reached its highest point in the mid-term of the COVID-19 epidemic, and declined in the later stage of the pandemic. International and domestic infectious disease prevention and control measures directly affect the public's participation in the early diagnosis and appropriate treatment, Changes in health administration and channels used by the public to receive information will affect the publicity channels and response measures during large-scale infectious diseases in the future. The individual in charge of the screening service at a medical institution, or responsible for the institution's policy, will face significant challenges in increasing public participation in preventive healthcare, while also taking into account the medical institution's cost-effectiveness.