本研究目的在探討臺灣高中職學生正確使用制酸劑知識、效能及藥袋素養的現況及相關因素。研究對象為103學年度第一學期全國高中職學生為研究對象，採抽取率與單位大小成比例之等距抽樣法。研究工具採自填結構式網路調查問卷，共調查20所學校，計1947名學生完成問卷填寫。研究結果如下：

一、五成學生過去一年曾有胃痛，三成以上學生曾胃酸過多，約兩成學生有服用制酸劑。三成以上學生因課業壓力、熬夜、吃刺激性的食物、三餐不定時等原因而胃痛。超過三成學生至藥局購買藥品時不會看藥盒或仿單說明。
二、超過三成學生答錯或不知道「吃藥一定要搭配制酸劑（胃藥）才不會傷胃」是錯誤的觀念，也不知道制酸劑與其他藥品一起服用，可能會影響其他藥品療效。
三、學生的正確使用制酸劑效能與藥袋素養呈中高程度。
四、複迴歸分析結果顯示，學生為女性、會看藥盒或仿單使用說明、正確使用制酸劑知識愈高及正確使用制酸劑的效能愈高者，其藥袋素養就愈高。

建議學校積極推動正確用藥教育、增能學生的健康生活型態、加強正確使用制酸劑的宣導，以提升學生正確使用藥物的知能與行為。

The purpose of this study was to explore students’ knowledge, self-efficacy and literacy regarding correct antacids use and to examine the related factors. A probability-proportionate-to-size sampling method was used. Twenty senior/vocational high schools were randomly selected in Taiwan. A total of 1,947 students completed the online self-administered questionnaire in 2014. The main findings were as follows.

1.Half of the students reported that they had stomachache, while 35% experienced gastric hyperacidity during the past year. About 20% of students ever used antacids, while more than 30% of students experienced stomachache due to academic stress, stay up late, spicy food, and irregular meals. More than 30% of students did not read drug labels when purchasing medicines.
2.More than 30% of students did not know that it is not necessary to take medicines with antacids, while antacids can also interfere with other medications.
3.Students tend to have middle-high level of self-efficacy and literacy regarding the correct antacids usage.
4.Multiple regression analysis showed that female students who read drug labels, had higher knowledge and higher self-efficacy of correct antacids usage were more likely to have higher medication literacy.

It is suggested that schools implement correct medication use education and promote healthy lifestyle to enhance students' medication literacy and proper medication usage.

一、中文文獻
朱淑敏（2012）。正確用藥教育介入之成效研究－以宜蘭縣國民中學學生為例（未出版碩士論文）。臺北巿立師範學院，臺北巿。
江云懷（2012）。國中學生正確用藥知識、態度與行為之研究－以新北巿立某國民中學學生為例（未出版碩士論文）。國立臺灣師範大學。臺北巿。
行政院衛生署（2011）。正確用正確用藥五大核心能力。取自http://doh.gov.whatis.com.tw/01_about_1.asp
行政院衛生福利部中央健康保險署編印（2014）。103年11月份全民健康保險業務執行報告。臺北巿：行政院衛生福利部中央健康保險署。
行政院衛生福利部食品藥物管理署（2014）。取自http://www.fda.gov.tw/TC/siteListContent.aspx?sid=1824&id=10910&chk=a461f089-7815-4f73-b99f-2a0140077b0c¶m=pn%3d5%26sid%3d1824#.VWsT0c-qqko
李杰年（2002）。民眾對抗生素使用的認知、態度與其行為之研究（未出版碩士論文）。國立臺灣大學。臺北市。
李炳鈺（2001）。醫院門診病患用藥行為之相關因素探討（未出版碩士論文）。高雄醫學大學。高雄巿。
季瑋珠、柯源卿（1989）。台北某學院學生胃痛症狀相關因素之探討。中華雜誌，9(2)，105-110。
姜郁美（2004）。國人對用藥安全之認知、行為及態度之探討－以懷疑中藥摻西藥送驗之民眾為例（未出版碩士論文）。臺北醫學大學。臺北巿。
紀雪雲（2012）。安全用藥, 從小紮根-用藥安全推廣在校園。醫療品質雜誌，6（2），24-29。
紀雪雲、石彩慧、張榮珍、顏錦惠、吳淑美、許秀蘊、廖繼洲（2009）。國小高年級學生正確用藥用語認知與用藥知識之先導型研究。醫療爭議審議報導系列41，2-17。
財團法人國家衛生研究院（2009）。2009年「國民健康訪問暨藥物濫用調查」結果報告。臺北巿：行政院衛生署。
張麗春（2008）。健康素養－評價衛生教育計畫成效的新新指標。護理雜誌，55(1)，81-86。
曹惠良（2006）。高屏地區原住民用藥行為之調查研究（未出版碩士論文）。高雄醫學大學。高雄巿。
許郁琦（2010）。中部地區國小高年級學童用藥認知及其相關因素之探討（未出版碩士論文）。嘉南藥理科技大學。台南巿。
陳曾基、劉瑞瑤、黃信彰（2002）。非類固醇抗發炎劑與制酸劑的合併處方：台灣全民健康保險申報檔案分析。中華醫學雜誌，65，588-593。
陳緋娜、李珮端、謝慶良、林正介、江秀梅、林香汶、朱和翔、蔡文正、侯鈺琪、洪寶蓮（2008）。台灣中部民眾就醫及用藥概況調查－以某醫學中心門診病患為例。中西整合醫學雜誌，10(2)，1-14。
陳學漪（2013）。新北市地區成人正確用藥五大核心能力與感冒糖漿使用行為之研究（未出版碩士論文）。南華大學。嘉義縣。
童雅玲（2008）。慢性病患者之成人健康知能程度與用藥安全認知之探討－以高雄縣某地區醫院為例（未出版碩士論文）。高雄醫學大學。高雄巿。
黃憶雯（2008）。藥袋標示與民眾用藥安全關係之研究（未出版碩士論文）。高雄醫學大學。高雄市。
楊淑婷（2007）。媒體對用藥安全的知識、態度及行為之影響（未出版碩士論文）。臺北醫學大學。臺北市。
葉明功（2008）。病人用藥安全教育－如何為自己的用藥安全把關。臺電月刊，544，52-55。
葉明莉、張英睿、黃莉蓉、馬晟凱、李震亞、王金龍、張文森（2008）。門診民眾用藥安全知識與經驗。亞東學報，28，117-124。
管玉娟（2012）。臺北市某國中學生正確用藥知識、態度與行為之研究（未出版碩士論文）。國立臺灣師範大學。臺北市。
趙憲麟（2004）。國小高年級學童對藥品概念認知之研究（未出版碩士論文）。臺北巿立師範學院，臺北巿。
劉上永（2003）。正確用藥教育介入成人感冒患者高就醫行為之研究（未出版碩士論文）。雲林科技大學。雲林縣。
蕭美玲、林慶豐、陳惠芳、許明滿、張天韻（2005）。胃藥的迷失。藥品食品安全週報，8。
簡淑真、陳必立（2006）。你知道如何正確使用藥品嗎？正確用藥健康罩－系列報導1。全民健康保險雙月刊，59，27-29。
龐琇綾、項怡平、溫軒琳、李炳鈺（2011）。「正確用藥教育資源中心」推動民眾正確用藥教育經驗分享。醫療品質雜誌，5(2)，18-22。

二、英文文獻
Alkatheri AM, Albekairy AM. (2013). Does the patients' educational level and previous counseling affect their medication knowledge? Annals of Thoracic Medicine, 8(2), 105-108.
Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J, (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. Amercian journal of public health, 92(8), 1278-1283.
Baker DW, Parker RM, Williams MV, Clark WS, (1998). Health literacy and the risk of hospital admission.Journal of general internal medicine, 13(12), 791-798.
Bohanny W, Wu SF, Liu CY, Yeh SH, Tsay SL, Wang TJ, (2013). Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners, 25(9), 495-502. . doi: 10.1111/1745-7599.12017.
Burge S, White D, Bajorek E, Bazaldua O, Trevino J, Albright T, Wright F, Cigarroa L, (2005). Correlates of Medication Knowledge and Adherence: Findings From the Residency Research Network of South Texas. Family Medicine, 37(10),712-718.
Calamusa A, Marzio AD, Cristofani R, Arrighetti P, Santaniello V, Alfani S, Carducci A (2012). Factors that influence Italian consumers’ understanding of over-the-counter medicines and risk perception. Patient Education and Counseling, 87(3), 395-401. doi: 10.1016/j.pec.2011.10.003.
Cameron KA, Ross EL, Clayman ML, Bergeron AR, Federman AD, Bailey SC, Davis TC, Wolf MS, (2010). Measuring patients' self-efficacy in understanding and using prescription medication. Patient Education and Counseling, 80(3), 372-376. doi: 10.1016/j.pec.2010.06.029.
Cha E, Kim KH, Lerner HM, Dawkins CR, Bello MK, Umpierrez G, Dunbar SB, (2014). Health literacy, self-efficacy, food label use, and diet in young adults. American journal of health behavior, 38(3), 331-339. doi: 10.5993/AJHB.38.3.2.
Chambers CT., Reid GJ., McGrath PJ, & Finley GA (1997). Self-administration of over-the-counter medication for pain among adolescents. Archives of pediatrics & adolescent medicine, 151(5), 449.
Chen TJ, Chou LF, Hwang SJ, (2003). Utilization of hepatoprotectants within the National Health Insurance in Taiwan. J Gastroenterol Hepatol., 18(7),868-872.
Chi HY, Chang FC, Lin HJ, Huang LJ, Chang JC, Yeh MK, Kang JJ., (2014). Evaluation of a health-promoting school program to enhance correct medication use in Taiwan. Journal of Food and Drug Analysis, 22(2), 271-278.
Cramer T, (1992). When do you need an antacids? FDA Consumer, 26(1), 18-23.
Davis TC, Wolf MS, Bass PF, Middlebrooks M, Kennen E, Baker DW, Bennett CL, Durazo-Arvizu R, Bocchini A, Savory S, Parker RM (2006). Low literacy impairs comprehension of prescription drug warning labels. Journal of general internal medicine. 21(8), 847-851.
DeMuth K, Stecenko A, Sullivan K, Fitzpatrick A. (2013). Relationship between treatment with antacid medication and the prevalence of food allergy in children. Allergy Asthma Proc., 34(3), 227-232. doi: 10.2500/aap.2013.34.3657.
Eom CS, Jeon CY, Lim JW, Cho EG, Park SM, Lee KS, (2011). Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis. CMAJ, 183(3), 310-319. doi: 10.1503/cmaj.092129.
Fishman LN, Houtman D, Groningen JV, Arnold J, Ziniel S, (2011). Medication knowledge: An Initial Step in Self-management for Youth With Inflammatory Bowel Disease. JPGN., 53(6), 641-645.
Fossmark R, Waldum H, (2013). The Distressing Overuse of Gastric Acid Inhibitors. Dig Dis Sci., 58, 600-601. doi : 10.1007/s10620-012-2532-6.
Furu K, Straume B, (1999). Use of antacids in a general population: the impact of health-related variables, lifestyle and sociodemographic characteristics. J Clin Epidemiol., 52(6),509-516.
Ghandour RM, Overpeck MD, Huang ZJ, Kogan MD, Scheidt PC., (2004). Headache, stomachache, backache, and morning fatigue among adolescent girls in the United States associations with behavioral, sociodemographic, and environmental factors. Arch Pediatr Adolesc Med., 158(8), 797-803.
Gryfe-Becker BM, Segal HJ, Einarson TR., (1989). Effect of auxiliary prescription labels on the elderly ambulatory patient’s drug knowledge. DICP., 23(4), 324-329.
Hsiao FY, Lee JA, Huang WF, Chen SM, Chen HY, (2006). Survey of Medication Knowledge and Behaviors Among College Students in Taiwan. American Journal of Pharmaceutical Education, 70(2), 1-7.
Hsieh CF, Huang SL, Chen CL, Chen WT, Chang HC, Wu ML, Yang CC, (2012). Increased risk of chronic kidney disease among users of non-prescribed Chinese herbal medicaine in Taiwan. Preventive Medicine, 55(2), 155-159.
Huang YM, Wang HP, Yang YH, Lin SJ, Lin HW, Chen CS, Wu FL, (2006). Effects of a national health education program on the medication knowledge of the public in Taiwan. The Annals of Pharmacotherapy, 40(1), 102-108.
Kripalani S, Henderson LE, Jacobson TA, Vaccarino V. (2008). Medication use among inner-city patients after hospital discharge : patient-reported barriers and solutions. Mayo Clin Proc., 83(5), 529-535. doi: 10.4065/83.5.529.
Lee, KE., Hwang, SJ., Gwak, HS., Lee, BK., Bae, SJ., Rhie, S. (2013). A cross-sectional study of factors related to gastrointestinal drug use in Korean adolescents. Arch Pharm Res, 36(10), 1238-1243. doi: 10.1007/s12272-013-0220-5
Maniaci MJ, Heckman MG, Dawson NL, (2008). Functional health literacy and understanding of medications at discharge. Mayo Clin Proc., 83(5), 554-558. doi: 10.4065/83.5.554.
Marks JR, Schectman JM, Groninger H, Plews-Ogan ML, (2010). The association of health literacy and socio-demographic factors with medication knowledge. Patient Education and Counseling, 78(3), 372-376. doi: 10.1016/j.pec.2009.06.017.
McGavock H. (2009). Treatment failure due to antacids. PulseClinical, 33.
Meadows, M. (2006). Outreach program to teach safe medicine use to middle school children. FDA consumer, 40(6), 9.
Moisan J, Gaudt M, Gregoire JP, Bouchard R, (2002). Non-compliance with drug treatment and reading difficulties with regard to prescription labelling among seniors. Gerontology. 48(1), 44-51.
Nahin RL, Pecha M, Welmerink DB, Sink K, DeKosky ST, Fitzpatrick AL; Ginkgo Evaluation of Memory Study Investigators(2009). Concomitant use of prescription drugs and dietary supplements in ambulatory elderly people. J Am Geriatr Soc., 57(7), 1197-1205. doi: 10.1111/j.1532-5415.2009.02329.x.
Nielsen-Bohlman, I., Panzer, AM, & Kindig DA, (2004). Health literacy: A prescription to end confusion .Washington, DC: The National Academies Press.
Nutbeam, D. (2001). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267.
Ogawa,R.& Echizen,H. (2011). Clinically significant drug interactions with antacids: an update. Drugs, 71(14), 1839-1864. doi: 10.2165/11593990-000000000-00000
Ohinmaa, A., Langille, J.-L., Jamieson, S., Whitby, C., & Veugelers, P. J. (2011). Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program. Canadian Journal of Public Health/Revue Canadienne de Sante'e Publique, 451-454.
Pandit AU, Tang JW, Bailey SC, Davis TC, Bocchini MV, Persell SD, Federman AD, Wolf MS, (2009). Education, literacy, and health: Mediating effects on hypertension knowledge and control. Patient Education and Counseling, 75(3), 381-385. doi: 10.1016/j.pec.2009.04.006.
Parojcic, J., Corrigan, O. (2008). Rationale for ibuprofen co-administration with antacids: potential interaction mechanisms affecting drug absorption. Eur J Pharm Biopharm, 69(2), 640-7. doi: 10.1016/j.ejpb.2008.01.001
Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. ( 2008). Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA, 300(24), 2867-2878. doi: 10.1001 /jama.2008.892.
Ratzen SC, (2001). Health literacy: Communication for the public good. Health Promotion International, 16(2), 207-213.
Raynor DK., (2009). Addressing medication literacy : a pharmacy practice priority. Int J Pharm Pract., 17(5), 257-259.
Rollnick S, Mason P, Butler C.,(1999). Health behavior change: a guide for practitioners. .Edinburgh: Churchill Livingstone.
Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB, (2008) Association of health literacy with diabetes outcomes. JAMA. 288(4), 475-482.
Stoelben, S., Krappweis, J., Rössler, G., & Kirch, W. (2000). Adolescents' drug use and drug knowledge. European journal of pediatrics,159(8), 608-614.
Terrin G, Canani RB, Passariello A, Caoci S, De Curtis M, (2012). Inhibitors of gastric acid secretion drugs increase neonatal morbidity and mortality. J Matern Fetal Neonatal Med., 4, 85-87. doi: 10.3109/14767058.2012.714975.
Wen MF, Lin SJ, Yang YH, Huang YM, Wang HP, Chen CS, Wu FL, (2007). Effects of a national medication education program in Taiwan to change the public's perceptions of the roles and functions of pharmacists. Patient Education and Counseling, 65(3), 303-310.
Wolf MS, Davis TC, Osborn CY, Skripkauskas S, Bennett CL, Makoul G, (2007). Literacy, self-efficacy, and HIV medication adherence. Patient Education and Counseling, 65(2), 253-260.
Wolf MS, Davis TC, Shrank W, Rapp DN, Bass PF, Connor UM, Clayman M, Parker RM, (2007). To err is human: patient misinterpretations of prescription drug label instructions. Patient Education and Counseling, 67(3), 293-300.
Wolf MS, Davis TC, Tilson HH, Bass PF, Parker RM, (2006). Misunderstanding of prescription drug warning labels among patients with low literacy. American Journal of Health-System Pharmacy. 63(11), 1048-1055.
Wolf MS, Gazmararan JA, Baker DW, (2005). Health literacy and functional health status among older adults. Archives of Internal Medicine, 165, 1946-1952.
World Health Organization (2004). Pharmacovigilance: ensuring the safe use of medicines. WHO policy perspectives on medicine. World Health Organization.
World Health Organization (2007). Promoting safety of medicines for children. World Health Organization.
World Health Organization. (1998). Health promotion glossary. Retrieved from http://whqlibdoc.who.int/hq/1998/WHO_HPR_HEP_98.1.pdf
Yamada J, Takayanagi R, Yokoyama H, Suzuki Y, Sinohara S, Yamada Y., (2012). Survey on Junior High School Student’s Attitudes toward Rational Drug Use and the Educational Effect by School Pharmacists. The Pharmaceutical Society of Japan, 132(2), 215-224.
Zuckerman B, Stevenson J, Bailey V, (1987). Stomachaches and headaches in a community sample of preschool children. Pediatrics. 79(5), 677-682.