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研究生: 瞿正婕
Chu, Cheng-Chieh
論文名稱: 台灣幼兒園教師健康識能量表之建構及調查研究
Construction and Survey Research of Health Literacy Scale for Kindergarten Teachers in Taiwan
指導教授: 胡益進
Hu, Yih-Jin
口試委員: 王英偉
Wang, Ying-Wei
陳秀熙
Chen, Hsiu-Hsi
張鳳琴
Chang, Fong-ching
董貞吟
Tung, Chen-yin
胡益進
Hu, Yih-Jin
口試日期: 2024/05/31
學位類別: 博士
Doctor
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2024
畢業學年度: 112
語文別: 中文
論文頁數: 164
中文關鍵詞: 健康識能調查研究幼兒園教師量表建構
英文關鍵詞: Health literacy, Survey research, Kindergarten teachers, Scale construction
研究方法: 調查研究內容分析法
DOI URL: http://doi.org/10.6345/NTNU202400543
論文種類: 學術論文
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  • 研究背景:健康識能是決定個人獲得、了解以及使用訊息的動機與能力,也是健康促進的一項重要因子和指標。健康識能與健康行為習習相關,臺灣對於「教師健康識能」方面的相關調查,目前無尚全國性的調查單位,且針對「幼兒園教師健康識能」之長期性調查或研究數量也甚少。但幼兒園教師之於兒童,不僅可以影響兒童發展,也因長時間與兒童相處,是能有效發現與改善兒童健康的至關重要者。因此,了解和提升幼兒園教師的健康識能程度,對於個人、家庭、學校甚或是社會,都是非常重要且值得關注的議題。本研究旨在以國內外文獻為基礎的自編健康識能量表對台灣幼兒園教師進行健康識能現況的調查,並探討人口學變項對於幼兒園教師健康識能的影響。
    研究目的與方法:本研究分三階段方式進行,第一階段為研究者根據國內外文獻、書籍與量表為基礎,建立台灣幼兒園教師的健康識能量表,第二階段為預試階段,研究者利用橫斷式調查法,在建立自編幼兒園教師的健康識能量表後,以立意取樣的方法,蒐集30位公立幼兒園教師之資料,並依上述資料進行量表的項目分析、信效度分析與題目的刪減。第三階段為正式施測階段,利用國家發展委員會出版之111年「都市及區域發展統計彙編」,將臺灣分為:北部區域、中部區域、南部區域及東部區域,各地區依據幼兒園分佈及幼兒園教師人數進行分層隨機抽樣,最終搜集了186位幼兒園教師之資料,並進行獨立樣本t檢定與ANOVA單因子變異數分析,探討幼兒園教師之健康識能現況及社會人口學變項與健康識能間的關聯與影響。
    研究結果:本研究建立了一具有良好的信度、建構效度及可靠性的健康識能量表,研究結果顯示,受試幼兒園教師在一般健康識能和疾病預防健康識能方面表現較佳,超過了評量尺度的80%。然而,在心理健康識能和醫療保健健康識能方面的表現則屬於中等水平。他們在學校系統健康識能方面的表現相對較低。此外,根據幼兒園的類型,教師的健康識能有顯著差異。公立或非營利幼兒園教師在一般健康識能、心理健康識能和醫療保健健康識能方面的表現略低於私立幼兒園教師,而在疾病預防健康識能方面稍高於私立幼兒園。此研究還指出,幼兒園教師的健康識能在社會人口學變項(如年齡、教育程度、婚姻狀況、年資等)方面並無顯著差異。同時,教師自覺的健康狀況也對其健康識能有影響。自覺健康狀況良好的教師在各個健康識能方面的表現優於自覺健康狀況一般或不佳者。
    研究結論:本研究顯示,幼兒園教師的健康識能在不同方面有著不同的表現,其中一般健康識能和疾病預防健康識能表現較佳,而心理健康識能和醫療保健健康識能則處於中等水平。教師健康識能表現的差異可能與幼兒園類型與教師自覺健康狀況有關。此研究建立了幼兒園教師健康識能的相關評估工具,為教育機構和健康政策制定者提供了有益見解,促進教師健康與職業發展,並提供了建議,以建立更健康的學校環境。

    Background: Health literacy is a crucial factor and indicator for health promotion, as it determines an individual's motivation and ability to acquire, understand, and use information. Health literacy is closely related to health behaviors. In Taiwan, there is currently no national survey unit specifically investigating "teacher health literacy," and long-term studies or surveys focusing on " kindergarten teachers' health literacy" are scarce. Kindergarten teachers not only influence children's development but, due to their extended interaction with children, play a pivotal role in identifying and improving children's health. Thus, understanding and enhancing kindergarten teachers' health literacy is an important issue that warrants attention for the benefit of individuals, families, schools, and society. This study aims to investigate the current state of health literacy among kindergarten teachers in Taiwan using a self-compiled health literacy scale based on domestic and international literature and to explore the impact of demographic variables on kindergarten teachers' health literacy.
    Objectives and Methods: This study was conducted in three stages. In the first stage, the researcher established a health literacy scale for Taiwanese kindergarten teachers based on domestic and international literature, books, and scales. The second stage was the pilot testing phase, where the researcher used a cross-sectional survey method, collecting data from 30 public kindergarten teachers through purposive sampling. The data was then subjected to item analysis, reliability and validity analysis, and item reduction. In the third stage, the formal survey was conducted using stratified random sampling based on the distribution of kindergartens and the number of kindergarten teachers in different regions (Northern, Central, Southern, and Eastern Taiwan) as published in the 2022 "Urban and Regional Development Statistics Compilation" by the National Development Council. A total of 186 kindergarten teachers' data were collected and analyzed using independent sample t-tests and one-way ANOVA to investigate the current state of health literacy among kindergarten teachers and the relationship and impact of sociodemographic variables on health literacy.
    Results: This study established a health literacy scale with good reliability, construct validity, and reliability. The results indicated that the kindergarten teachers in the sample performed well in general health literacy and disease prevention health literacy, exceeding 80% of the scale. However, their performance in mental health literacy and healthcare health literacy was at a moderate level, and their performance in school system health literacy was relatively low. Additionally, significant differences in health literacy were observed based on the type of kindergarten. Public or non-profit kindergarten teachers performed slightly lower in general health literacy, mental health literacy, and healthcare health literacy compared to private kindergarten teachers, while their performance in disease prevention health literacy was slightly higher. The study also found no significant differences in health literacy across sociodemographic variables such as age, education level, marital status, and years of experience. However, teachers' self-perceived health status impacted their health literacy, with those perceiving their health as good performing better in all aspects of health literacy compared to those perceiving their health as average or poor.
    Conclusions: This study demonstrates that kindergarten teachers exhibit varying levels of health literacy across different domains, with better performance in general health literacy and disease prevention health literacy, and moderate levels in mental health literacy and healthcare health literacy. The differences in health literacy performance may be related to the type of kindergarten and teachers' self-perceived health status. The study established a relevant assessment tool for kindergarten teachers' health literacy, providing valuable insights for educational institutions and health policy makers, promoting teacher health and professional development, and offering recommendations for creating a healthier school environment.

    謝辭 i 摘要 ii Abstract iv 目次 vii 表次 ix 圖次 x 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 6 第三節 名詞釋義 7 第二章 文獻探討 9 第一節 健康識能的定義與概念 9 第二節 影響健康識能的因素與其相關研究 18 第三節 健康識能的評估工具 33 第四節 教師健康識能的相關研究 42 第三章 研究設計 49 第一節 研究架構 49 第二節 研究對象 50 第三節 研究工具 58 第四節 研究步驟 62 第四章 研究結果 69 第一節 預試問卷項目分析與信度分析 69 第二節 預試問卷效度分析 80 第三節 正式版量表內容 88 第四節 正式問卷之題項驗證分析 92 第五節 正式問卷調查結果分析 96 第六節 研究限制 105 第五章 結論與建議 107 第一節 結論 107 第二節 建議 108 參考文獻 111 附錄一 文獻與量表初稿內容 143 附錄二 預試問卷內容 151 附錄三 受試者招募文件 158 附錄四 正式量表 160

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