高度近視併發症防治教育介入效果研究：以北部某大學一年級高度近視學生為例

Effectiveness of a High Myopic Complications Preventive Intervention Program among High Myopic Freshmen in a University of North Taiwan

本研究以健康信念模式與成人教育為理論基礎，設計高度近視併發症防治教育介入課程，以探討在大學生教育介入的效果。本研究採等組前後測及後後測真實驗設計，以北部某大學一年級高度近視學生為研究母群體，在103學年度大學部新生體檢時，初步篩檢出近視度數（球面當量）600度及以上的學生，隨機分派為實驗組與控制組，實驗組接受本研究研發之「高度近視併發症防治教育」課程，兩組學生於前測（9月）、後測（10月）及後後測（11月）時進行問卷調查。統計方式採單因子共變數分析以鑑別實驗組與控制組間的差異。
統計結果，實驗組的後測成績在「知識」、「自我效能」及「預防性健康行為」三變項明顯高於控制組。但在後後測時，實驗組成績只有在「自我效能」及部分「預防性健康行為」，即「自我檢查」兩變項明顯高於控制組。針對大學高度近視新生實施「高度近視併發症防治教育」介入後的立即效果與延宕效果評估結果顯示：教育介入可有效增加學生對高度近視併發症的防治知識，並可透過觀察學習、情境模擬、言語說服等課程，提高並維持自我效能，雖在整體行為意向中只見到立即效果，但是防治行為中的「自我檢查」仍具有延宕效果，表示教學介入對實驗組學生確實產生教育效果，造成其行為改變。
目前臺灣相關的高度近視併發症防治資訊相當不足，也沒有一套有效的課程與教材教具，本研究所設計的課程與特殊教具，針對提升高度近視併發症防治知識、自我效能與行為意向，經研究證實具有相當成效。日後於學校或相關衛生單位實施防治教育宣導時，應可多加運用推廣，建立高度近視族群健康自主管理概念，達成高度近視併發症「及早診斷、及早治療」的防治效果。

The purpose of this study was to evaluate the effectiveness of a high myopic complications preventive intervention program, based on health belief model, among high myopic freshmen. The study employed a true experimental design, based on the health belief model and adult education special elements, at one university in north Taiwan. High myopia subjects (myopic spherical equivalence 6 diopters or more) were identified at routine freshmen physical examination program of 2014 and were allocated randomly as experimental or control group. Subjects in the experimental group were enrolled in the intervention program, while subjects in control group were not. Questionnaires were distributed at three time points, that were September, October and November 2014 respectively, and one-way analysis of covariance (one way-ANCOVA) was conducted for all collected data.
Compared to the control group, high myopic freshmen in the experimental group performed better post-test in “knowledge,” “self-efficacy,” and “preventive health behavior” issues of high myopic complications prevention. While in the post post-test, experimental group performed better only in “self-efficacy” and “self-examination behavior,” which is part of “preventive health behavior” issues. In conclusion, this study demonstrated that high myopic complications preventive intervention program had immediate effective with respect to promote high myopic complications preventive knowledge, self-efficacy, and preventive health behavior. Also this program was proved to have prolonged effect in self-efficacy and self-examination behavior.
There are lack of information and instruction course about high myopic complications prevention in our college and community. This program could be adopted by school or local governmental departments for high myopic students or residents, in the purpose of self-management of health and “early diagnosis and early treatment” of high myopic complications.