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系統識別號 U0026-0812200912113613
論文名稱(中文) 台灣南部大學生嚼檳榔行為之社會認知因素探討
論文名稱(英文) Social Cognitive Determinants of Betel Quid Chewing among College Students in Southern Taiwan
校院名稱 成功大學
系所名稱(中) 行為醫學研究所
系所名稱(英) Institute of Behavioral Medicine
學年度 94
學期 2
出版年 95
研究生(中文) 張志宏
研究生(英文) Chih-Hung Chang
電子信箱 hung217@gmail.com
學號 s8692402
學位類別 碩士
語文別 中文
論文頁數 74頁
口試委員 指導教授-柯慧貞
口試委員-鄭中平
召集委員-楊奕馨
中文關鍵字 社會影響  意圖  拒用自我效能  嚼食檳榔  修正ASE模式  效果預期 
英文關鍵字 betel quid chewing  revised ASE model  outcome expectancy  social influence  refusal self-efficacy  intention 
學科別分類
中文摘要 研究背景與目的 嚼食檳榔對身體健康的危害已被廣泛證實,國內研究多聚焦於檳榔使用盛行率與口腔癌等疾病之分析,因此值得對使用檳榔的成因進行深入探討。在社會科學領域中,ASE(Attitudes–Social influence–Efficacy Model)廣被應用來驗證人類的行為,其中的社會認知因子:效果預期、自我效能感、社會影響以及行為意圖,已累積不少的研究證據;然而實徵研究的證據卻指出效果預期較無法直接預測行為,而必須透過自我效能的間接影響,此與原ASE模式的假設有些出入。因此本研究採用原模式中的預測變項,重新假設變項之間的關係而提出「修正性的ASE模式」,以期能找出解釋大專學生嚼食檳榔的最佳社會認知模式。簡言之,本研究目的在於從社會認知的觀點,探討大學生嚼食檳榔的心理歷程,以期提供未來設計介入方案的參考依據。

研究方法 (1)受試者:以南區大專院校學生為母群體,依學院與學制分層後,再隨機以叢集抽樣擬選出5,137人,最終共回收3,741份問卷;在排除未填寫或填答不完整的檳榔相關問卷的受試者之後,所得有效問卷為3,162份(佔擬抽樣樣本之61.55%)。 (2)研究工具:個人基本資料表、檳榔嚼食意圖與行為量表、正向與負向檳榔效果預期量表、社會影響量表、拒用檳榔自我效能量表。 (3)研究程序:2003年11月~12月間,由南區十四所大專校院中抽樣,受試者在經過詳細的解說研究目的、以及填寫同意書後,以自陳的方式填寫相關問卷。 (4)統計分析:以描述統計呈現本研究樣本的基本人口學特徵、檳榔使用情形,並計算使用檳榔的盛行率;其次以結構方程模式(Structural Equation Modeling, SEM)的統計方式,進行兩競爭模式的比較以及檢驗修正模式解釋觀察資料的程度。

研究結果 本研究有效樣本的檳榔盛行率為7.1%(223/3162),其中男生為13.8%、女生為2.1%。利用SEM進行比較模式的各項適配評估,結果驗證研究者所提出的修正ASE模式,是更適合用來解釋南區大專學生嚼食檳榔的社會認知模式,並且擁有良好的整體模式適配度。在變項間的關係部分,社會影響與拒用自我效能可以直接預測使用意圖與使用行為,也可以透過使用意圖來間接預測檳榔使用行為;除此之外,正、負向效果預期以間接的方式,透過拒用自我效能來預測檳榔使用意圖與使用行為。本模式可解釋南區大專學生檳榔使用行為26.5%的變異量。

結論與建議 本研究結果支持修正的ASE模式,是較適合用來解釋南區大專學生嚼食檳榔的行為。研究結果指出拒用自我效能與社會影響為預測大專學生檳榔使用行為的直接因素,而正、負向效果預期需透過自我效能才能間接影響檳榔使用行為。在理論應用部分,建議未來能以縱貫性的研究設計,驗證此修正模式的因果關係;在臨床應用部分,建議相關單位利用本研究的發現,從三級預防的觀點,設計提升學生拒用檳榔自我效能與降低社會影響的介入計畫,推動大專學校無檳榔活動,以期能使學生遠離檳榔的禍害。


英文摘要 Background It has been well documented that the use of betel quid is harmful for health. However, a majority of literature about betel quid focused on its prevalence and oral cancer. It is worth and imperative to understand the psychosocial process of betel quid chewing. In social science, the Attitudes- Social Influence-Self-Efficacy (ASE) model has been applied to explain human behavior widely. According to the ASE model, behaviors are predicted by intention, which is explained by three important social cognitive factors: attitude, social influence, and self efficacy. However, the full model has not been completely supported by empirical data; for example, outcome expectancy would have an indirect impact on the intention to chew and actual betel quid use through refusal self-efficacy. Therefore, this study proposed a revised ASE model and aimed to examine the revised ASE Model in explaining the psychosocial process of betel quid use among Southern Taiwan college students through Structural Equation Modeling.

Methods (1).participants: a cluster sampling was used to sample the population of southern Taiwan college students. There were 5,137 college students invited to participate, with a final of 3,741 college students joining the study. After excluding incompletely data, the valid sample included 3,162 students (61.55%). (2). measurements: demographic data, betel quid chewing intention, betel quid chewing behavior, betel quid outcome expectancy, social influence, and betel quid refusal self-efficacy (3).procedure: data were collected in 2003 from 14 colleges in Southern Taiwan. Before the group administration, the purpose and details of the study and their confidentiality were fully explained and obtained their informed consents. (4). statistical analysis: we compared two competing models and examined the relationship among the variables through the Structural Equation Model (SEM) which was carried out by AMOS program (Amos 5.0)

Results The prevalence of betel quid use was 7.1% (223/3 162) for all college students, which accounted for 2.1% in females and 13.8% in males. It showed that the revised ASE model accounted for 26.5% of the variance in betel quid use and had a better model-fit evaluation than the original model. Intention to chew affected the use of betel quid, while both social influence and refusal self-efficacy had a direct impact on intention and use as well as an indirect effect on use through intention. Additionally, both positive and negative outcome expectancies predicted intention and betel quid use via refusal self-efficacy.

Conclusion and Implication The revised ASE model contributed additional information to the literature which may help researchers understand the psychosocial process of betel quid chewing. Moreover, implications of the revised ASE model were provided with respect to the development of effective prevention programs and clarified the relationships between social cognitive variables, suggesting that more attention should be given towards the development of school-based preventive programs on diminishing social influence and promoting refusal self-efficacy in betel quid use.


論文目次 目錄
中文摘要………………………………………………………………………………… I
英文摘要…………………………………………………………………………………III
誌謝……………………………………………………………………………………… V
目錄…………………………………………………………………………………… VII
表目錄……………………………………………………………………………………IX
圖目錄…………………………………………………………………………………… X
附錄目錄………………………………………………………………………………… XI

第一章 緒論 ……………………………………………………………1
第一節 研究背景………………………………………………………… 1
第二節 嚼檳榔對健康的影響……………………………………… 2
一、檳榔的成分分析…………………………………………… 2
二、對健康的危害……………………………………………… 3
三、對身體的其它影響………………………………………… 4
第三節 國內檳榔使用現況分析…………………………………… 5
第四節 從社會認知架構探討大學生的檳榔使用行為…………… 6
一、效果預期…………………………………………………… 7
二、自我效能感…………………………………………………10
三、社會影響……………………………………………………12
四、行為意圖……………………………………………………13
五、修正後的整合模式…………………………………………14
六、小結…………………………………………………………15
第五節 研究目的與假設……………………………………………16
第二章 研究方法………………………………………………………17
第一節 研究樣本……………………………………………………17
第二節 研究工具……………………………………………………18
一、個人基本資料表……………………………………………18
二、檳榔嚼食意圖量表…………………………………………18
三、檳榔嚼食行為量表…………………………………………18
四、嚼食檳榔預期量表…………………………………………18
五、社會影響量表………………………………………………19
六、拒用檳榔之自我效能量表…………………………………20
第三節 研究程序……………………………………………………20
第四節 資料處理……………………………………………………21
第三章 研究結果………………………………………………………23
第一節 人口學變項與盛行率之分析………………………………23
一、排除樣本與有效樣本的基本人口學變項比較……………23
二、有效樣本之結構分析………………………………………23
三、有無使用檳榔者在基本人口學變項的比較………………23
四、南區大專院校學生使用檳榔之盛行率調查………………24
第二節 研究變項之相關分析………………………………………24
一、預測變項與檳榔使用行為之間的相關分析………………24
二、分量表之間的相關分析……………………………………24
三、人口學變項與研究變項之間的相關………………………25
第三節 有無使用檳榔在社會認知變項之差異分析………………25
第四節 假設模式之分析……………………………………………26
一、兩競爭模式之比較…………………………………………26
二、評鑑模式的適配度…………………………………………27
三、模式潛在變項間的效果……………………………………30
第四章 討論……………………………………………………………33
第一節 本研究的主要結果與解釋…………………………………33
一、南區大專學生使用檳榔之盛行率探討……………………33
二、南區大專學生使用檳榔之人口學變項探討………………33
三、南區大專學生使用檳榔之社會認知因素探討……………34
第二節 研究限制與未來研究之建議………………………………38
一、受試者部分…………………………………………………38
二、研究工具部分………………………………………………39
三、研究設計部分………………………………………………39
第三節 本研究的理論貢獻與應用價值……………………………40
一、理論貢獻部分………………………………………………40
二、本研究應用價值……………………………………………40
參考文獻……………………………………………………………………42
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