臺灣北部學生初次嘗試毒品之成因探討：11年長期追蹤資料分析

中山醫學大學機構典藏 CSMUIR > 健康管理學院 > 公共衛生學系暨碩士班 > 博碩士論文 > Item 310902500/8975

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/8975

Title:	臺灣北部學生初次嘗試毒品之成因探討：11年長期追蹤資料分析 The Factors of Initial Drug Use among Adolescents in north of Taiwan：An 11-Year Longitudinal Study
Authors:	蔡晏櫻 Tsai, Yen-Ying
Contributors:	中山醫學大學：公共衛生學系;江宜珍
Keywords:	青少年;長期追蹤;初次嘗試毒品 adolescents;longitudinal;onset of drug use
Date:	2013
Issue Date:	2014-01-15T04:34:28Z (UTC)
Abstract:	目的：目前國內研究發現青少年毒品使用年齡呈下降趨勢，但過去研究多針對已成癮，或因使用毒品而進入戒治機構之青少年做為研究對象，使用長期追蹤資料探討初次嘗試毒品之研究鮮少。基於公共衛生預防勝於治療觀點，應及早了解造成青少年初次嘗試毒品使用之可能因素，故本研究目的有二：(1)了解臺灣北部學生初次嘗試毒品使用之分佈情況。(2)探討影響臺灣北部學生初次嘗試毒品使用之個人因素（個人認知及行為影響因素）及社會因素（重要他人行為影響因素及社會依附因素）。方法：使用國家衛生研究院CABLE（Child &Adolescent Behaviors in Long-term Evolution）計畫之部分資料進行次級資料分析，樣本為2001年就讀臺北市及新竹縣兩地區之小學四年級學童（隨機抽取18所公立國民小學），長期追蹤至2011年（該世代學生就讀大二），11年皆有填答者為1,106人，連續追蹤率53.28%。由於臺灣青少年毒品使用之盛行率偏低及個案數較少，以存活分析進行統計分析。結果：依本研究樣本分析後結果顯示從小五至大二初次嘗試毒品之平均發生率約為0.04%，且隨年級增加有上升趨勢，發生率最高年級為大一（1.71%）。此外，可能影響學生初次嘗試毒品之危險因子為個人吸菸與嚼食檳榔經驗，以及同儕吸毒經驗；反之，父母行為監督、家庭支持為重要保護因子。以固定值法之存活分析顯示小四時家庭衝突程度越高（HR=3.82）、自覺不受人喜愛程度越高（HR=1.97）為重要危險因子；同儕有飲酒經驗（HR=2.83）者，出現初次嘗試毒品行為的風險較高。以隨年度變動值法探討延遲效應發現前一年同儕有飲酒經驗（HR=2.27）或吸毒經驗（HR=5.83）、個人有嚼檳榔經驗（HR=10.75）為危險因子；前一年家庭支持程度較高（HR=0.59）和父母行為監督程度較高（HR=0.61）為保護因子。結論：結果顯示家庭衝突、自覺不受人喜愛、同儕物質使用經驗以及個人有吸菸或嚼食檳榔經驗皆屬危險因子；家庭支持、父母行為監督與健康價值觀為保護因子。因此針對家長建議：降低家庭衝突並持續行為監督以及心理支持；於學校方面應注意自覺不受人喜愛或邊緣化學生之交友狀況；在毒品防制政策部份，應協助學校監控毒品使用學生及學生藥頭，同時提升拒藥效能及壓力因應技巧，且提早於小學低年級階段介入管制監督。 Objectives：The initial age of drug use is decreasing in Taiwanese adolescents. The past researches focused on addictive users and drug dependent users. Using the longitudinal survey to explore the reasons of onset drug use was rare. Base on the view of prevention, we should know the possible involvement factors to onset of drug use. There are two purposes of our study, first of all is to understand the distribution of onset of drug use in Taiwanese adolescents. Secondly , the study examine the involvement between personal factors（personal recognition and behavioral factors）and social factors（behaviors of important persons and social attachment factors）to onset of drug use. Methods：Data was obtained from the 2001 to 2011 phase of the Child and Adolescent Behaviors in Long-term Evolution（CABLE）project, at which time the study participants were in a grade four student to a sophomore college student . Data were 2688 participants who lived in Taipei City or Hsin-Chu County is analyzed. There were 53.28% participants completed the self-reported questionnaire in the 11-year follow-up study. Because of the low prevalence of adolescents drug use, the study using the Survival Analysis to evaluate the relationships between personal factors, social factors and onset of drug use. Results：Among the participants, the equally incident was 0.04% in the year from 2002 to 2011. And there was an increasing trend of the onset of drug use with grade. By using the time-invarying method we realize that risk factors are family conflict in grade four（HR=3.82）, self likeability（HR=1.97）,and peer drinking （HR=2.83）. Using the time-varying method we realize the lag effect that peer drinking （HR=2.27）, peer drug use（HR=5.83）,self-betel nut use（HR=10.75）are risk factors, and family support（HR=0.59）, parent monitoring（HR=0.61）are protective factors. Conclusions：Our evidence suggest that parents should reduce the family conflict and keep behavioral monitoring in students’ childhood, and teachers should be concerned with isolated students’ and their friendships. For the policy, the government should promote earlier detection and drug-refusing efficacy, and be aware of drug use in school to avoid aggregation in students.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/8975
Appears in Collections:	[公共衛生學系暨碩士班] 博碩士論文

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