民眾對中醫藥的認知度、信賴度、使用度及其相關因素之探討
蔡文正
中國醫藥學院
台灣具有多元化醫療體系，大致上可區分為西醫、中醫及民俗醫療等三種主要醫療體系，民眾之醫療利用雖然以西醫為主，但根據健保局統計資料顯示，近年來中醫門診次數、件數及醫療費用均呈現成長的趨勢，顯示中醫醫療是不可或缺的,且多篇研究皆顯示台灣民眾具有複向求醫的特性。由於一般民眾對於中醫藥的認知，多處於「藥性溫和，且較無副作用」，因此經常未經醫師處方自行購買、服用。消基會統計資料顯示，2006年檢出中藥摻雜西藥之比例有17.3%，皆未經過醫師診斷及處方，因此民眾對於用藥安全的認知及行為有待加強。知識(Knowledge)、態度(Attitude)、行為(Practice)三者間存在相互影響的關係。有鑑於中醫醫療利用普遍存在，且多次就醫及重複用藥情況日益重，除了造成醫療資源浪費，更可能危害民眾用藥安全。而用藥安全不僅是醫療院所或醫護人員的責任，更是民眾本身的責任。因此本研究主要目的在於瞭解民眾對於中醫藥的認知度、信賴度、使用度以及藥物不良反應之經驗，進而提出導正民眾對於中醫藥用藥安全的認知與行為之建議。本研究以台灣地區二十三個縣市中20歲以上民眾為研究對象，依各縣市人口、性別及年齡比例進行分層隨機抽樣，並委由專業民意調查單位，以電腦輔助之電話訪問系統(CATI)進行抽樣訪問，預計回收有效問卷1000份。回收之問卷，將以次數、百分比描述樣本個人基本特性、健康狀況、就醫習慣與經驗、用藥習慣與用藥不良之經驗，並以平均值、標準差，描述樣本對於中醫藥認知度、中醫藥信賴度及中醫藥使用行為等部分作答得分情形。推論性統計部分，除利用卡方分析、變異數，分析比較不同特性的民眾對於中醫藥認知、態度、與行為之差異外，將運用複迴歸統計方法，探討影響民眾中醫藥認知度、中醫藥信賴度、中醫藥使用度之相關因素。藉由研究結果之彙整，提出提升民眾中醫藥用藥安全之認知與行為之建議，供衛生主管機關未來政策推行之參考。
關鍵字：中醫；中藥；用藥安全；認知；態度；行為
Peoples perception, reliability and utilization of Chinese medicine and its associated factors
Tsai, Wen-Chen
China Medical University
Taiwan has diversified health care system, which include western, Chinese and alternative health care systems. Although western medicine treatment were the first choices when patient got sick, but according to the Bureau of National Health Insurance (NIH) statistics, the utilization and cost in Chinese medical treatment was increasing recently. Besides, many studies pointed out the problems of health care utilization variations among patients in Taiwan. The patients’ perceptions of Chinese medicine were “moderate and with seldom side effects”. Therefore, it is common that patients buy and take Chinese medicine without prescriptions. According to the statistics of Consumers’ foundation in Taiwan, the ratio of Chinese medicine mixed with western medicine was 17.3%, also these medicine did not approved by physicians prescriptions. Therefore, the patients’ perceptions and behaviors on drug safety were the main problems that we have to focus on. Knowledge, attitude and practice constitute a triad of interactive factors characterized by dynamism and unique interdependence. The situations of high utilization of Chinese medical treatment and repeated medicine bring out the problems of wasting medical resources and endangering patients’ drug safety. Drug safety is the responsibility of health care providers, and also the responsibility of patients’ themselves.
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