影響繼發性骨質疏鬆症高危險群對骨質疏鬆症之認知及預防行為之相關因素探討
中文摘要
骨質疏鬆症造成的骨折、失能，不僅使罹病者身心受創、生活品質下降，骨折後所需之醫療、復健、長期照護等問題，對病患及家人都是沉重的負擔。文獻指出男性約 30% 至 60% ，停經前婦女則 約五成是因疾病或藥物而導致繼發性骨質疏鬆症，然而國內目前多針對更年期婦女進行相關研究，
但對繼發性骨質疏鬆症之高危險族群卻甚少，因此本研究之目的主要是想瞭解繼發性骨質疏鬆症高 危險群骨密度現況及其對骨質疏鬆症之認知與預防行為，進而探討其影響因素。採橫斷式研究設計
，以方便取樣方式選取臺北市某區域級以上教學醫院之內外科住院及門診 20 歲以上病患，且至少 符合一項繼發性骨質疏鬆症之危險因子者為研究對象，並以結構式問卷收集相關資料及 GE Lunar A chilles Express Bone Ultrasonometer 測量跟骨骨密度，共取得有效樣本 197 人。結果發現骨密度正常
（ T-score>-1 ）者佔 46.2% 、骨質減少（ -1<T-score<-2.5 ）者為 29.4% 、骨質疏鬆（ T-score<-2.
5 ）則為 24.4% ，平均骨密度值介於 -1 至 -2.5 間屬骨質減少情形；有無罹患疾病、罹病種類及藥物 使用情形與其骨密度間並無顯著相關。個案對骨質疏鬆症認知普遍不足（ M = 57.64, SD = 28.18 ）
，僅“偶爾”執行相關預防行為（ M = 2.05, SD = 0.57 ）。年紀輕、教育程度、職業等級能正向影 響個案認知；曾接觸過骨質疏鬆症相關訊息者之認知與預防行為較佳。女性、自覺健康狀況愈佳者 預防行為愈好，且與認知呈顯著正相關。個案的骨密度情形並不會影響其對骨質疏鬆症之認知與預 防行為，但罹病種類則與認知及預防行為呈顯著差異。有無接觸過骨質疏鬆症相關訊息、教育程度
、年紀，能解釋個案對骨質疏鬆症認知 42% 之變異量；而認知、罹患肝臟疾病、性別與年齡則能 顯著預測其預防行為執行情形（ R2 = .26, F = 16.39, p < .001 ）。藉由本研究初步瞭解繼發性骨質疏 鬆症高危險族群對骨質疏鬆症認知不高，且偶爾才執行預防行為，因此預防骨質疏鬆症的相關衛教 活動之執行是必要的，建議未來之介入性措施可考量族群特性，加強民眾對此疾病之認知，建立相 關預防與醫藥保健常識，以增進預防行為之執行。
Factors Influencing Osteoporosis Prevention Knowledge and Behaviors Among Secondary Osteoporosis High Risk Population
英文摘要
Osteoporosis is a major health threat. The quality of life of osteoporosis patients can be traumatized both physically and ment ally induced by the consequences of the illness such as fracture and disability. Further medical treatment, rehabilitation, and lo ng-term care will cause further financial burden to patients and their families. Literature indicated that around 30-60% in male and 50% in perimenopausal female of osteoporosis were secondary, however, investigations on this high risk population have not been fully explored. The purpose of this study was to examine the bone mineral density (BMD), knowledge and preventiv e behaviors of osteoporosis among secondary osteoporosis high risk population, and to explore its related factors. A cross-sect ional research design was used. The structural questionnaire and GE Lunar Achilles Express Bone Ultrasonometer were used f or data collection. The convenience sample of 197 secondary osteoporosis high risk cases aged 20 years and over were recruit ed from outpatient and inpatient of the medical and surgical department of 1 regional hospital in Taipei. Results indicated that participants had inadequate knowledge about osteoporosis (M = 57.64, SD = 28.18) and delivered osteoporosis preventive beh aviors only occasionally (M = 2.05, SD = 0.57). BMD screening revealed that 48 subjects (24.4%) were osteoporosis and 58 (29.4%) cases would be classified having osteopenia. BMD would not be different by types of medical conditions and medica tion used which would lead to osteoporosis. Participants who were younger, with higher educational level and occupational st atus were positively correlated with osteoporosis preventive knowledge. Subjects’ past expose of osteoporosis related informa tion were positively related to their knowledge and preventive behaviors. Osteoporosis preventive behaviors were positively c orrelated with women, knowledge and self-rated health. There were significant difference in both knowledge and preventive b ehaviors of osteoporosis by disease patterns. Results of stepwise multiple regression analyses indicated that previous expose o f osteoporosis related information, age, and educational level accounted for 42% of total variances of knowledge; and knowle dge on osteoporosis prevention, having hepatized problems, gender, and age accounted for 26% of the variation in osteoporosi s preventive behaviors. Based on results of this study, educational interventions specifically based on individual characteristic s to improve preventive knowledge and behaviors among secondary osteoporosis high risk population are recommended.
