台灣幼兒園教師健康識能量表之建構及調查研究

Abstract

研究背景：健康識能是決定個人獲得、了解以及使用訊息的動機與能力，也是健康促進的一項重要因子和指標。健康識能與健康行為習習相關，臺灣對於「教師健康識能」方面的相關調查，目前無尚全國性的調查單位，且針對「幼兒園教師健康識能」之長期性調查或研究數量也甚少。但幼兒園教師之於兒童，不僅可以影響兒童發展，也因長時間與兒童相處，是能有效發現與改善兒童健康的至關重要者。因此，了解和提升幼兒園教師的健康識能程度，對於個人、家庭、學校甚或是社會，都是非常重要且值得關注的議題。本研究旨在以國內外文獻為基礎的自編健康識能量表對台灣幼兒園教師進行健康識能現況的調查，並探討人口學變項對於幼兒園教師健康識能的影響。研究目的與方法：本研究分三階段方式進行，第一階段為研究者根據國內外文獻、書籍與量表為基礎，建立台灣幼兒園教師的健康識能量表，第二階段為預試階段，研究者利用橫斷式調查法，在建立自編幼兒園教師的健康識能量表後，以立意取樣的方法，蒐集30位公立幼兒園教師之資料，並依上述資料進行量表的項目分析、信效度分析與題目的刪減。第三階段為正式施測階段，利用國家發展委員會出版之111年「都市及區域發展統計彙編」，將臺灣分為：北部區域、中部區域、南部區域及東部區域，各地區依據幼兒園分佈及幼兒園教師人數進行分層隨機抽樣，最終搜集了186位幼兒園教師之資料，並進行獨立樣本t檢定與ANOVA單因子變異數分析，探討幼兒園教師之健康識能現況及社會人口學變項與健康識能間的關聯與影響。 研究結果：本研究建立了一具有良好的信度、建構效度及可靠性的健康識能量表，研究結果顯示，受試幼兒園教師在一般健康識能和疾病預防健康識能方面表現較佳，超過了評量尺度的80%。然而，在心理健康識能和醫療保健健康識能方面的表現則屬於中等水平。他們在學校系統健康識能方面的表現相對較低。此外，根據幼兒園的類型，教師的健康識能有顯著差異。公立或非營利幼兒園教師在一般健康識能、心理健康識能和醫療保健健康識能方面的表現略低於私立幼兒園教師，而在疾病預防健康識能方面稍高於私立幼兒園。此研究還指出，幼兒園教師的健康識能在社會人口學變項（如年齡、教育程度、婚姻狀況、年資等）方面並無顯著差異。同時，教師自覺的健康狀況也對其健康識能有影響。自覺健康狀況良好的教師在各個健康識能方面的表現優於自覺健康狀況一般或不佳者。研究結論：本研究顯示，幼兒園教師的健康識能在不同方面有著不同的表現，其中一般健康識能和疾病預防健康識能表現較佳，而心理健康識能和醫療保健健康識能則處於中等水平。教師健康識能表現的差異可能與幼兒園類型與教師自覺健康狀況有關。此研究建立了幼兒園教師健康識能的相關評估工具，為教育機構和健康政策制定者提供了有益見解，促進教師健康與職業發展，並提供了建議，以建立更健康的學校環境。

Background: Health literacy is a crucial factor and indicator for health promotion, as it determines an individual's motivation and ability to acquire, understand, and use information. Health literacy is closely related to health behaviors. In Taiwan, there is currently no national survey unit specifically investigating "teacher health literacy," and long-term studies or surveys focusing on " kindergarten teachers' health literacy" are scarce. Kindergarten teachers not only influence children's development but, due to their extended interaction with children, play a pivotal role in identifying and improvingchildren's health. Thus, understanding and enhancing kindergarten teachers' health literacy is an important issue that warrants attention for the benefit of individuals, families, schools, and society. This study aims to investigate the current state of health literacy among kindergarten teachers in Taiwan using a self-compiled health literacy scale based on domestic and international literature and to explore the impact of demographic variables on kindergarten teachers' health literacy. Objectives and Methods: This study was conducted in three stages. In the first stage, the researcher established a health literacy scale for Taiwanese kindergarten teachers based on domestic and international literature, books, and scales. The second stage was the pilot testing phase, where the researcher used a cross-sectional survey method, collecting data from 30 public kindergarten teachers through purposive sampling. The data was then subjected to item analysis, reliability and validity analysis, and item reduction. In the third stage, the formal survey was conducted using stratified random sampling based on the distribution of kindergartens and the number of kindergarten teachers in different regions (Northern, Central, Southern, and Eastern Taiwan) as published in the 2022"Urban and Regional Development Statistics Compilation" by the National Development Council. A total of 186 kindergarten teachers' data were collected and analyzed using independent sample t-tests and one-way ANOVA to investigate the current state of health literacy among kindergarten teachers and the relationship and impact of sociodemographic variables on health literacy. Results: This study established a health literacy scale with good reliability, construct validity, and reliability. The results indicated that the kindergarten teachers in the sample performed well in general health literacy and disease prevention health literacy, exceeding 80% of the scale. However, their performance in mental health literacy and healthcare health literacy was at a moderate level, and their performance in school system health literacy was relatively low. Additionally, significant differences in health literacy were observed based on the type of kindergarten. Public or non-profit kindergarten teachers performed slightly lower in general health literacy, mental health literacy, and healthcare health literacy compared to private kindergarten teachers, while their performance in disease prevention health literacy was slightly higher. The study also found no significant differences in health literacy across sociodemographic variables such as age, education level, marital status, and years of experience. However, teachers' self-perceived health status impacted their health literacy, with those perceiving their health as good performing better in all aspects of health literacy compared to those perceiving their health as average or poor. Conclusions: This study demonstrates that kindergarten teachers exhibit varying levels of health literacy across different domains, with better performance in general health literacy and disease prevention health literacy, and moderate levels in mental health literacy and healthcare health literacy. The differences in health literacy performance may be related to the type of kindergarten and teachers' self-perceived health status. The study established a relevant assessment tool for kindergarten teachers' health literacy, providing valuable insights for educational institutions and health policy makers, promoting teacher health and professional development, and offering recommendations for creating a healthier school environment.