創意教學方案對國小學生月經知識、態度、自我效能與男生月經關懷行為之成效

Abstract

研究目的：本研究在探討創意教學方案對國小五年級學生之月經知識、月經態度、女生經期保健自我效能、男生月經關懷行為自我效能及男生月經關懷行為之成效。 研究背景：月經是青春期女生身體成熟與具有生育能力的重要象徵，更是青春期女生認識自己身體、建立自尊與女性角色定位的重要過程，但研究顯示國小高年級學生對月經知識不正確，校園中最常見的月經事件為：男生拿月經/衛生棉開玩笑、女生用過的衛生棉沒包好就亂丟、女生常發生月經滲漏。然而，當前鮮少針對上述月經相關議題所設計之教學方案。 研究設計：本研究採類實驗研究之不對等前後測對照組設計，以「創意教學方案」為介入處置，實驗組與對照組均於教學前進行前測，教學介入後一週進行後測，教學後六個月進行後後測。 研究方法：本研究主要以花蓮地區313位國小五年級學生為對象，以學校為隨機分派單位，實驗組接受創意教學方案，對照組接受傳統課室教學，成效測量指標為月經知識、月經態度、女生經期保健自我效能、男生月經關懷行為自我效能及男生月經關懷行為得分；過程評量則包括創意教學方案滿意度調查及焦點團體訪談結果。研究資料採用共變數分析、相依樣本單因子變異數進行統計分析。 研究結果：研究對象四成以上從未主動和父母討論月經問題，近三成學生聽過同學拿月經開玩笑。過程評量結果，實驗組對創意教學方案之滿意度高，焦點團體訪談呈現三個主要概念：「上課幫助我…」、「上課好好玩」及「冏很大的課後作業」。創意教學方案介入後，實驗組月經知識、月經態度、女生經期保健自我效能、男生月經關懷行為自我效能、男生月經關懷行為後測、後後測得分均顯著高於前測。排除前測成績的影響效果後，創意教學方案介入後一週，實驗組之月經知識、前測持負向月經態度者、女生經期保健自我效能、男生月經關懷行為自我效能、男生月經關懷行為得分均高於對照組；創意教學方案介入後六個月，實驗組前測月經知識答對率低者、前測持負向月經態度者、女生經期保健自我效能得分均顯著高於對照組。 結 論：學校環境對學生有極大的影響，因此校園中同學對月經之態度、因月經事件衍生之互動行為對國小高年級女生將產生莫大影響；研究結果顯示創意教學方案可顯著增進學生之月經知識，提升負向月經態度者之正向月經態度，促進女生之經期保健自我效能，男生之月經關懷行為自我效能，增進男生對月經事件之關懷行為。未來可將本研究結果作為學校月經教育執行之參考，並評估由學校老師進行創意教學方案之成效。

Aim: The purpose of this study was to examine the effects of a creative teaching program on menstrual knowledge, menstrual attitude, female students’ menstrual health care self-efficacy, male students’ menstrual caring behaviors’ self-efficacy, and male students’ menstrual caring behaviors of 5th grade elementary students. Background: Menstruation is the hallmark maturation event in the female transition from childhood into adulthood. It has also been identified as a process related to familiarization with the female body, establishing self-esteem, and female role identification. According to the literature, negative aspects of menarche/menstruation include: elementary school students often lack accurate menstrual knowledge, boys in school make jokes about menstruation or menstrual sanitation products, menstrual sanitary products not properly disposed of, and girls often have menstrual blood seepage. However, little has been done to design a menstrual teaching program addressing these specific issues. Design: A quasi-experimental research design was used. During the week before the intervention began, one week and six months after the intervention, experimental group and control group completed pretest, posttest, and post-posttest. Methods: A total of 313 5th grade students from 4 elementary schools in Taiwan’s Hualien Country participated in this study. The four schools were randomly assigned to either the experimental or control group. The experimental group received a 4-week researcher-developed creative teaching program administered in 40-minute-session classes each week. The control group received the 3-week traditional classroom instruction. The questionnaire used in the study consisted of six sections: personal information, a menstrual knowledge questionnaire, a menstrual attitude questionnaire, a female students’ menstrual health care self-efficacy questionnaire, a male students’ menstrual caring behaviors self-efficacy questionnaire, and a male students’ menstrual caring behaviors questionnaire. Program evaluation included a creative teaching program satisfaction survey and focus group discussions. Data were analyzed using analysis of covariance and repeated measure analysis of variance. Results: More than forty percent of the participants reported that they never discussed menstrual-related issues with their parents. Nearly one third indicated that they heard menstrual related jokes from their classmates. Program’s evaluation showed that the mean score for the creative teaching program students’ satisfaction was high. The following three dominant themes were identified in comments among the participants in the focus group discussions: I learned from the class, the class was fun, and the homework was embarrassed. Findings showed that the effect of the experimental treatment was significant when students’ pretest scores were controlled. One week after the intervention, the experimental group’s scores were higher than those of the control group in: menstrual knowledge, menstrual attitude of those whose pretest scores were low, female students’ menstrual health care self-efficacy, male students’ menstrual caring behaviors self-efficacy, and male students’ menstrual caring behaviors. Six months after the intervention, the experimental group’s scores were higher than those of control group in: menstrual knowledge whose pretest correct answer rate was low, menstrual attitude whose pretest score was low, and female students’ menstrual health care self-efficacy. Conclusions: School is an influential environment for most elementary school aged students. In particular, the environment significantly influences female elementary students’ menstrual attitude and menstrual related behaviors. A creative teaching program significantly improves students’ menstrual knowledge, promotes a positive menstrual attitude for those whose attitudes were negative, and increases female students’ menstrual health care self-efficacy, male students’ menstrual caring behaviors self-efficacy, and male students’ menstrual caring behaviors. Study results suggest that our creative teaching program can be applied in other elementary schools as a benefit to menstrual instruction. Additional studies should examine the efficacy of our creative teaching program when employed by elementary school teachers.