博奕行為與健康相關生活品質之探討：以台灣北部大學生為例

Abstract

目標：建立關於台灣大學生博奕行為的基本背景資料，並使用世界衛生組織生活品質問卷（台灣簡明版）探討博奕行為對健康相關生活品質（HRQOL）之影響，提供相關單位作為適當介入及訂定政策以達健康促進之效。 方法：於2011年6月至10月，依據科系和年級進行分層隨機抽樣，訪問對象為18歲以上之台灣北部某大學日間部學生，過程中蒐集基本人口學資料、健康相關生活品質、博奕相關變項及健康危險因子等資訊。有效樣本共909人。 結果：多變項回歸分析發現臺灣大學生族群中，無問題賭博者（non-problem gamblers）與不賭博者（non-gamblers）在生活品質上（分數範圍為4-20）並無顯著差異。然而次臨床症狀賭博者（sub-clinical gamblers）相較於無問題賭博者，在「生理健康」（β = -0.377, p = 0.037）與「社會關係」（β = -0.439, p = 0.02）兩個範疇的生活品質有較低的分數。問題性賭博者（problem gamblers）相較於無問題賭博者，則是在「生理健康」（β = -1.706, p = 0.005）範疇的生活品質分數較低。 結論：依據本研究結果，證實了博奕行為對於健康相關生活品質存在著小賭怡情的現象，而非全然負面。相較於其他常見的健康危險行為（health risk behaviors）對於健康相關生活品質的影響，博奕行為在大學生族群中所扮演的角色需要受到研究者的更多關注。未來的研究可更著重於瞭解健康的博奕行為如何演變成問題性賭博，以及這些變項如何影響健康相關生活品質。在「健康博奕」（healthy gambling）的概念下，建議相關當局應多努力於三段五級的預防方式，避免博奕行為演變成問題性賭博（problem gambling）及賭博相關問題（gambling-related problems）。

Introduction: With a widespread expansion of gambling activities, emerging evidence suggests that college students are at an even higher risk for negative health consequences. However, relatively little is known about whether gambling activities, as opposed to other well-known health risk behaviors, have significantly different effects on various domains of health-related quality of life (HRQOL) among college students. Methods: Data from 909 college students were collected via a self-administered anonymous survey, which included a DSM-IV-based gambling screen (score: 0-10); the WHOQOL-BREF, an abbreviated version of the World Health Organization QOL assessment (WHOQOL-100); and questions regarding health risk behaviors. Gamblers were classified into 3 groups: 1) non-problem gamblers (score=0); 2) sub-clinical gamblers (score=1-3); and 3) problem gamblers (score≥4). After adjusting for sociodemographic/background variables and other health risk behaviors, multivariate linear regression was used to analyze whether gambling problems had significantly different effects on various domains of HRQOL among college students. Results: Multivariate analysis found that with regard to physical health HRQOL (value: 4-20), both problem gamblers (β=-1.706, p=0.005) and sub-clinical gamblers (β=-0.377, p=0.037) reported significantly poorer HRQOL than non-problem gamblers. Additionally, sub-clinical gamblers reported significantly poorer HRQOL in the social relationships domain (β=-0.439, p=0.02) than non-problem gamblers. There is no significant difference between non-gamblers and non-problem gamblers. Discussion and Conclusions: In addition to the well-known health risk behaviors, more attention should be paid to the significantly adverse effects of gambling problems on different domains of HRQOL among college students. Future research could explore the possible mechanisms of how gambling problems affect different domains of HRQOL. Also, in the notion of “Healthy gambling,” efforts should be made to prevent gambling behaviors turning into gambling problems.