臺灣國小學童課後學習質量與屈光狀態之相關

本研究旨在探討學童課後學習與其近視發展之相關，研究採橫斷式調查研究法進行，針對國小二至六年級學童之屈光狀態及學童課後學習進行現況描述，邇後再探討國小學童近視發展與課後學習環境、課後學習類型、及課後用眼習慣之相關。除屈光檢查之數據外，問卷調查用以蒐集國小學童課後學習之現況。研究結果指出，國小學童屈光狀態之發展在一年級升二年級(ODBCSEP：t=2.195, p=0.029；OSBCSEP： t=2.308, p=0.022)、二年級升三年級(ODBCSEP：t=2.254, p=0.025；OSBCSEP： t=2.171, p=0.031)、五年級升六年級(ODBCSEP：t=2.418, p=0.016；OSBCSEP： t=2.094, p=0.037)時發展得最快；且「學童課後所處的環境」(OD: r=-0.165, p=0.000, OS: r=-0.122, p=0.002)、「學童課後的安置方式」(OD: r=0.123, p=0.002, OS: r=0.132, p=0.001)、以及「家長花費在陪學童課業學習的時間」（OD: r= -0.080,p=0.041）與學童的近視發展均有顯著的相關。此外，學童課後學習的類型以「英文」(OD: r= 0.150, p=0.000, OS: r= 0.178,p=0.000)及「珠算或心算」(OD: r= -0.097, p=0.016, OS: r= -0.093, p=0.021)影響近視的發展最為顯著；且學童課後的用眼習慣以戶外活動的時間(OD: r= -0.088,p=0.027, OS: r= -0.095, p=0.016)亦與其屈光狀態達顯著相關。綜合研究之結果，學童近視發展與課後學習環境、課後學習類型、課後學習課程時數、戶外活動皆有一定之相關，因此研究者根據研究結果，針對物理環境、人文環境、課程與學習時間及戶外活動此四項提出建議，最後再對未來之研究提出建議。

Purpose: To investigate correlation between after-school learning andrefractive error in the elementary school students in Taiwan.Methods: 1,067 students aged from 7 to 12 years with no ocular or systemicdiseases participated in the study. Ocular examination included uncorrectedvisual acuity measurement, autorefraction, and subjective refraction to obtainthe best corrected vision. In addition, students and their parents were asked tofill out a questionnaire on the students’ learning environment, study subjects,and habitual visual use during after-school hours.Results: A change of refractive errors was noted, from OD: -0.1447D, OS:-0.1332 in the first grade to OD: -1.5832D, OS: -1.5899 in the 6th grade. Plus asudden increase in myopia between Grades 1 and 2 (OD: t = 2.195, p = 0.029;OS: t = 2.308, p = 0.022), Grades 2 and 3 (OD: t = 2.254, p = 0.025; OS: t =2.171, p = 0.031), and also between Grades 5 and 6 (OD: t = 2.418, p = 0.016;OS: t = 2.094, p = 0.037). Refractive error was significantly correlated withthe students’ after-school environment, placement, and the time of theparents'' accompanying the students. In addition, refractive error wassignificantly correlated with the learning of English as a foreign language,abacus operation, and mental arithmetic, and also outdoor activities.Discussion: Our results indicate that refractive error is significantlycorrelated with after-school learning environment, after-school learningsubjects, and outdoor activities. Given that these activities are often chosen bythe parents, they have played a main role in the developmental stage of thestudents, and unwittingly, also when the latter are most susceptible tomyopization.