目標：本研究目的為了瞭解山地鄉兒童過動及注意力缺陷症的盛行率和相關危險因子。方法：本研究為橫斷面研究設計，以花蓮縣三個山地鄉26個國小學童共2,634人為研究樣本。第一階段由教師版之兒童活動量表來初篩，共有疑似個案為386人進入第二階段，經兒童青少年精神科醫師確定診斷為352人；並針對家長關於ADHD之相關因子，包括父母親喝酒、吸菸、嚼檳榔等行為，或是否罹患精神疾病者等，進行量性問卷調查，以及深度訪談。結果：地區平均盛行率為14.2%。利用多變量邏輯式回歸模型來檢定及調整勝算比，發現過動及注意力缺陷症家長較非過動及注意力缺陷症家長在使用香菸(AOR＝6.51，95% CI＝5.14-7.25，p＝0.004)、檳榔(AOR＝11.32，95% CI＝4.61-10.38，p＝0.002)及酒精(AOR＝14.56，95% CI＝3.21-19.32，p＝0.001)，達顯著相關。結論：本研究顯示花蓮縣山地鄉兒童過動及注意力缺陷症的盛行率可能不見得較高，但其父母親喝酒、吸菸、嚼檳榔、罹患憂鬱症及失眠症等與過動及注意力缺陷症的盛行率有顯著相關。

Objectives: To investigate the prevalence of ADHD and the relative risk factors among children in grades 1-6 and their parents in the mountainous region of Hualien. Methods: This was a cross-sectional study involving 2634 children in 26 primary schools. The first stage of the study
utilized the clinical hyperactivity scale (teacher form), with the results providing 386 suspected cases for the second stage evaluation. Of these children, 352 were confirmed to have ADHD by a child-adolescent psychiatrist. Finally, through the use of questionnaires and intensive interviews,data were collected from their parents regarding parental factors relative to ADHD children. These included: drinking alcohol, smoking, chewing betel nut, and mental illness. Results: The average
prevalence in this geographic area was 14.2%. A multivariate logistical regression model was used to identify factors significantly associated with adjusted odds rations: smoking (AOR=6.51,95% CI=5.14-7.25, p=0.004), chewing betel (AOR=11.32, 95% CI=4.61-10.38, p=0.002) and drinking alcohol (AOR=14.56, 95% CI=3.21-19.32, p=0.001). Conclusions: The prevalence of ADHD among children might not necessarily be higher in the mountainous region of Hualien than in other areas of Taiwan, but it was significantly associated with the parental factors of drinking
alcohol, smoking, chewing betel nuts, and the existence of depression or insomnia. (Taiwan J Public Health.