目標：本研究旨在瞭解台灣城鄉國中生睡眠品質現況，並探討其重要之個人、家庭、學校 和社區因素。方法：依縣市人口密度，以台北市和花蓮縣分別代表城市和鄉村。採兩步驟隨機 抽樣方式，先自每縣市選取3所國中，再自六校各年級中選取四分之一班級為樣本。以匹茲堡 睡眠品質問卷(Pittsburgh Sleep Quality Index, PSQI)和自陳結構式問卷進行調查，得1,796份有效 資料。分析方法有卡方檢定、獨立樣本t檢定及多元迴歸分析。結果：1.城鄉國中生整體睡眠品 質得分(PSQI=6.47和6.28)均大於5分，相對不理想，且城市學生週間睡眠品質較鄉村學生差(t= 2.74, p< .01)。2.自覺健康狀況、使用電腦習慣、睡眠規律性、家庭關係、學業壓力和人際壓力 是城鄉國中生整體睡眠品質的共同因素。3.七項個人、3項家庭和2項學校因素是城市國中生整 體睡眠品質的重要因素，共可有效解釋27.5%的變異量。4. 五項個人、1項家庭、2項學校和1項 社區因素是鄉村國中生的整體睡眠品質的重要因素，共可有效解釋27.4%的變異量。結論：台 灣城鄉國中生整體、週間或週末睡眠品質仍有改善空間，且相關因素不盡相同，故未來宜針對 城市和鄉村國中學生發展與推動不同睡眠改善介入計畫。(台灣衛誌 2015；34(3)：335-347)

Objectives: The purpose of this study was to investigate the sleep quality and related personal, family, school, and community factors of urban and rural middle school students in Taiwan. Methods: Based on county population density, Taipei City and Hualien County were selected to represent urban and rural areas, respectively. Based on two-stage random sampling, we first selected three middle schools from each county and then selected one-fourth of the classes from each grade in the six selected schools. Valid data were collected from 1,796 participants by using the Pittsburgh Sleep Quality Index (PSQI) and a self-administered structural questionnaire. The data were analyzed using χ2 and t tests and multiple regression. Results: (1) The sleep quality of the urban and rural middle school students was not favorable (PSQI = 6.47 and 6.28); on weekdays, the quality of sleep (QOS) of urban students was poorer than that of rural students (t = 2.74, p < .01). (2) Health status, computer use, sleep regularity, family relationships, academic stress, and interpersonal stress were common QOS factors among both urban and rural students. (3) Seven personal, three family, and two school factors were influential and explained 27.5% of the variance of QOS among urban students. (4) Five personal, one family, two school, and one community factor were influential and explained 27.4% of the variance of QOS among rural students. Conclusions: The QOS of urban and rural middle school students must be improved. However, the related factors for each group were different. Improvement programs specific to each group should be developed and implemented to promote the sleep quality of urban and rural students. (Taiwan J Public Health. 2015;34(3):335-347)