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研究生: 林怡岑
Lin Yi Tsen
論文名稱: 應用健康信念模式探討子宮頸癌疫苗接種行為意向之研究–以臺灣師範大學女學生為例
Health Belief Model in an investigation on the factors influencing the National Taiwan Normal University female students in human papillomavirus vaccination intention
指導教授: 胡益進
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2009
畢業學年度: 97
語文別: 中文
論文頁數: 112
中文關鍵詞: 人類乳突病毒子宮頸癌子宮頸癌疫苗大學女生健康信念模式
英文關鍵詞: human papillomavirus, cervical cancer, human papillomavirus vaccine, university female students, Health belief Model
論文種類: 學術論文
相關次數: 點閱:539下載:86
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  • 本文旨在探討大學女生子宮頸癌疫苗認知及接種行為意向相關因素,資料蒐集以自填式問卷調查為主,採分層集束法抽樣,取得就讀於臺灣師範大學之大學女生374人為研究樣本。資料以百分比、平均值、單因子變異數分析、薛費氏事後多重比較、皮爾森積差相關及多元廻歸等統計方法進行分析。重要結果歸納如下:
    一、研究對象有57.5%對於子宮頸癌疫苗得分低於平均值9.54,顯示研究對象對於 子宮頸癌疫苗相關認知偏中低程度。「子宮頸癌的知覺罹患性」、「子宮頸癌的知覺嚴重性」、「子宮頸癌疫苗的知覺有效性」、「子宮頸癌疫苗的知覺障礙性」及「自我效能」之態度偏正向,而研究對象對於「子宮頸癌疫苗接種的行動線索」以電視為主要資訊來源。
    二、研究對象「子宮頸癌的知覺嚴重性」會因為家中是否有被診斷為子宮頸癌的親人而呈顯著差異;研究對象「子宮頸癌的知覺障礙性」及「自我效能」會因為是否有過性行為而呈顯著差異。
    三、研究對象之「子宮頸癌知覺罹患性」、「子宮頸癌疫苗知覺有效性」越高,而「子宮頸癌疫苗知覺障礙性」越低,越傾向採取疫苗接種行為;而社會人口學變項、子宮頸癌疫苗相關健康信念、行動線索與自我效能之層面來預測子宮頸癌疫苗接種行為時,可解釋力為37.3%;其中以「子宮頸癌知覺罹患性」及「自我效能」為主要預測因素。
    根據研究結果,建議教育單位未來可加強子宮頸癌疫苗相關教育,提高接種對象及其重要他人之接種行為自我效能;在公共衛生方面建議可加強宣導疫苗益處及增加宣導管道;在研究方面建議可擴大研究對象及配合追蹤調查或質性研究,以求更完整客觀之子宮頸癌疫苗接種行為影響因素。

    This study aimed to investigate the knowledge, behavior intention and related factors of human papillomavirus vaccination toward university female students. By using a stratified cluster sampling method, 374 university female students who study in National Taiwan Normal University were selected to participate in this survey. T-test, one-way ANOVA, Scheffe’s Post Hoc Multiple Comparison, Pearson’s product-moment correlation, and multiple regression were used to analyze the data. The results indicated that:
    1.The knowledge about human papillomavirus vaccine in the subjects was medium to low degree. A large proportion of participants answered “ Perceived susceptibility to Cervical cancer “, “Perceived severity to Cervical cancer”, “Perceived benefits of human papillomavirus vaccine “, “Perceived barriers of human papillomavirus vaccination”, and “self efficacy about human papillomavirus vaccination.” The human papillomavirus vaccine information of participants was mainly from television.
    2.Participants who answered “Perceived severity to Cervical cancer” were influenced by whether the participant has cervical cancer history in her family is emerged obviously difference. Participants’ “Perceived barriers of human papillomavirus vaccination”, and “self efficacy about human papillomavirus vaccination” were influenced by whether the participant had sex.
    3.Participants that: “Perceived severity to Cervical cancer”, “Perceived benefits of human papillomavirus vaccine “are high, has encountered few “Perceived barriers of human papillomavirus vaccination”, have a higher tendency to vaccinate human papillomavirus vaccine. Furthermore, the following factors: “the population change indices”, “Health belief in human papillomavirus vaccination”, “Taking preventative for human papillomavirus vaccination cue in action”,and ” self efficacy about human papillomavirus vaccination” explain 37.3% of university female students to human papillomavirus vaccination. Among this, are the main of predictive tow factors: perceived susceptibility to cervical cancer, and self efficacy about human papillomavirus vaccination.
    This research suggests that the education organizations sould enhance the education of human papillomavirus vaccine, and help the vaccination objects and their import others to promote their self efficiency of human papillomavirus vaccination; the public health organizations sould strengthen the propaganda of the benefit of human papillomavirus vaccine, and increase the channels of communication of human papillomavirus vaccine. Regarding the future research, it is suggested that the sample size of the subject group should be expanded, and the collection of the human papillomavirus vaccine information should be achieved follow the trail of target gpoup or the qualitative method of the detailed interview.

    書名頁 …………………………………………………………………i 論文口試委員審定書 …………………………………………………ii 授權書 …………………………………………………………………iii 中文摘要 …………………………………………………………………iv 英文摘要 …………………………………………………………………vi 誌謝 …………………………………………………………………viii 目錄 …………………………………………………………………ix 表目錄 …………………………………………………………………xi 圖目錄 …………………………………………………………………xiii 第一章 緒論 …………………………………………………………………1 第一節 研究動機與重要性…………………………………………………………………1 第二節 研究目的 …………………………………………………………………4 第三節 研究問題 …………………………………………………………………5 第四節 研究假設 …………………………………………………………………6 第五節 名詞定義 …………………………………………………………………6 第六節 研究限制 …………………………………………………………………8 第二章 文獻探討 …………………………………………………………………9 第一節 子宮頸癌症與子宮頸癌疫苗 …………………………………………………………………9 第二節 國內外子宮頸癌疫苗接種政策與實施效益 …………………………………………16 第三節 影響子宮頸癌疫苗接種之相關因素 …………………………………………………………………18 第四節 以健康信念模式探討影響子宮頸癌疫苗接種相關因素 …………………………………………………………………23 第三章 研究方法 …………………………………………………………………27 第一節 研究架構 …………………………………………………………………27 第二節 研究對象 …………………………………………………………………28 第三節 研究工具 …………………………………………………………………29 第四節 研究步驟 …………………………………………………………………38 第五節 資料處理與分析 …………………………………………………………………39 第四章 研究結果與討論 …………………………………………………………………43 第一節 研究對象背景變項與子宮頸癌疫苗相關因素之分析 …………………………………………………………………43 第二節 探討研究對象之不同社會人口學變項對於子宮頸癌疫苗相關因素之差異分析…………………………………………………………………62 第三節 研究對象對於子宮頸癌疫苗行為意向之分析 …………………………………………………………………71 第五章 結論與建議 …………………………………………………………………79 第一節 結論 …………………………………………………………………79 第二節 建議 …………………………………………………………………81 參考文獻 …………………………………………………………………84 附錄一、專家效度名單 …………………………………………………………………92 附錄二、預試問卷 …………………………………………………………………93 附錄三、正式問卷 …………………………………………………………………104

    中文部分
    KingNet國家網路醫院(2006)。防癌新觀念:四價人類乳突病毒+定期子宮頸抹片檢查。2007年4月20日,取自http://hospital.kingnet.com.tw/essay/essay.html
    王保進(1999)。視窗版SPSS與行為科學研究。台北:心理出版社。
    行政院衛生署。衛生統計系列。2008年5月23日,取自http://www.doh.gov.tw/statistic/index.htm
    行政院衛生署。衛生統計系列。2009年6月26日,取自http://www.doh.gov.tw/statistic/index.htm
    行政院衛生署國民健康局(2003)。台灣地區民國九十一年國民健康促進知識、態度與行為調查,第一卷。
    行政院衛生署癌症登記小組。癌症登記年度報告。2008年6月20日,取自http://crs.cph.ntu.edu.tw/crs_c/annual.html
    吳明隆、涂金堂(2006)。SPSS與統計應用分析。台北:五南。
    李文森(1991)。解剖生理學。台北市:華杏出版股份有限公司。
    李翠鳳、郭旭崧、陳錫中、陳天順、周碧瑟(1997)。金門縣婦女子宮頸防癌抹片查的影響因素。中華衛誌,16(3),198-209。
    周碧瑟、賴明芸(1993)。各國子宮頸癌篩檢計畫之初探。公共衛生,19,384–395。
    林士弘(2006)。台灣子宮頸癌防台的新里程碑~衛生署核准子宮頸癌疫苗上市~。2006年5月10日,取自http://www.doh.gov.tw/c
    林玉琇、顏明賢(2003)。人類乳突狀病毒第十六型疫苗之臨床研究與發展。臨床醫學,52,114–118。
    林生傳(2000)。教育社會學。台北:巨流圖書公司。
    金門縣衛生局(2009)。金門縣實施人類乳突病毒疫苗(HPV)16~26歲女性免費施打活動。2009年5月5日,取自http://www.kmhb.gov.tw
    紀雪雲、張榮珍、王惠珠、陳毓璟、周素珍、戴桂英(2007)。衛生企劃人員之教育訓練對子宮頸癌疫苗接種的自我效能的影響及其相關因素之探討。臺灣醫學,11(5),556–563。
    婦癌研究委員會(2007)。婦癌臨床診療指引。苗栗縣:國家衛生研究院癌症研究所 臺灣癌症臨床研究合作組織。
    張如薰(2006)。臺灣地區機構外老人未接種流感疫苗之影響因素研究。未出版碩士論文,國立陽明大學,臺北市。
    許博欽(2006)。抗癌新希望–子宮頸癌疫苗。台北市醫師公會會刊,50(4),46–51。
    許朝添(譯)(2002)。病理學。台北縣:藝軒圖書出版社。(Alan Stevens & James Lowe, 2002)
    陳協勝、吳濟華、朱斌妤(2002)。婦女接受子宮頸抹片檢查行為意向模式之研究。中華心理衛生學刊,15(3),31–66。
    陳松吟(2003)。全民健康保險子宮頸癌抹片篩選使用型態六年之踨研究。全國博碩士論文資訊網,091YM000599008。
    陳祁安(2002)。人類乳突病毒檢測在子宮癌篩檢的角色。台灣醫學,6(4),613–617。
    陳曉悌、李怡娟、李汝禮(2003)。健康信念模式之理論源起與應用。臺灣醫學,7(4),632–639。
    程嘉文(2007)。女立委呼籲子宮頸癌疫苗納入健保。2007年1年31日,取自:http://epochtimes.com/b5/7/1/31/n1609247.htm
    童寶玲(2004)。如何預防子宮頸癌 談子宮頸癌疫苗。健康世界,228,13–16。
    黃月桂、葉明義、林勤豐(1998)。全民健康保險子宮頸抹片檢查之利用度研究。中華衛誌,17(1),28–34。
    溫麗芬(2006)。應用健康信念模式探討青少女接種子宮頸癌疫苗意向之相關因素 。私立弘光科技大學護理研究所碩士論文。全國博碩士論文資訊網,095HKU05563010。
    鄒宗珮(2006)。人類乳突病毒(HPV)疫苗簡介。台灣兒童過敏氣喘及免疫學會學會通訊,7(4),22-23。
    臺北市衛生局(2008)。臺北市政府衛生局施政報告。2008年7月14日,取自http://74.125.153.132/custom?q=cache:ubXCcx6FWXoJ:w
    趙灌中、梁惟信、陳晟立(2001)。子宮頸癌的癌前病變篩檢。中華民國婦癌醫學雜誌,2(18),18–24。
    劉士豪(2000)。預防接種的成本效益。疫情報導,16(9),367-379。
    蔣立琦、郭雅雯、林綽娟(2004)。自我效能之概念分析。護理雜誌,51(2),67–72。
    蕭培靜、許維邦、林恆賜、陳民虹(2003)。人類乳突病毒。基層醫學,18(9),222-227。

    英文部分
    Australian Government Department of Health and Ageing. (2007). The national HPV vaccination program. Retrieved November 4, 2007, from http://www.health.gov.au/
    Becker, M. H. (1974). The health belief model and personal health behavior. Helat Edu Monog, 4, 328- 353.
    Beutner, K. R., & Tyring, S. (1997). Human Papillomavirus and Human Disease. The American Journal of Medicine, 102(5A), 9-15.
    Boehner, C. W., Howe, S. R., Bernstein, D. I., & Rosenthal, S. L. (2003). Viral sexually transmitted disease vaccine acceptability among college students. Sexually Transmitted Diseases, 30(10), 774- 778.
    Bosch, F., Castellsague, X., & Sanjose, S. (2008). HPV and cervical cancer. Screening or vaccination ? Birtish Journal of Cancer, 98, 15-21.
    Centers for Disease Control and Prevention. (2006). HVP and HPV vaccine information for healthcare providers. Retrieved May 13, 2007, form http://www.cdc.gov/std/HPV/STDFact-HPV-vaccine-hcp.htm#hpvvxeff.
    Clifford, G. M., Smith, J. S., Plummer, M., Munoz, N., Franceschi, S. (2003) Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Birtish Journal of Cancer, 88(1), 63-73.
    Constantine, N. & Jerman, P. (2007). Acceptance of Human Papillomavirus Vaccination among Californian Parents of Daughters: A Representative Statewide Analysis.Journal of Adolescent Health, 40(2), 108-115.
    Diana, L. D., Hillary, C., Farah, A., Donna, S. (2000). Knowledge about human papillomavirus among adolescents. Obstetrics & Gynecology, 96(5), 653-656.
    Dursun, P., Altuntasa, B., Kusca, E., & Ayhan, A. (2009). Women's knowledge about human papillomavirus and their acceptance of HPV vaccine. Australian & New Zealand Journal of Obstetrics & Gynaecology, 49(2), 202-206.
    Eduardo, L. P., Leonor, R., Edna A. S., Jorge S., Mauricio H. A., and Nubia M. (2001). Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Archives of Medical Research, 32(3), 243-247.
    EUROPA. (2008). Cervial cancer: role of vaccines against human papilloma virurs (HPV). Retrieved July 8, 2008, form http://ec.europa.eu/health/ph_threats/com/comm_diseases_en.htm
    Fact sheet NO.289 (2006). Development of new vaccines, Retrieved May 13, 2007, from http://www.who.int/mediacentre/factsheets/fs289/en/
    FDA News. (2006). FDA Licenses New Vaccine for prevention of Cervical Cancer and Other Diseases in Females Caused by Human Papillomavius-Rapid Approval Marks Major Advancement in Public Health. Retrieved May 2, 2007, from http://www.fda.gov/bbs/topics/
    Gary, M. C., Rashida, K. R., Silvia, F., Jennifer, S. S., Gerald, G., and Jeanne, M. P. (2005). Human Papillomavirus Genotype Distribution in Low-Grade Cervical Lesions: Comparison by Geographic Region and with Cervical Cancer. Cancer Epidemiol Biomarkers Prev, 14(5), 1157-1164.
    Giles, M., Garland, S. M. (2006). HPV vaccines. In: Campo MS, editor. Papillomavirus biology: From natural history to vaccine and beyond. Norfolk: Caister Academic Press. pp. 341-356.
    Ho, G. Y., Bierman, R., Beardsley, L., Chang, C. J., and Burk. R. D. (1998). Natural history of cervicovaginal papillomavirus infection in young women. The New England Journal of medicine, 338(7), 423-428.
    International Agency for Research on Cancer. (2008). T-Primary tumour. Retrieved May 12, 2007, from http://screening.iarc.fr/atlasclassiftn
    Jansen, K. U., & Shaw, A. R. (2004). Human Papillomavirus Vaccines and Prevention of Cervical Cancer. Annu Rev Med, 55, 319-331.
    Kahn, J. A., Zimet, G. D., Bernstein, D. I., Riedesel, J. M., Lan, D., Huang, B., et al. (2005). Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. Journal of Adolescent Health, 37, 502-510.
    Koutsky, L. (1997). Epidemiology of genital human hapillomavirus infection. The American Journal of Medicine, 102(A), 3-8.
    Krejcie, R. V., Morgan, D. W. (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement, 30(3), 607-10
    m.php
    Marlow, L. A., Waller, J., Wardle, J. (2007). Parental attitudes to pre-pubertal HPV vaccine. Vaccine, 25(11), 1945-1952.
    Marshall, H., Ryan, P., Roberton, D., & Baghurst, P. (2007). Across-sectional survey to assess community attitudes to introduction of Human Papillomavirus vaccine. Australian and New Zealand journal of public health, 31(3), 235-242.
    Michelle, G., and Suzanne, G. (2006). A study of women’s knowledge regarding human papillomavirus infection, cervical canner and human papillomvirus vaccines. Australian and New Zealand Journal of Obstetrics and Gynaecology, 46, 311–315.
    Moeira, L. A., Waller, J., & Wardle, J. (2007). Paarental attitudes to pre-pubertal HPV vaccine. Vaccine, 25(11), 1945-1952.
    Molano, M., Adriaan, V. D. B., Plummer, M., Weiderpass, E., Posso, H., Arslan, A., et al. (2003). Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study. American journal of epidemiology, 158(5), 486-494.
    Moreira, E. D., Oliveira, B. G., Neves, R. C., Karic, G., Filho, J. O. (2006). Assessment of knowledge and attitudes of young uninsured women toward human papillmavirus vaccination and clinical trials. Journal of Pediatric and Adolescent Gynecology, 19(81), 81-87.
    Nada, O. K., & Jerry, W. L. (2005). Understanding Reduced-fat Milk Consumption Among Male Adolescents Using the Theory of Planned Behavior. American Journal of Health Education, 36(1), 16-24.
    Nexoe, J., Kragstrup, J., & Sogaard, J. (1999). Decision on influenza vaccination among the elderly: A questionnaire study based on the Health Belief Model and the Multidimensional Locus of Control Theory. Scandinavian Journal of Primary Health Care, 17(2) , 105-110.
    ov.uk/en/Nl1/Newsroom/DG_068750NEWS/2006/NEW01385.html
    Rosenstock, I. M. (1974). Historical origins of the health belief model. Helath educational monographs. 2(4), 409-419.
    Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social Learning Theory and the Health Belief Model. Health Education Quarterly, 15(2), 175-182.
    Sellors, J. W., & Sankaranarayanan, R. (2003). Colposcopy and treatment of cervical intraepithelial neoplasia: a beginners’ manual. Lyon, France: International Agency for Research on Cancer.
    Slomovitz, B. M., Sun, C. C., Frumovitz, M., Soliman, P. T., Schmeler, K. M., Pearson, H. C. et al. (2006). Are women ready for the HPV vaccine? Gynecologic Oncology, 103, 151-154.
    Szilagyi, P. G., Rodewald, L. E., Savageau, J., Yoos, L., & Doane, C. (1992). Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics, 90(6), 871-875.
    The National HPV vaccination Program. (2007). Australian Government Department of Health and Ageing. Rretrieved May 2, 2007, from http://www.health.gov.au/internet/standby/publishing.nsf/Content/about
    Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., Shah, P. J. et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. The Journal of Pathology, 189(1), 12-19.
    Wang P.D. & Lin R.S. (1995). Risk Factors for Cervical Intraepithelian Neoplasia in Taiwan. Gynecologyic Oncology,62(3), 10-18.
    Website of the UK government. (2007). Cervical cancer vaccine will be introduced. Rretrieved November 4, 2007, form http://www.direct.g
    World Health Organization. (2006). Guidelines to assure the quality, safety and efficacy of recombinant human humanpapillomavirus virus-like particle vaccines [Absract]. Geneva: expert committee on biological standardization.
    Zimet, G. D. ( 2005 ). Improving adolescent health: Focus on HPV vaccine acceptance. Journal of Adolescent Health,37, S17-S23.

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