研究生: |
陳燕儀 YEN-YI |
---|---|
論文名稱: |
影響女性教職員工子宮頸抹片檢查相關因素之探討—以國立臺灣師範大學為例 |
指導教授: | 陳政友 |
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: | 2001 |
畢業學年度: | 89 |
語文別: | 中文 |
中文關鍵詞: | 子宮頸抹片檢查 |
論文種類: | 學術論文 |
相關次數: | 點閱:190 下載:80 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
本研究之研究目的在瞭解女性教職員工接受子宮頸抹片檢查行為的現況以及探討其相關因素,以做為推展校園教職員工健康促進工作之參考。本研究以民國八十九年七月至九十年七月任職於國立臺灣師範大學的女性教職員工為母群體,採系統隨機抽樣法,於民國八十九年十一月進行施測,得有效樣本244人。資料以描述統計、卡方檢定、單因子變異數分析、多元邏輯迴歸等方法進行分析,重要結果歸納如下:
一、研究對象對於子宮頸抹片檢查相關知識的程度約屬中等程度;而子宮頸抹片檢查的訊息來源,主要來自電視、報紙、以及健康中心的通知單;如果由別人提醒她們去做子宮頸抹片檢查,主要是由同事、朋友、醫師等人提醒她們去做檢查;在婦科求診頻率與固定就醫場所方面,僅有六成的人有固定的婦產科醫師及去固定醫院診所看病;另外,增強因素中以親人的社會支持最重要,其次為朋友、醫護人員。
二、研究對象中認為自己需要做子宮頸抹片檢查的人佔84.0﹪;而實際接受子宮頸抹片檢查的經驗,有23.0﹪從未接受子宮頸抹片檢查,31.6﹪未定期接受子宮頸抹片檢查,45.5﹪定期接受子宮頸抹片檢查;多數的人以健康非常重要或學校健康中心通知的理由,而專程去做子宮頸抹片檢查。
三、與研究對象子宮頸抹片檢查行為有關的因素,屬於社會人口學變項有年齡、教育程度、以及婚姻狀況等;屬於素質因素有罹患性認知、嚴重性認知、障礙性認知、以及內控分數高低等;屬於促進因素有抹片檢查訊息來源多寡、提醒人士的人數、抹片檢查場所的方便性、檢查場距離不遙遠、婦科求診頻率與固定就醫場、以及親友的檢查經驗等;屬於增強因素有親人的社會支持等。
四、年齡、教育程度、罹患性認知、障礙性認知、親人的社會支持等,是預測研究對象子宮頸抹片檢查行為的重要變項,年齡越大、教育程度越高、罹患性認知越高,親人的支持越多、障礙性認知越少者,越會傾向於採取子宮頸抹片檢查行為;至於研究對象採取定期抹片檢查與否,主要的決定因素在於教育程度,教育程度越高者越會傾向於採取定期抹片檢查。
依據研究結果,本研究針對教育單位、行政單位提出若干建議,以作為日後子宮頸抹片檢查教學介入與未來類似研究之參考。
The purpose of this study was to understand behavior of school employee’s on adaptation of cervical cancer screening and to explore some of the relevant factors on it. The result of this research served as a reference for the promotion of school employee’s health programs. This study was conducted during November 2000,and the subjects were sampled from the female employees of National Taiwan Normal University by using a system random sampling method.The effective samples were 244 people.The data were analyzed by frequence distribution chi-square test,one-way ANOVA ,Multiple logistic Regression Analysis.Important findings of this study were concluded as follows:
1. cervical cancer and cervical cancer screening knowledge average knowledge level. The accesses to cervical cancer screening information were mostly from television, newspaper and notice forms from health care centers. They were reminded by colleagues, friends and doctors. The fixed gynecologist obstetrican and fixed clinic orhospital who 60﹪of them had under regular gynecological observation and who had ever done screening before. In addition, enabling factors were mostly from the social support of family members and than the support from friends or medical workers.
2. On the present state of cervical cancer screening behavior, 84﹪of the subjects thought they need cervical cancer screening. 77﹪of them had done cervical cancer screening before and 23.0﹪of them had never. Non-routinely screening were 31.6﹪and routinely screening were 45.5﹪.Majority of people do cervical cancer screening intentionally on the ground of health is very important or being notified by the school health center.
3. socialemographic variable includes age,education,marriage. All of these factors reached statistical significance in this study. Predisposing factors includes cervical cancer screening knowledge, gynecological symptoms,perceived susceptibility,perceived severity,perceived benefits of action, perceived barriers of action, and internal health locus of control. All of these factors reached statistical significance in this study. Enabling factor includes the information resource of the cervical cancer screening , reminders ,Exam place convenient , Exam place not faraway,fixed gynecologist obstetrican, fixed clinic orhospital , friends ever have cervical cancer screening. All of these factors reached statistical significance in this study. Reinforcing factor includes the family member supported. All of these factors reached statistical significance in this study.
4. On the significant factors that affect the cervical cancer screening were age,education,perceived susceptibility, perceived barriers of action,the family member supported which all provide clues to the observation of cervical cancer screening behavior. People who had more age,more education, more perceived susceptibility,less perceived barriers of action,more the family member supported tend to adapt cervical cancer screening. Whether the research objects adopt cervical cancer screeing or not ,depending mainly on education,more education tend to have cervical cancer screening.
To sum up, this study aims to provide suggestions for the educational and governmental institutes and the result would be a reference to the teaching and research agency in the future.
于漱(1988)。台北市20-60歲居民預防性健康行為之調查研究。公共衛生,14 (4),p391-406。
王莉莉(1991)。影響婦女保健服務利用模式相關因素之探 討――以子宮頸抹片檢查為例。東海大學社會工作研究所碩士論文。
王廷甫(1990)。台中地區居民中西醫療行為取向之研究。公共衛生,17(1),p21-23。
王秀紅、邱啟潤、王瑞霞、李建廷(1992)婦女健康促進行為及其相關因素的探討—以高雄市區及屏東縣高樹鄉民為例。公共衛生,9(3),251-265。
行政院衛生署(1998)。衛生簡訊。
行政院衛生署(1999)。衛生統計—臺灣地區主要癌症死亡原因。
李守義、周碧瑟、宴涵文(1989)。健康信念模式的回顧與前瞻。中華衛誌,9(3),p123-147。
李卓倫(1987)。以健康信念模式分析鹿谷鄉民的肝癌篩檢行為。國立陽明醫學院公共衛生研究所碩士論文。
李卓倫(1987)。以健康信念模式分析鹿谷鄉民的肝癌篩檢行為。國立陽明醫學院公共衛生研究所碩士論文。
李翠鳳(1991)。影響金門地區婦女抹片篩檢行為相關因素探討。國立陽明大學公共衛生研究所碩士論文。
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檢查的影響因素。中華衛誌,16(3),p198-210。
臺灣省婦幼衛生研究所(1997)。婦幼衛生之主要統計。中華民國公共衛生研究概況,p43-45。
孟玲玲(1999)。衛生教育介入對彰化都市地區國小女教師參與子宮頸抹片檢查意願與行為的影響。國立臺灣師範大學衛生教育學系碩士論文。
邱燦宏、葉季森(1993年)。城市、鄉村婦女接受子宮頸抹片檢查決定因子之比較研究。行政院衛生署保健處研究計劃。
呂昌明(1985)。以健康信念模式分析公共衛生護理人員執行乳房自我檢查之意圖衛生。教育論文集刊,7,p142-153。
呂昌明(1985年)。健康信念與婦女參加子宮頸癌篩檢活動之研究。衛生教育論文集刊,1期,p67-75。
吳肖琪(1991)。健康保險與醫療網區域資源對醫療利用影響。國立臺灣大學公共衛生研究所博士論文。
吳韻淑(1991)。血液透析病患自我照顧之研究。國立臺灣師範大學衛生教育學系碩士論文。
明勇(1990)。慢性阻塞性肺部疾病患者之自我照顧與社會支持之相關性探討。國防醫學院護理學研究所碩士論文。
吳香達(1996)。臨床婦科學第三版---子宮頸癌。茂昌圖書有限公司。
周碧瑟(1982年)。臺灣地區子宮頸癌流行病學的探討。臺灣醫誌,81期,p1074-1081。
周碧瑟(1983)。臺灣地區農村婦女對子宮防癌抹片檢查的消息來源之探討。中華醫誌,31(6)期,p446-456。
周碧瑟、李卓倫、張鴻仁(1987)。鹿谷鄉民對癌症的知識、態度與行為。公共衛生雜誌,14期,p140-146。
周碧瑟(1983)。臺灣地區農村婦女對子宮防癌抹片檢查認知與接受之分析研究。中華醫誌,31(4),p302-311。
周建盛、李慧娥、鄭振明、鍾弘臨、吳孝平(1999)。侷限於子宮頸之鱗狀上皮癌的病理診斷。臺灣醫界,42(4),p26-28。
胡文郁、曾春典、戴玉慈、余玉眉(1996)。高血壓患者服藥遵從行為及其相關因素之探討。中華衛誌,15(4),p319-331。
胡月娟(1988)。台中市成年市民癌症篩檢的施行與相關因素之探討。公共衛生,14(2),p140-146。
許維邦(1998)。抹片和子宮頸癌。基層醫學,13(2),p34-36。
許志成(1992)。基層醫療資源濫用之影響因素分析—群醫中心門診高度使用之探討。行政院衛生署八十一年度委託研究計劃。
柯懿嬖(1996)。以健康信念模式分析某工作場所員工之大腸癌糞便篩檢行為研究。國立臺灣大學衛生教育研究所碩士論文。
黃松元(1995)。教師健康促進。健康教育,75期,p1-7。
黃璉華(1983)。婦女接受子宮頸細胞抹片檢查動機之探討。公共衛生,10(1),p99-106。
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),p18-35。
黃秀梨(1994)。教育介入方案對婦女接受子宮頸抹片檢查之知識、健康信念及行為的影響。國立臺灣大學護理研究所碩士論文。
黃薇爾(1996)某專科學校夜間部男生嚼檳榔行為之研究。國立臺灣師範大學衛生教育學系碩士論文。
陳尚民、傅振宗、蕭永薰、閻中傑(1994)。龍潭社區婦女對子宮頸癌認知、態度與預防行為之探討。中華家醫誌,4,p83-89。
陳錫中、周碧瑟(1995)。臺灣鄉村婦女對「子宮頸防癌抹片檢查」的認知及參與之調查研究。中華衛誌,14(6),p494-501。
葉季森(1987)。影響婦女抹片檢查之有關因素研究。國立師範大學衛生教育研究所碩士論文。
葉季森、周碧瑟(1987)。以健康信念模式分析桃園縣婦女的抹片檢查行為。衛生教育,8期,p58―77。
張桂禎(1999)。國立臺灣師範大學B型肝炎帶原學生參與肝功能檢查之行為研究。國立臺灣大學衛生教育研究所碩士論文。
楊玉玫(1993)。影響民眾前往性病防治所接受愛滋病毒抗體檢驗相關因似的探討。國立臺灣大學衛生教育研究所碩士論文。
楊南屏、周碧瑟(1991)。國小老師對癌症知識、態度與行為。中華醫誌,47(4),p271-279。
劉秀鳳、周碧瑟、江宏(1987)。鹿谷鄉社區性子宮頸篩檢的分析與評估。中華醫誌,11期,p43-46。
劉偉民(1997)。六分鐘 護一生——婦女保健指南。台北,聯合文學出版社。
曾炳憲、劉裕森、蘇韻青、李月娥、黃一文、蕭雪紅(1996)。台北市立忠孝醫院婦產科門診子宮頸抹片篩檢三年之研究初步報告。臺灣醫界,39(5),p38-40。
鄭承傑(1993)。華人婦癌排行榜的冠軍—— 子宮頸癌(上)。健康世界,89,P97-99。
盧美秀總校閱(1993)。內外科謢理學(下冊),p3021。台北:華杏。
簡大任、季瑋珠(1995)。台北市有偶婦女接受子宮頸抹片檢查影響因素之探討。中華衛誌,14(2),p111-128。
Agars, J.,& McMurray A.(1993)An evaluation of comparative strategies for teaching breast self examination. Journal of Advanced Nursing,18(10),1595-1603.
Anderson,A.S.,&Leake,P.A.(1987)Model for physician utilization within 2 weeks :Analysis of norwigian data.Medical care,25(4),300-310.
Bates, A.S., Fitzgerald, J.F.& Wolinsky, F.D.(1994)The parent health belief scales: Replication in an urban clinic population. Medical care, 32(9),958-964。
Beaulieu ,A. D. ,Beland, F. Roy, S., Falardeau, A.& Hebert, G.(1996). Factors determining compliance with screening mammography. Canadian Medical Association journal,154(9),1335-1343.
Branoff, R., Santi, k.,Campbell, J. K., Roetzheim ,R., & Older, M. (1997). A Family practice residency cervical screening project: perceived screening barriers. Family medicine, 29(2),119-123.
Briggs, M. j., & Thomas,J.(1994).Obstacles to hepatitis B vaccine uptake by health care staff. American journal of Public Health, 108, 137-148.
Bundek, N. I., Marks, G., & Raichardson, J. V.(1993).Role of health locus of control beliefs in cancer screening of elderly Hispanic women. Health Psychology, 12(3), 193-199.
Buller D., Modiano M.R., De-Zapien J.G., Meister J., Saltzman S., &Hunsaker F.(1998) Predictors of cervical cancer screening in Mexican American women of reproductive age. Journal of health care for the poor and underserved, 9(1),76-95.
Burack, R. C., & Liang, J. (1989).The acceptance and completion of mamongraphy by older black women. American journal of public health, 79, 721-726.
Chavez L.R., Hubbell F.A., Mishra S.I., Valdez R.B.(1997) The influence of fatalism on self-reported use of papanicolaou smears. American journal of peventive medicine, 13(6),418-424。
Champion, V.(1994). Relationship of age to mammography compliance. Cancer Supplement, 74(1), 329-335.
Chen C.M.(1995) Factors influencing cervical cancer screening in Taiwanese women:Use of aday and andersen’s access to medical care model(China). Indiana University School of Nursing. AAC 9605326.
Chi,P.H.,Lin,Y.C.,Hong,J.C.,&Pesus,C.(1999)Cognition and utilization of papanicolaou testing after the implementation of national health insurance in rural Taiwan.Journal forms medication association,98(1),19-23.
Friedman, L. C., Nelson D. V., Webb J. A., Cooper, H. P., & Bruce, S.(1995). Dispositional optimism, self-efficacy, and beliefs as predictors of breast self-examination.America Journal of Preventive Medicine.10(3),130-135.
Funke, B. L., &Nicholson, M. E. (1993). Factors affecting patient compliance among women with abnormal Pap smears. Patient Education Counseling, 20(1), 5-15.
Gill,J.M.,&McClellan,S.A.(2001).The impact of referral to primary physician on cervucal cancer screening. American journal of public health 91,451-457.
Green, L. W. (1980). Health education planning: A diagnostic approach. Mayfield Publishing Company. The John Hopkins University.
Green,L.W.,Kreuter,M.W.,Deeds,S.G.&Partrudge,K.B.(1980)Health education planning:A diagnostic approach.Mayfield publishing company,58-64.
Holmquist,N.D.(2000).Revisiting the effect of the pap test on cervical cancer. American journal of public health 90,620-625.
Kahn,J.A.,Chiou,V.,Allen,J.D.,Googman,E.,Perlman,S.E.,&Emans,S.J.(1999).Beliefs about Papanicolaou smears and comliance with Papanicolaou smear follow-up in adolescents.Archives of pediatrics & adolescent medicine,153(10),1046-1054.
Kathleen,J.D.,&Deirdre,L.(2000).Sociodemographic preductors of adherence to annual cervical cancer screening .Cancer Nursing,23(5),350-356.
Katz, R. C., & Meyers, k.,& Walls, J. (1995). Cancer awareness and self-examination practices in young men and women. Journal of Behavior and Medicine, 18(4),377-384.
Kiefe, C. I., McKay, S. V., halevy, A., & Brody, B. A.(1994). Is cost a barrier to screening mammography for low income women receiving Medicare benefits? A randomized trial. Archives of Internal Medicine, 154(11),1217-1224.
King, E. S., Rimer, B. K., Seay, J ., Balshem, A., & Engstrom. (1994). Promoting mammography use through progressive interventions: Is it effective? American Journal of Public Health, 84, 104-106.
Krejcie,R.V.,&Morgan,D.W.(1970)Determining sample size for research activities.Educational and psychologinal measurement 30,607-610.
Lawson , H.W., Henson , R., Bobo ,J .K., & Kaeser, M. K. (2000). Implementing recommendations for the early detection of breast and cervical cancer among low-income women.MMWR,49,35-45.
Lic, C. C., &Liang, C.C.(1997). The relationship between health locus of control and compliance of hemodialysis patients. Kao Hsiung I Hsueh Ko Tsa Chih, 13(4),243-254.
Lin, W. C., &Ball, c.(1997). Factors affecting the decision of nursing students in taiwan to be vaccinated against Hepatitis B infection. Journal of Advanced Nursing, 25,709-718.
Mandelblatt J., Traxler M., Lakin P., Manetsky P., Kao R.& the Harlem Study team. (1993)Targeting breast and cervical cancer screening to elderly poor black women: Who will participate? Preventive medicine, 20,20-33.
McCarthy, B. D., Yood, M. U., Janz, N. K., Boohaker, E. A., Ward, R. E., & Johnson, C.C.(1996). Evaluation of factors potentially associated with inadquate follow-up of mammographic abnormalities. Cancer,77(10),2070-2076.
Mcphee S. J., Bird J. A., Davis T., Ngoc-The H., Jenkins C. N. H. & Le B. (1997) Barriers to breast and cervical cancer screening among vietnamese-American women. American journal of peventive medicine, 13(3),205-213.
Miok, C.L.(2000).Knowledge barriers and motivators related to cervical cancer screening among Korean-american :a focus group approach.Cancer Nursing,23(3),168-175.
Murata, P. J. & Young, l. c. (1993). Physician’ attitudes and behaviors regarding hepatitis B immunization. Journal of Family Practing, 36, 163-168.
Murray, M., & Mcmillan, C.(1993).Health beliefs, locus of control, emotional control and women’s cancer screening behaviour. The British Psychological Society,32,87-100.
Myers, R. E., & Ross e.s.(1994). Modeling adherence to colorectal cancer screening. Preventive Medicine, 23, 142-151.
Myers, R. E., Vernon, S. W., Tilley, B. C., Lu, M., &watts, B. G. (1998).Intention to screen for colorectal cancer among white male employees. Preventive medicine,27(2),279-287.
Myers, R. E., Wolf, T. A., McKee, L., McGrory, G., Burgh, D. Y., Nelson, G., & Nelson, G. A.(1996). Intention to screen for colorectal cancer among white male employees. Cancer, 78(3), 471-479.
Orbell S., Crombie I., Johnston G. (1996) Social cognition and social structure in the prediction of cervical screening uptake. British journal of health psychology, 1(1),35-50.
PaskettE.D.,Mcmahon K.,Tatum C.,Velez R.,Shelton B.,Case L.D.,Wofford J.,Moran W., &Wymer A.(1998)Clinic-based to promote interventions breast and cervical cancer screening.Preventive medicine,27,120-128.
Pender, N. J.(1975). A concepotual model for preventive health behavior. Nursing Outlook, 23(6), 385-360.
Rutledge, D. N., & Davis, G. T. (1998). Breast self-examination compliance and the health belief model. Oncology Nursing Forum, 15(2), 175-179.
Seow A., Wong M. L., Smith W. C. S. &Lee H. P. (1995) Beliefs and attitude as determinants of cervical cancer screening: A community-based study in Singapore. Preventive medicine, 24,134-141.
Shepperd, S. L., Solomon, L. J., Atkins, E., Foster, R. S. Jr, & Frankowski, B. (1990). Determinants of breast self-examination among women of lower income and lower education. Journal of Behavior Medicine, 13(4), 259-371.
Solomon T.G.A. (1998) The psychosocial correlates of cervical cancer screening among young american indian women. The university of Taxas at Austin. AAC 9838122.
Strickland,B.R.(1978)Internal external experctancics and health related behavior.Journal of consulting and clinical psychology,46(6),33-40.
Thomas, L. R., Fox, S. A., Leake, B. G., & Roetzheim, R. G. (1996). The effects health beliefs on screening on screening mammography unilization among a diverse sample of older women. Women Health, 24(3), 77-94.
Wallston, B.S.&Devellis,R.(1978) Development of the multidimensional health locus of control (MHLC) scales; Health education monographs,6(2),161-171。
Wallston, B. S., & Wallston, K. A.(1978). Locus of control and health :A review of the literature. Health Education Monographs, 6(2), 107-117.
Wallston, B. S., Wallston, K. A. & DeVellis, R. (1978) . Develpoment of the multidimensional health locus of control scale. Health Education Monographs, 6(2), 160-170.
Wang, H. H., & Hou, M. F. (1993). Diagnostic delay and related factors in women with breast cancer. Kao Hsiung I Hsueh Ko Tsa Chih, 9(2),103-113.
Watter,B.L.(1989).Anxiety and control beliefs in adolescents preventive health decision-making..MI:U.M.I.(U.M.I.Dissertation information service No.9011814)
Wyper, M. A. (1990). Breast self-examination and health belief model. Research in Nursing & Health, 13, 421-428.
Yi J.K. (1994) Factors associated with cervical cancer screening behavior among vietnamese women. Journal of community health, 19(3),189-200.