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研究生: 葉季森
論文名稱: 子宮頸抹片檢查結果異常婦女複診行為及其相關因素研究
指導教授: 呂昌明
Lu, Chang-Ming
學位類別: 博士
Doctor
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: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 143
中文關鍵詞: 子宮頸抹片結果異常延遲複診行為焦慮健康信念健康控握
英文關鍵詞: Abnormal Pap smear, return-check behavior, anxiety, healty beliefs, health locus of control
論文種類: 學術論文
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  • 子宮頸抹片檢查是早期發現子宮頸癌的篩檢方法,當抹片結果為異常時,若未及時複診以確定診斷,將失去抹片篩檢的意義。本研究旨在探討抹片結果異常婦女的複診行為及其相關因素。研究以問卷調查法為主,醫療機構實地訪問法為輔。總計完成304名抹片異常婦女的問卷調查及18所醫療機構訪問。訪問發現各醫療機構對抹片異常追蹤工作之投入,不盡相同。問卷調查主要發現如下:
    一、婦女接到抹片異常通知後第一次的複診時間,並非均勻分佈,而是集中在第一週和第一個月。複診時間以超過三個月以上為延遲來看,有延遲複診者佔19.4%。
    二、以簡單邏輯迴歸分析發現:焦慮、障礙性認知、宗教外控與有無延遲複診呈正相關;罹患性認知、嚴重性認知、有效性認知、社會支持與有無延遲複診呈負相關。
    三、以複邏輯迴歸分析發現:延遲複診婦女的相關特性為:嚴重性認知較弱,有效性認知較弱、障礙性認知較強、焦慮較高。
    針對研究結果,本研究提出提昇抹片結果異常婦女複診行為的衛生教育策略及對抹片結果異常個案追蹤工作的建議。
    關鍵字:子宮頸抹片結果異常、延遲複診行為、焦慮、健康信念、
    健康控握

    This study aimed to investigate the behavior and related factors of return-check toward women after being informed the results of abnormal Pap smear. The method of the study was primarily questionnaire survey, associated with interviews from medical institutions. The respondents of the questionnaire survey included 304 abnormal Pap smear women and the interviewees were 18 staffs from medical institutions in the study.
    The findings of the study were as follows:

    1. The respondents who had their first return-check, the check that women returned the hospitals over three months, were within first week or first month. 19.4 percent of the respondents, however, had their return-check more than three months.
    2. There were significant positive relationships between delay return-check and anxiety, perceived barriers of action, and religious health locus of control. Negative relationships were found between delay return-check and perceived susceptibility, perceived severity, perceived benefits of action and social support.
    3. Multiple Logistic Regression analysis found that perceived severity, perceived benefits of action, perceived barriers of action and anxiety were significantly associated with delay return-check.

    The suggestions of the study included: (1) for health policy makers, providing a comprehensive health education program to these abnormal Pap smears women, and (2) for hospital managers, constructing a well-designed follow-up case management system.

    Key words: Abnormal Pap smear, return-check behavior, anxiety, health beliefs, health locus of control.

    中文提要 ii 英文提要 iii 誌謝 iv 目次 v 表目次 vii 圖目次 ix 第一章 緒論 1 第一節 研究重要性 1 第二節 研究目的 3 第三節 研究問題 3 第四節 研究假設 4 第五節 名詞操作型定義 4 第六節 研究限制 7 第二章 文獻探討 9 第一節 子宮頸抹片檢查之醫學探討 9 第二節 影響抹片異常婦女複診行為的相關因素探討 15 第三章 研究方法 27 第一節 研究設計 27 第二節 研究架構 27 第三節 研究對象 28 第四節 研究工具 30 第五節 研究步驟 38 第六節 資料處理與分析 40 第四章 研究結果 41 第一節 醫療機構訪問結果 41 第二節 量性問卷調查結果 48 第五章 討論 91 第一節 研究方法的討論 91 第二節 國內抹片異常個案追蹤工作的討論 93 第三節 研究結果的綜合討論 95 第六章 結論與建議 109 第一節 結論 109 第二節 建議 110 參考文獻 115 附錄一:全民健康保險婦女子宮頸抹片檢查單 133 附錄二:研究問卷 134 附錄三:宗教外控量表作者同意函 141 附錄四:研究問卷專家效度考驗名單 143

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