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研究生: 孟玲玲
Ling-ling Meng
論文名稱: 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
Effects of Health Education Intervention on Elementary School Female Teachers'Cervical Cancer Screening Intention and Behavior in Chung-hwa Urban Cities
指導教授: 鄭惠美
Jeng, Huey-Mei
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
畢業學年度: 87
語文別: 中文
論文頁數: 150
中文關鍵詞: 衛生教育介入子宮頸抹片檢查女教師
英文關鍵詞: health education, intervention, cervical cancer screening, female teachers
論文種類: 學術論文
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  • 子宮頸癌高居我國婦癌發生率第一名,但透過子宮頸抹片檢查可早期發現,且初期治癒率很高。本研究的主要目的在探討兩種介入方式對彰化都市地區國小女教師子宮頸抹片檢查意願與行為的影響,並分析其他影響因素。以立意取樣的方式選取15所小學,並分為教學組、單張組與對照組,前後測配對後共得250名有效樣本。所得資料以描述性統計、複迴歸分析、邏輯迴歸分析等方法進行分析。重要結果如下:
    一、社會人口學特徵對子宮頸抹片檢查意願、行為的影響並不穩定。自覺障礙性愈低的人,愈可能在未來三年內接受抹片檢查,也愈可能定期接受檢查。
    二、教學組的知識得分顯著高於單張組與對照組。教學組的自覺利益性顯著高於單張組。
    三、教學組與對照組、單張組與對照組在子宮頸抹片檢查意願、行為上均無顯著差異。
    四、教學介入對象比單張介入對象更願意在未來三年內定期接受抹片檢查,但在子宮頸抹片檢查行為方面則無顯著影響。
    本研究建議未來研究可延長調查時間,以瞭解介入的長期效果,並利用國小女教師的影響力,以提高社區婦女的子宮頸抹片檢查率。

    Cervical cancer is the first incidence of female cancer in Taiwan. Through cervical cancer screening, cervical cancer can be detected early and treated properly. The purpose of this research is to exam the effect of two intervention strategy on elementary school female teachers' cervical cancer screening intention and behavior in Chung-hwa urban cities. Fifteen elementary schools were selected on purpose, and assigned to teaching group , leaflet group and control group. There were 250 subjects who completed pre-test and post test questionnaire. The questionnaire investigated these subjects' past behaviors and future intention for cervical cancer screening. Multiple regression and logistic regression were used to analyze the data. The results showed that:
    1. The effect of demographic factors on cervical cancer screening intention and behavior were not consistent. Subjects with lower perceived barriers were more likely to participate in cervical cancer screening in the future three years, and were more likely to participate in screening routinely.
    1. In past test, the subjects of teaching group had significantly better improvement in knowledge than those of leaflet group and control group.
    1. No significant differences were found in cervical cancer screening intention and behavior between teaching group and control group, neither were between leaflet group and control group.
    1. No significant difference were found in cervical cancer screening behavior between teaching group and leaflet group. But the subjects of teaching group would be more likely to participate in cervical cancer screening than those of leaflet group in the future three years.
    Based on the findings of this research , I provide some suggestions for future research and the implementation of cervical cancer screening in Chapter 5.

    第一章 緒論  第一節 研究動機與重要性…………………………………………….1  第二節 研究目的……………………………………………………….4  第三節 待答問題……………………………………………………….5  第四節 研究假說………………………………………………………6  第五節 名詞界定……………………………………………………….7  第六節 研究限制……………………………………………………….9 第二章 文獻探討  第一節 子宮頸癌與子宮頸抹片檢查………………………………11  第二節 臺灣與各國婦女子宮頸抹片檢查概況……………………13  第三節 影響婦女接受子宮頸抹片檢查的因素……………………16  第四節 教育介入對婦女接受子宮頸抹片檢查的影響……………23 第三章 研究方法  第一節 研究設計與研究架構………………………………………27  第二節 研究對象……………………………………………………28  第三節 研究工具……………………………………………………30  第四節 主要變項的定義與測量……………………………………36  第五節 研究步驟……………………………………………………43  第六節 資料分析與處理……………………………………………46 第四章 研究結果與討論  第一節 研究對象之社會人口學特徵與介入前後之狀況…………49  第二節 社會人口學特徵、健康信念及子宮頸抹片檢查意願與 行為間之關係….……………..……………………………..............67  第三節 衛生教育介入之效果……………..…………………………80  第四節 研究對象對衛生教育介入的評價與需求…………………88 第五章 重要發現、結論與建議  第一節 重要發現……………………………………….….………….91  第二節 結論…………………………………………………………...97  第三節 建議………………….……………………….……………….98 參考文獻  一、中文部分…………………………………………………………101  二、英文部分………………………………………….………………103 附錄  附錄一  問卷初稿…………………………………………………109  附錄二  內容專家效度名單………………………………………114  附錄三  前測問卷…………………………………………………115  附錄四  後測教學組問卷…………………………………………121  附錄五  後測單張組問卷…………………………………………128  附錄六  後測對照組問卷…………………………………………135  附錄七  量表信度分析……………………………………………142  附錄八  知識題目之鑑別指數與難度……………………………144  附錄九  教學介入教案計劃………………………………………145  附錄十  學校公文…………………………………………………146  附錄十一 介入單張…………………………………………………147

    一、中文部分
    中國時報(民88.3.20)。九版,社會脈動。
    王培東(民84年)。台灣地區子宮頸贅瘤之流行病學研究。國立臺灣大學公共衛生研究所博士論文。
    王莉莉(民80年)。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。私立東海大學社會工作研究所碩士論文。
    台閩地區各國民中小學基本統計(民86)。教育部統計處編印。
    成佳憲、周碧瑟(民82年)。國中老師對癌症的知識與態度。中華醫誌中文附刊,53(6):1-8。
    何師竹(民86)。臺灣婦女的首號敵人──子宮頸癌。聲洋防癌之聲,86年春季號:30-33。
    呂昌明(民74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,1:67-75。
    呂昌明、陳瓊珠(民72)。所謂健康信念模式。健康教育,51:32-34。
    呂槃(民 84年)。衛生教育教法應用與研究。
    呂槃、姚克明、黃松元譯(Helen S. Ross & Paul R. Mico原著)。(民77年)。衛生教育的理論與實際。台北:中華民國衛生教育學會。
    李翠鳳、敦旭崧、陳錫中、陳天順、周碧瑟(民86年)。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):198-210。
    周碧瑟(民71年)。臺灣地區子宮頸癌流行病學的探討。臺灣醫誌,81:1074-1081。
    周碧瑟(民72年)。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):446-456。
    周碧瑟(民72年)。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):302-311。
    周碧瑟、李卓倫、張鴻仁(民76)。鹿谷鄉民對癌症的知識、態度與行為。公共衛生雜誌,14:140-146。
    周碧瑟、賴明芸(民82年)。各國子宮頸癌篩檢計畫之初探。公共衛生,19(4):384-395。
    林政道、賴瓊慧、曾志仁(民87)。子宮頸抹片的偽陰性──談利用核酸檢驗的重要理由。長庚醫訊,19(9):18-20。
    邱燦宏、葉季森(民82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DOH82-HP-050-4501。
    姜逸群、黃雅文編著(民81)。衛生教育與健康促進。台北,景文出版社。
    陳錫中、周碧瑟(民84年)。台灣鄉村婦女對「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):494-501。
    黃月桂、葉明義、林勤豐(民87年)。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):18-35。
    黃秀梨(民83年)。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。
    黃思誠(民80年)。可以防治的子宮頸癌。健康世界,71:61-64。
    楊育正(民86)。人類乳突病毒與子宮頸癌。聲洋防癌之聲夏季號:9-12。
    楊南屏、周碧瑟(民80年)。國小老師對癌症知識、態度與行為。中華醫誌,47(4):271-279。
    葉季森、周碧瑟(民76年)。以健康信念模式分析桃園縣婦女的抹片檢查行為。衛生教育雜誌,8:58-77。
    彰化縣統計要覽(民86)。彰化縣政府編印,46期。
    劉秀鳳、周碧瑟、江宏(民76)。鹿谷鄉社區性子宮癌篩檢的分析與評估。中華醫誌,11:43-46。
    劉偉民(民86年)。六分鐘 護一生──婦女保健指南。台北,聯合文學出版社。
    鄭丞傑(民82年)。華人婦癌排行榜的冠軍──子宮頸癌(上,中,下)。健康世界,89:97-99、91:55-58、92:37-41。
    簡大任、季瑋珠(民84年)。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)111-128。
    顏明賢(民86年)。婦女的首號殺手──子宮頸癌的篩檢和預防。媽媽寶寶,128:154-157。

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    Chou P. (周碧瑟)(1991)。Review on cervical cancer screening. Chin Med J (Taipei), 48:1-12.
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