簡易檢索 / 詳目顯示

研究生: 吳秀玉
Shiow-Yuh Wu
論文名稱: 臺北市人類乳突病毒(HPV)篩檢陽性個案之複診行為及其相關因素
Referral Practice and Related Factors of the Human PapillomaVirus (HPV)-Positive Women in Taipei
指導教授: 葉國樑
Yeh, Gwo-Liang
曾治乾
Tseng, Chie-Chien
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: 2012
畢業學年度: 101
語文別: 中文
論文頁數: 99
中文關鍵詞: 子宮頸癌人類乳突病毒篩檢知識自我效能
英文關鍵詞: cervical cancer, HPV screening, knowledge, self-efficacy
論文種類: 學術論文
相關次數: 點閱:646下載:15
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
  • 本研究旨在探討臺北市人類乳突病毒(HPV)篩檢陽性個案對人類乳突病毒與子宮頸癌的知識、態度、自我效能和複診行為之間的關係。本研究採用橫斷式研究設計,以臺北市101年度36歲至69歲6年以上未接受抹片婦女,在接受公費人類乳突病毒(HPV)篩檢結果為陽性的所有個案為研究母群體,以自編結構式問卷郵寄641份,實得有效問卷255份。研究結果如下:
    一、研究對象齡61歲至69歲組知識得分最低,以36歲至40歲組知識最佳、複診行為也較佳。高教育程度、有工作及高家庭平均月收入,與知識呈正相關。
    二、研究對象的知識平均正確率74.11%;整體態度及自我效能偏正向;有/無複診行為者的知識有顯著差異,態度與自我效能在有/無複診行為皆無顯著差異。已經接受後續複診者70.2%。
    三、研究對象有工作,態度較為正向。家庭平均月收入愈高,自我效能與複診行為也較佳。
    四、研究對象知識與態度,知識與複診行為,態度與複診行為,自我效能與複診行為,有顯著相關。
    五、研究顯示所有變項對複診行為總解釋力為23.0%;年齡、知識、態度與自我效能為複診行為的主要預測因子;預測力的影響大小依序為「態度」、「知識」、「自我效能」和「年齡」。

    The present study investigated the relationships among knowledge, attitude, self-efficacy, and subsequent visit behavior of HPV-positive individuals in Taipei City toward human papillomavirus (HPV) and cervical cancer. In the study, a cross-sectional research design was adopted in which all cases of women in Taipei City aged between 36 and 69 who had not had a Pap smear for over 6 years but tested positive for HPV after undergoing government-sponsored HPV screening in 2012 were taken as the research population. 641 copies of a self-developed structured questionnaire were mailed, and 255 valid copies of the questionnaire were returned. The results were as follows:
    The 61~69 age group of research subjects scored the lowest in knowledge, whereas the 36~40 age group scored the highest in knowledge and also demonstrated a better behavior in regard to subsequent visit. Higher level of education, being employed, and higher average family monthly income were found to be positively related to knowledge.
    The average knowledge accuracy of research subjects was 74.11%; the overall attitude and self-efficacy of research subjects were slightly positive; there was a significant difference in knowledge between subjects who did and did not return for subsequent visits, however, there was no significant difference in attitude and self-efficacy between subjects who did and did not return for subsequent visits. 70.2% of subjects had already returned for subsequent visits.
    Employed research subjects demonstrated a more positive attitude. The higher the average family monthly income of the subject, the better was the self-efficacy and subsequent visit behavior of the subject.
    Significant relationships were demonstrated among knowledge and attitude, knowledge and subsequent visit behavior, attitude and subsequent visit behavior, and self-efficacy and subsequent visit behavior of research subjects.
    The study showed that the gross explanatory power of all variables on subsequent visit behavior was 23.0%; age, knowledge, attitude, and self-efficacy were the primary predictor factors for subsequent visit behavior; the predictive power of “attitude” was the greatest, followed by “knowledge”, then “self-efficacy”, and finally “age”.

    目 次 中文摘要....................................................I 英文摘要..................................................III 目次.................................. ..................VII 表目次.....................................................IX 圖目次.....................................................XI 第一章 緒論 第一節 研究動機及重要性----------------------------------------1 第二節 研究目的-----------------------------------------------4 第三節 研究問題-----------------------------------------------4 第四節 研究假設-----------------------------------------------4 第五節 名詞解釋-----------------------------------------------5 第六節 研究限制-----------------------------------------------6 第二章 文獻探討 第一節 子宮頸癌-----------------------------------------------9 第二節 人類乳突病毒與子宮頸癌變---------------------------------12 第三節 人類乳突病毒篩檢與處置----------------------------------14 第四節 影響研究對象複診行為的相關因素查證-------------------------18 第三章 研究方法 第一節 研究架構----------------------------------------------31 第二節 研究對象----------------------------------------------32 第三節 研究工具----------------------------------------------33 第四節 研究步驟----------------------------------------------37 第五節 資料處理與分析-----------------------------------------38 第四章 結果與討論 第一節 個人特質、知識、態度、自我效能與複診行為之分佈---------------41 第二節 個人特質、知識、態度、自我效能與複診行為之關係---------------56 第三節 知識、態度、自我效能與複診行為之相關情形--------------------68 第四節 複診行為的重要預測因子----------------------------------69 第五節 綜合討論----------------------------------------------71 第五章 結論與建議 第一節 結論-------------------------------------------------79 第二節 建議-------------------------------------------------80 參考文獻 中文部分---------------------------------------------------83 英文部分---------------------------------------------------87 附錄一 專家效度考驗名單--------------------------------------94 附錄二 行政院衛生署國民健康局婦女人類乳突病毒檢查單----------------95 附錄三 研究正式問卷------------------------------------------96

    中文部分
    王本仁、黃心苑、周穎政、李丞華、張鴻仁(2005)。全民健保子宮頸抹片檢查受檢情形影響因子分析--個體時間序列資料之實證研究,1997~2000。臺灣公共衛生雜誌,17(1),28-35。
    王鵬惠、趙灌中、顏明賢(1998)。子宮頸癌的篩檢。中華民國婦癌醫學雜誌,10,11-14。
    行政院衛生署國民健康局(2002)。臺灣地區國民健康促進知識、態度與行為調查。
    行政院衛生署國民健康局。子宮頸抹片追蹤管理子系統。瀏覽日期:2012年12月8日。網址:http://mscs.bhp.doh.gov.tw/Default.aspx
    行政院衛生署國民健康局子宮頸癌篩檢登記工作。瀏覽日期:2012年10月20日。網址:http://www.twcxr.org.tw/user.aspx
    行政院衛生署衛生統計資訊網。瀏覽日期:2012年10月8日。網址:
    http://www.bhp.doh.gov.tw/BHP/do/chinese/Press/View?p_No=200744164312LIAOIB。
    李金治、李思賢、陳天順、盧玉梅、林勳(2010)。金門縣婦女對接種人類乳突病毒疫苗之意向及其相關因素研究。健康促進暨衛生教育雜誌,30,1-16。
    李翠鳳、郭旭崧、周碧瑟(1997)。金門縣婦女子宮頸防癌抹片檢查的影響因素。中華公共衛生雜誌,16(3),198-210。
    林生傳(2005)。教育社會學。高雄。
    林欣樺、陳淑華、鄭秀玉、陳秀敏(2007)。提昇子宮頸抹片篩檢率之改善專案。護理雜誌,54(1),62-69。
    林惠賢、王琳華、劉淑敏、康啟杰(2003)。屏東地區婦女接受子宮頸抹片檢查之相關因素。臺灣公共衛生雜誌,22(3),127-133。
    林雅真(2010)。社區民眾社會支持、自我效能、自律學習與飲食、運動行為之相關研究(未發表碩士論文)。國立臺北教育大學生命教育與健康促進學系,臺北市。
    林薇、劉貴雲、陳聖惠、劉怡君(1999)。成人降低脂肪攝取營養教育課程:「減脂之旅」成效評估研究。臺灣營養學會雜誌,26(3),181 - 192。
    邱秀渝(2012)。人類乳突病毒HPV篩檢結果陽性婦女子宮頸抹片篩檢遵從性研究工具建立。臺北市政府衛生局101度委託研究計畫工作研究報告。臺北市:臺北護理健康大學。
    徐佩華(2002)。婦女預防保健之評估-以子宮頸癌病患抹片給查利用率為例(未發表碩士論文)。國立中山大學人力資源管理研究所碩士論文,高雄市。
    徐瑋宏、郭平欣(2008)。子宮頸抹片篩檢“認知”與“利用”的影響因素分析-雙元普羅比模型之實證研究。臺灣公共衛生雜誌,27(3),232 -242。
    國家衛生研究院(2007)。子宮頸癌篩檢臨床指引(TCOG)。A1-A30。
    張方玫(2006)。臺灣地區軍訓護理教師子宮頸抹片檢查與其相關因素研究(未發表碩士論文)。臺灣師範大學衛生教育學系,臺北市。
    張玉婷、羅淑芬、施仁興(2005)。結核病患同住之青少年對結核病知識、態度健康促進行為之探討。慈濟護理雜誌,4,79-87。
    許嘉琳(2008)。臺灣地區影響婦女接受子宮頸抹片醫療服務之研究(未發表碩士論文)。亞洲大學健康管理研究所,臺中市。
    陳慈怡、李嬿如、游山林、陳建仁、謝長堯、陳素秋(2005)。全民健保實施前後影響子宮頸抹片篩檢之因素及成果。臺灣公共衛生雜誌,17(1),28-35。
    陳慧祺主編(2011)。臺灣癌病流行病學特性與預防對策。臺北市:財團法人陶聲洋防癌基金會。
    陳憲佐(2010)。臺北市某國中學生預防齲齒行為及其相關因素之研究(未發表碩士論文)。國立臺灣師範大學健康促進與衛生教育學系,臺北市。
    陳環辰(2012)。國中女生身體意象與體重控制自我效能對體重控制行為意圖影響之研究-以嘉義市某國中為例(未發表碩士論文)。國立臺灣師範大學健康促進與衛生教育學系碩士論文,臺北市。
    湯澡薰(2006)。婦女對人類乳突病毒與子宮頸癌關係的認知,對人類乳突病毒疫苗施打及篩檢的態度。行政院衛生署國民健康局95度委託研究計畫工作研究報告(DOH95-HP-1501)。臺北市:臺北醫學大學。
    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。中華公共衛生雜誌,17(2),28-35。
    黃淑貞(1997)。大學生健康信念、自我效能、社會支持與吸菸行為研究。學校衛生,31,30-44。
    黃毓華、邱啓潤(1997)。高雄地區大學生健康促進生活型態之預測因子。中華公共衛生雜誌,16 (1),24 - 36。
    楊鎧玉、陳靜敏、林佳靜、李龍騰(2004)。臺北市子宮頸抹片檢查陽性個案求醫行為相關因素之探討。腫瘤護理雜誌,3(2),1-18。
    溫麗芬、洪麗珍、張彩秀(2008)。青少女為自費接種子宮頸癌疫苗亦項之相關因素探討。臺灣公共衛生雜誌,27(2),133-141。
    葉季森(2001)。烏日鄉已婚婦女接受子宮頸抹片檢查影響因素研究。中臺學報,醫護卷,13,1-12。
    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,8,58-77。
    趙灌中、陳晟立(2001)。新世紀子宮頸癌與癌前病變篩檢。臺北市醫師公會會刊,45(12),22-32。
    劉偉民(1997)。六分鐘 護一生-婦女保健指南。臺北市:聯合文學出版社。
    樓美玲(2003)。登革熱流行期間民眾相關的知識、態度及預防行為。護理雜誌,51,37-44。
    賴宜弘、蕭聖謀、楊雪華(2011)。影響台灣地區婦女子宮頸癌抹片篩檢使用之研究。亞東學報,31,121 - 137。
    賴明芸、周碧瑟(1993)。各國子宮頸癌篩檢計畫之初探。臺灣公共衛生雜誌,19(4),384-393。
    謝芳宜、羅偉成、宋銘展、陳義勳(2006)。子宮頸抹片檢查未受檢者衛生教育暨影響因子分析計畫。臺北市政府衛生局95年度委託研究計畫。臺北市:臺北醫學大學。
    簡大任、季瑋珠(1995)。臺北市有偶婦女接受子宮頸抹片檢查影響因素之探討年。中華公共衛生雜誌,14(2),111-128。

    英文部分
    Adejumo, A. (2010) . Influence of social support, Self-Efficacy, and personality on the general health of retirees in Lagos, Nigeria. Educational Gerontology, 36, 907-918.
    Bais, A. G., Kemenade, F. J.van , Berkhof, J., Verheijen, R. H. M., Snijders, P. J. F., Voorhorst, F., Babovi, M., Ballegooijen, M. van, Helmerhorst, T. J.M., Meijer, C.J.L.M. (2007) . Human papillomavirus testing on self-sampled cervicovaginal brushes: An effective alternative to protect nonresponders in cervical screening programs. International Journal of Cancer, 120 (7), 1505–1510. DOI: 10.1002/ijc.22484.
    Bandura, A. (1977) . Self-efficacy and self-motivation as predictors of weight loss. Addictive Behaviors,12 (1), 63-66.
    Bandura, A. (1986) . Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.
    Bernard, H. U., Chan, S. Y., manos, M. M., Ong, C. K., Villa, L. L., Delius, H., Peyton, C. L., Bauer, H. M., Wheeler, C. H. (1994) . Identification and assessment of known and novel human papillomaviruses by polymerase chain reaction amplification, restriction fragment length polymorphisms, nucleotide sequence, and phylogenetic algorithms. The Journal of Infectious Diseases, 170 (5), 1077-1085.
    Bory, J-P., Cucherousset, J., Lorenzato, M., Gabriel, R., Quereux, C., Birembaut, P., Clave, C.(2002). Recurrent human papillomavirus infection detected with the hybrid capture II assay selects women with normal cervical smears at risk for developing high grade cervical lesions: A longitudinal study of 3,091 women. International Journal of Cancer, 102 (5), 519–525. DOI: 10.1002/ijc.10735
    Cardin, V. A. , Grimes, R. M., Jiang, Z. D., Pomeroy, N. , Harrell, L. , Cano, P. (2001). Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations. Public Health Rep, 116 (6), 608–616.
    Dhamija, S. , Sehgal, A., Luthra, U. K., Sehgal, K.(1993). Factors Associated with Awareness and Knowledge of Cervical Cancer in a Community: Implication for Health Education Programmes in Developing Countries. Perspectives in Public Health, 113 (4), 184-186. DOI: 10.1177/146642409311300407 .
    Cleary, M. C.(2011). Health literacy and its association with diabetes knowledge, self-efficacy and disease self-management among african americans with diabetes mellitus, The ABNF Journal, 25-32.
    Elovainio, L., Nieminen, P., Miller, A. B.(1997). Impact of cancer screening on women’s health. International Joural of Gynecoloy & Obstetrics,58(1), 137-147.
    Godding, P. R., Glasgow, R. E.(1985). Self-efficacy and outcome expectations as predictors of controlled smoking status. Cognitive Therapy and Research, 9 (5), 583-590.
    Harvard’s Center for Cancer Prevention(2000). 上網日期:2012年11月30日,website:http://www.diseaseriskindex.harvard.edu/update/hccpquiz.pl?lang=english&func=home&quiz=cervical
    Herrero, R., Castle, P. E., Schiffman, M., Bratti, M. C., Hildesheim, A., Morales, J., Alfaro, M., Sherman, M. E., Wacholder, S., Chen, S., Rodriguez, A. C., Burk, R. D. (2005). Epidemiologic Profile of Type-Specific Human Papillomavirus Infection and Cervical Neoplasia in Guanacaste, Costa Rica. J Infect Dis, 191 (11), 1796-1807. DOI:10.1086/428850.
    Ho, G. Y. F., Bierman, R. , Beardsle, Ly., Chang, C. J., Burk, R. D.(1998). Natural History of Cervicovaginal Papillomavirus Infection in Young Women. New England Journal Medicine, 338, 423-428. DOI: 10.1056/NEJM199802123380703.
    Holcomb, B., Bailey, J. M., Crawford, K., Ruffin, I. V.(2004). Adult knowledge and Behaviors Related to Human Papillomavirus Infection. J Am Board Fam Pract, 17, 26-31.
    Ideström, M., Milsom, I., Andersson-Ellström, A.(2002). Knowledge and attitudes about the Pap-smear screening program: a population-based study of women aged 20–59 years. Acta Obstetricia et Gynecologica Scandinavica, 81 (10), 962–967.
    Julie, H., Delphine, L-M., Julie, K., Giovanna, B., A-C., Jacquard, Véronique, R., Yann, L., Philippe, V., Franck, C., Christine, L.(2012). French women's knowledge of and attitudes towards cervical cancer prevention and the acceptability of HPV vaccination among those with 14-18 year old daughters: a quantitative-qualitative study. BMC Public Health, 12, 1034.
    Kahn, J. A., Roseenthal, S. L., Jin, Y., Huang, B., Namakydoust, A., Zimet, G. D.(2008). Rates of human papillomavirus vaccine, attitudes about vaccination, and human papillomavirus prevalence in young women. PubMed, 111 (5), 1103-10. DOI: 10.1097/AOG.0b013e31817051fa.
    Kim, K., Yu, S.H., Chen, H., Kim, J.K., Kaufman, M., Purkiss, J.(1999). Cervical cancer screening knowledge and practices among Korean-American women. Cancer Nursing, 22 (4). 297-302.
    Kjær, S. K., Frederiksen, K. , Munk, C., Iftner, T.(2010). Long-term Absolute Risk of Cervical Intraepithelial Neoplasia Grade 3 or Wor e Following Human Papillomavirus Infection: Role of Persistence. JNCI, 102 (19), 1478-1488. DOI: 10.1093/jnci/djq356.
    Kotloff, K., L., Wasserman, S., S., Russ, K. , Shapiro, S., Daniel, R. , Brown, W., Frost, A., Tabara, S., Shah, K.(1998). Detection of genital human papillomavirus and associated cytological abnormalities among college women. Sexually Transmitted Diseases, 25 (5), 243–250.
    Koutsky, L.(1997). Epidemiology of genital human papillomavirus infection . The American Journal of Medicine, 102 (5), Supplement 1, 3-8
    Kulasingam, S. L., Hughes, J. P., Kiviat, N. B., Mao, C., Weiss, N. S., Kuypers, J. M., Koutsky, L. A .(2002). Evaluation of human papillomavirus testing in primary screening for cervical abnormalities: comparison of sensitivity,specificity,and frequency of referral. JAMA, 288, 1749-1757.
    Lefebvre, R. C., Flora, J. A.(1988). Social Marketing and Public Health Intervention. Health Educ Behav, 15 (3), 299-315. DOI: 10.1177/109019818801500305.
    Lothian, S. F., Ferrence, R., Kaiserman, M. J. (1996). Restrictions on smoking. In T. Stephens, Morin, M. (eds.), Youth Smoking Survey, Technical Report, Ottawa: Minister of Supply and Services Canada.
    Inoue, M., Okamura, M. , Hashimoto, S.,Tango, M., Ukita T.(2010). Adoption of HPV testing as an adjunct to conventional cytology in cervical cancer screening in Japan. International Journal of Gynecology and Obstetrics, 111, 110-114.
    Mays, R. M., Aimet, G. D., Winston, Y., Mays, R. M., Zimet, G. D., Winston, Y. , Kee, R., Dickes, J., Su, L.(2000). Human Papillomavirus, genital warts, pap smears, and cervical cancer:Knowledge and beliefs of adolescent and adult women. Health Care for Women International, 21 (5), 361-374. DOI:10.1080/07399330050082218.
    Miller, S. M. , Siejak, K. K., Schroeder, C. M. (1997). Enhancing Adherence Following Abnormal Pap Smears Among Low-Income Minority Women: a Preventive Telephone Counseling Strategy. JNCI, 89 (10), 703-708. DOI: 10.1093/jnci/89.10.703.
    Osborn, C. Y., Paasche-Orlow, M. K., Bailey, S. C., Wolf, M. S.(2011). The mechanisms linking health literacy to behavior and health status. Am J Health Behav, 35 (1), 118-128.
    Petry, K. U., Menton, S., Menton, M., van Loenen-Frosch, F., de Carvalho Gomes, H., Holz, B., Schopp, B., Garbrecht-Buettner, S., Davies, P., Boehmer, G., van den Akker, E., Iftner, T.(2003). Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8466 patients. British Journal of Cancer, 88 (10), 1570-7.
    Philips, Z., Johnson, S., Avis, M., Whynes, D. K.(2003). Human Papillomavirus and the value of screening: Young women’s knowledge of cervical cancer. Health Education Research, 18, 318-328.
    Pitts, M., Clarke, T.(2002). Human Papillomavirus infection and risks of cervical cancer:What do women know?Health Education Research , 17, 706-714.
    Richard, R. M.(1973). Cervical intraepithelial neoplasia:A review. Pathology annual,3 01-328.
    Sanjose, S. de., Diaz, M., Castellsague, X., Cliff ord, G,, Bruni, L., Munoz, N., Bosch, F.X.(2007). Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet, 7 (7), 453-459.
    Sherman, M. E., Lorincz, A. T., Scott, D. R., Wacholder, S., Castle, P. E., Glass, A. G., Mielzynska-Lohnas, I., Rush, I., Brenda, B., Schiffman, M.(2003). Baseline Cytology, Human Papillomavirus Testing, and Risk for Cervical Neoplasia: A 10-Year Cohort Analysis. JNCI, 95 (1), 46-52. DOI: 10.1093/jnci/95.1.46.
    Solomon, D., Schiffman, M., Tarone, R., For the ALTS Group.(2001). Comparison of Three Management Strategies for Patients With Atypical Squamous Cells of Undetermined Significance: Baseline Results From a Randomized Trial. JNCI, 93 (4), 293-299. DOI: 10.1093/jnci/93.4.293 .
    Stewart, D., Lickrish, G., Sierrs, Parkin, Heidi,(1993). The Effect of Educational Brochures on Knowledge and Emotional Distress in Women With Abnormal Papanicolaou Smears. Obstetrics & Gynecology, 81 (2), 161-164.
    Walboomers, J. M. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kumme, J. A., Shah, K. V., Snijders, P. J. F., Peto, J., Meijer, C. J. L. M., Muñoz, N.(1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. The Journal of Pathology, 189 (1), 12-19. DOI: 10.1002/(SICI)1096-9896(199909).
    Waller, J., McCaffrey, K., Forrest, S., Szarewski, A., Cadman, L., Wardle, J.(1999). Awareness of human Papillomavirus(HPV) among women attending a well woman clinic. Sexually Transmitted Infections, 79, 320-322.
    Waller, J., McCaffrey, K., Wardle, J.(2004). Beliefs about the risk factors for cervical cancer in a British population sample. Preventive Medicine , 38, 745-753.
    Wardle, J., Waller, J., Brunswick, N., Jarvis, M.J.(2001). Awareness of risk factors for cancer among British adults. Public Health, 115, 173-174.
    World Health Organization Health topics Cancer.(2004), 上網日期:2012年11月30日,website:http://screening.iarc.fr/cervicalindex.php
    Wright Jr , T. C., Stoler, M. H., Sharma, A., Zhang, G., Behrens, C., Wright, T. L., the ATHENA (Addressing THE Need for Advanced HPV Diagnostics) Study Group.(2011). Evaluation of HPV-16 and HPV-18 Genotyping for the Triage of Women With High-Risk HPV+ Cytology-Negative Results. American Journal of Clinical Pathology, 136, 578-586. DOI:10.1309/AJCPTUS5EXAS6DKZ.
    Yacobi, E., Tennant, C., Ferrante, J., Pal, N., Roetzheim, R.(1999). University student’ knowledge and awareness of HPV. Preventive Medicine , 28, 535-541.
    Yoo, H., Kim, C. J., Jang, Y., You, M-A.(2011). Self-efficacy associated with self-management behaviours and health status of South Koreans with chronic diseases. International Journal of Nursing Practice, 17, 599–606.

    下載圖示
    QR CODE