研究生: |
張方玫 Fang-Mei Chang |
---|---|
論文名稱: |
台灣地區軍訓護理教師子宮頸抹片檢查與其相關因素研究 A Study of Attitudes towards Pap Smear Test and Their Contributing Factors among Military Trained Nursing Instructors in Taiwan |
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: | 2006 |
畢業學年度: | 94 |
語文別: | 中文 |
論文頁數: | 138 |
中文關鍵詞: | 軍訓護理教師 、子宮頸抹片檢查 、健康信念 |
英文關鍵詞: | Military trained nursing instructors, Pap smear, Health belief |
論文種類: | 學術論文 |
相關次數: | 點閱:300 下載:36 |
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 |
摘 要
本研究目的在了解台灣地區軍訓護理教師參與子宮頸抹片檢查之情形,並探討背景因素、健康信念、健康動機、行動線索與子宮頸抹片檢查的關係及子宮頸抹片檢查預測因子。
本研究以台灣地區94學年度第一學期任教於高中職、大專院校之所有軍護教師為研究母群,採系統隨機抽樣,以自編之結構式問卷收集資料,獲得有效問卷299份。以SPSS12.0套裝軟體程式進行統計分析處理。
研究結果發現如下:
一、研究對象自覺子宮頸惡性腫瘤罹患性、嚴重性均在中上程度;自覺子宮頸抹片檢查行動利益屬中上程度,行動障礙則屬中下程度;有高程度的健康動機。研究對象中65.4%自覺有婦科症狀;63.2%曾有親友提醒或鼓勵其接受抹片檢查;89.0%的親友曾接受抹片檢查;71.6%表示沒有親友曾罹患子宮頸惡性腫瘤;63.1%表示會受大眾傳播影響而接受抹片檢查。
二、91.3%認為自己需要接受子宮頸抹片檢查,且有92.0%曾接受檢查;84.4%在最近三年曾受檢;有57.1%每1-3年定期檢查一次;多數人以例行性檢查和認為健康很重要,而專誠接受子宮頸抹片檢查;84.9%表示未來三年會參與子宮頸抹片檢查。
三、研究對象最近三年除子宮頸抹片檢查外曾看婦科、過去抹片檢查結果曾有不正常、自覺子宮頸抹片檢查行動利益高、行動障礙低、健康動機高和平常自覺有婦科症狀者,較傾向會定期接受子宮頸抹片檢查。
四、自覺子宮頸抹片檢查行動障礙、教育程度、最近三年除抹片檢查外是否看婦科、婚姻狀況、重要他人是否曾罹患子宮頸惡性腫瘤、平常是否自覺有婦科症狀是主要預測子宮頸抹片檢查行為的因子,而其中以自覺子宮頸抹片檢查行動障礙對子宮頸抹片檢查行為之影響最大。
依研究發現對未來研究和國內推動子宮頸抹片檢查提出相關建議。
A Study of Attitudes towards Pap Smear Test and Their Contributing Factors among Military Trained Nursing Instructors in Taiwan
A Master Thesis
by
Fang-mei chang
ABSTRACT
The purpose of this research study is to understand attitudes of military trained nursing educators in Taiwan towards Pap smear test. In order to accomplish this task, four categories of predictive factors related to taking Pap smear tests are analyzed:
1) individual background factors, 2) health beliefs, 3) health motivation, and 4) action clues to cervical smear tests.
The target population of this study was all military trained nursing educators, employed during the first semester of school year 2005 in high schools, vocational schools, colleges, and universities in Taiwan, and sampled systematically with a questionnaire. There were a total of 299 valid responses collected, and analyzed with statistical software SPSS version 12.0.
The following are the findings of the study:
1) The participants had moderate to high awareness towards the severity and susceptibility of cervical cancer and the benefits of undergoing Pap smear tests. They also had high health motivation and low barriers to actual action (of having Pap smear tests). Of those questioned, 65.4% had related gynecological symptoms, 63.2% were once encouraged or reminded by relatives or friends to have Pap tests, 89.0% showed that they had family or relatives who have taken Pap smear tests, 71.6% indicated that they had no relatives or friends who had experienced cervical cancer, and 63.1% revealed that they would take Pap smear tests due to the influence of mass media.
2) Pap smear tests were considered necessary by 91.3% of the participants in this study, and of those questioned, 92.0% had taken Pap smear tests before. 84.4% had Pap tests in the last 3 years, and 57.1% had tested regularly every one to three years. Majority of the participants had Pap tests because they considered regular check-ups necessary for good health. 84.9% indicated that they would probably have further Pap tests in the next 3 years.
3) People who are more likely to regularly take Pap tests include those who: underwent general gynecological examinations during the last three years, had abnormal results from Pap smear tests in the past, had high health motivation and low barriers to actual action, and had self awareness of gynecological problems.
4) The most important predictive factor of people taking Pap smear tests are barriers to actual action. Other factors include level of education, frequency of undergoing general gynecological examinations during the last three years, marriage situation, occurrence of cervical cancer among close family members and friends.
Based on the findings, the present study proposed relevant suggestions for related future research and domestic promotion of Pap smear.
參考文獻
中文部份
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。台灣衛誌,24(1),33-41。
王秀紅、王瑞霞、邱啟潤、李建廷(1993)。婦女健康促進及其相關因素的探討。公共衛生,19(3),251-265。
王莉莉(1991)。影響婦女健康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。
王美仁(2002)。影響婦女接受子宮頸抹片檢查因素之探討—以高雄縣阿蓮鄉為例。國立成功大學醫學院公共衛生研究所碩士論文。
朱後穗(2000)。如何預防子宮頸癌。當代醫學,27(11),930-937。
朱湄惠、陳靜敏、張碧真(2000)。婦女接受子宮頸抹片檢查護理介入之成效。新台北護理期刊,2(1),37-48。
行政院衛生署衛生統計資訊網(2006a)。死因統計結果摘要。民國95年2月10日,取自:http://www.doh.gov.tw/statistic/data/死因摘要/93年/表10.xls
行政院衛生署衛生統計資訊網(2006b)。93年衛生重要統計指標。民國95年2月10日,取自:http://www.doh.gov.tw/statistic/data/衛生統計重要指標/6.xls
行政院衛生署癌症登記網(2006)。癌症登記年報。民國95年1月20日,取自:http://crs.cph.ntn.edu.tw/crs_c/annual.html。
行政院衛生署(2005)。衛生署中程施政計劃。民國94年5月10日,取自:http://www.doh.gov.tw/ufile/doc/200410_94-97中程施政計畫-3.pdf
任金蘭(2000)。台灣地區預防保健子宮頸細胞抹片篩檢率之生態相關研究。國防醫學院公共衛生研究所流行病學組碩士論文。
李正亮(1993)。婦女接受子宮頸抹片的意願調查。中華民國家庭醫學雜誌,3(1),44-49。
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),198-209。
何師竹(1997)。台灣婦女的首號敵人-子宮頸癌。聲洋防癌之聲,86年3月春季號,30-33。
呂昌明(1994)。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(7),142-153。
呂昌明、陳瓊珠(1983)。所謂健康信念模式。健康教育,57,32-34。
吳秀英、黃彥方(1998)。推展婦女子宮頸癌防治工作與成果。北市衛生,40,15-19。
吳明義撰文(1999)。子宮頸抹片的迷思。健康世界,165,101-104。
吳岱穎、郭冠良、陳建志、林光洋、黃惠娟(2004)。子宮頸癌的篩檢。基層醫學,19(12),288-295。
阮正雄、傅堯喜、徐正光編著(2001)。子宮頸抹片與陰道鏡圖譜。台北市:嘉州出版社。
周子菁(2004)。婦女預防保健醫療利用分析與影響因素之探討--「國民健康訪問調查」資料分析。中國醫藥大學醫務管理研究所碩士論文。
周貴女(2005)。婦女子宮頸癌篩檢行為意向與相關因素之探討—護理人員與製造業女性員工之比較。高雄醫學大學護理學研究所碩士論文。
周碧瑟(1982)。台灣地區子宮頸流行病學的探討。台灣醫誌,81,1074-1081。
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(4),384-392。
周碧瑟(2000)。影響台灣婦女接受子宮頸抹片檢查之因素。生命科學簡訊,14(6),10-15。
林倖如(2003)。應用健康信念模式探討影響鉛作業勞工接受預防職業病健康檢查之相關因素研究。國立陽明大學衛生福利研究所碩士論文。
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。台灣公共衛生雜誌,22(2),127-133。
林麗珠(2003)。衛生教育介入對婦女參與子宮頸抹片檢查意願與行為影響之研究—以台南縣後壁鄉為例。高雄醫學大學健康科學院公共衛生研究所醫務管理碩士論文。
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。國立台灣師範大學衛生教育學系碩士論文。
柯懿嬖(1996)。以健康信念模式分析某工作場所員工之大腸直腸癌糞便篩檢行為研究。國立台灣師範大學衛生教育研究所碩士論文。
徐佩華(2002)預防婦女保健之評估—以子宮頸癌病患抹片檢查利用率為例。國立中山大學人力資源研究所在職專班碩士論文。
許維邦(1998)。抹片與子宮頸癌。基層醫學,13(2),34-36。
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),5-35。
黃秀梨、張媚(2000)。兩種教育方案介入對工作場所婦女接受子宮頸抹片檢查之知識、健康信念及行為的影響。護理研究,8(1),111-123。
黃松元(1995)。教師健康促進。學校衛生,26,38-43。
黃璉華(1983)。婦女接受子宮頸細胞檢查動機之探討。公共衛生,10(1),99-106。
張桂禎(1999)。國立台灣師範大學B型肝炎帶原學生參與肝功能檢查之行為研究。國立台灣師範大學衛生教育研究所碩士論文。
陳永川、曾炳憲、蕭雪紅、彭文瑤、鍾弘林(2000)。推廣婦女子宮頸抹片新策略與成果初步報告。台灣醫界,43(2),25-28。
陳宛辰(1998)。探討婦女子宮頸抹片檢查行為—以質性內容分析論述之。國立台灣大學公共衛生學研究所碩士論文。
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、行為之探討。中華家醫誌,4,83-89。
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。
陳信義(2004)。六分鐘護一生及預防子宮頸癌症婦癌預防的重要性。台灣醫界,47(6),37-39。
陳美燕、廖張京棣、廖照慧、周傳姜(1994)。公共護理人員健康促進—生活方式初步探討。護理研究,2(1),41-54。
陳美燕、廖張京棣(1995)。桃園地區護理學生與護理人員執行健康促進的生活方式之初步探討。護理研究,3(1),6-16。
陳雲絹、張遠萍、許玲女(1998)。某醫學中心婦女做子宮頸抹片檢查與其影響因素之探討。長庚護理,9(1),22-32。
陳錫中、周碧瑟(1995)。台灣鄉村婦女對「子宮頸防癌抹片檢查」的認知及參予之調查研究。中華衛誌,14(6),494-501。
陳燕儀(2001)。影響女性教職員工子宮頸抹片檢查相關因素之探討—以國立台灣師範大學為例。國立台灣師範大學衛生教育學系碩士論文。
陳曉悌、李怡娟、李汝禮(2003)。健康信念模式之理論起源與應用。台灣醫界,7(4),632-639。
國家衛生研究院癌症研究組(1998)。子宮頸癌篩檢及治療共識。民國94年5月10日,取自http://www.nhri.org/ca/main4.htm.
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。台灣醫界,39(5),406-408。
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。
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,13,1-12。
董貞吟、黃乾全、丁如真、張家儒(2002)。以健康信念模式分析醫院護理人員下被痛預防行為及其相關因素之研究。衛生教育學報,18,43-67。
趙明玲(2000)。基隆市中山區婦女執行子宮頸抹片檢查行為影響因素之探討。德育學報,16,137-147。
蔡慈儀(1995)。健康信念模式與乳房篩檢行為。長庚護理,6(1)=11,15-20。
劉偉民(1998)。有性經驗的婦女請注意—子宮頸抹片檢查讓您遠離癌症之苦。育兒生活,92,180-182。
鄭丞傑(1993)。華人婦癌排行榜的冠軍—子宮頸癌(上、中、下)。健康世界,89,p97-99、91,p55-58、92,37-41。
盧孳艷、阮月清(2003)。子宮頸抹片檢篩政策之身體政治。護理雜誌,50(5),10-15。
鍾昌宏(2003)。女性癌症的頭號殺手。現代保險。98-99。
鍾麗娟、謝明理、劉雪娥(2003)。應用健康信念模式探討影響前列腺高危險群男性執行前列腺篩檢行為之因素。慈濟護理雜誌,2(3),38-48。
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),111-128。
英文部分
Agurto, I., Bishop, A., Sanchez, G., Betancourt ,Z., & Robles, S.(2004).Perceived barriers and benefits cervical cancer screening in Latin America . Preventive Medicine , 39(1),91-98.
American Cancer Society (2005). Cancer Facts & Figures 2005. Retrieved May 5, 2005, from http://www.cancer.org/downloads/STT/CAFF2005f4PWSecured.pdf
American Cancer Society (2006a). Cancer Facts & Figures 2006.
Retrieved February 10, 2006, from http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf
American Cancer Society (2006b). Cancer Prevention & Early Dectection Facts & Figures 2005. Retrieved February 10, 2006, from http://www.cancer.org/downloads/STT/CPED2005v5PWSecured.pdf
Beaulieu, M.D., Beland, F., Roy, D., Falardeau, M., & Hebrt,G.,(1996).Factor determining compliance with screening mammography. Canadian Medical Association Journal,154(9),1335-1343.
Becker, M.H.,& Maiman, L.(1975).Sociobehavioral determinants of compliance with health and medical care recommendation. Medical care,13,10-24.
Boyes, D.A.(1978).The Value of Pap Smear Program and Suggestions for Its Implementation.Cancer, 48,613-621.
Byrd, T. L., Peterson, S.K., Chavez, R., & Heckert, A .(2004).Cervical cancer screening beliefs among young Hispanic women. Preventive Medicine , 38(2), 192-197.
Camirand J., Potvin, L., & Beland, F.(1995).Pap recency :Modeling women,s characteristics and their patterns of medical care use .Preventive Medicine ,24(3), 259-269.
Cervical Cancer Causes(2005).Early Detection Of Cervical Cancer Can Save Your Life. Retrieved May 11, 2005, from http://www.cervical-cancer-causes.com/html/the-pap-smear.php3
Coronado,G. D., Thompson, B., Koepsell, T. D., Schwartz, S. M., & McLerran, D.(2004).Use of Pap test among Hispanics and non-Hispanic whites in a rural setting. Preventive Medicine , 38(6),713-722.
Coughlin, S. S., & Uhler, R. J.(2002)Breast and Cervical Cancer Screening Practices among Hispanic women in the United States and Puerto Rico,1998-1999. Preventive Medicine , 34(2),242-251.
Eaker,S., Adami, H-O., & Sparen, P.(2001).Attitudes to screening for cervical cancer: a population-based study in Sweden .Cancer Causes and Control,12(6),519-528.
Elovainio, L., Nieminen, P., & Miller, A.B.(1997).Impact of cancer screening on women’s health. International Journal of Gynecology & Obstetrics,58(1),137-147.
Fernandez-Esquer, M. E., & Cardenas-Turanzas, M.(2004).Cervical cancer screening among Latinas recently immigrated to the United States. Preventive Medicine , 38(5) ,529-535.
Hewitt, M., Devesa, S. S., & Breen, N.(2004).Cervical cancer screening among U.S. women : analyses of the 2000 National Health Interview Survey. Preventive Medicine , 39(2) ,270-278.
Hsia, J., Kemper, E., Kiefe, C., Zapka, J., Sofaer, S., Pettinger ,M., Bowen, D., Limacher, M., Lillngton, L., & Mason, E.(2000).The Importance of Health Insurance as a Determinant of Cancer Screening : Evidence from the Women’s Health Initiative. Preventive Medicine , 31(3) ,261-270.
Huang, C.P., Chi, L.Y., Chang, H.J., & Chou, P.(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.
Information on Cervical Cancer(2005).It’s The Second Most Common Cancer In Women Worldwide. Retrieved April 11, 2005, from http://www.information-on-cervical-cancer.com/
Janz,N.K.,& Becker,M.H.(1984).The health belief model : A decade later. Health Education Quartiy, 11(4),1-47.
Kahn,J.A.,Chiou,V.,Allen,J.D.,Googman,E.,Perlman,S.ae.,& Emans,S.J.(1999).Beliefs about Papanicolaou smears and compliance with Papanicolaou smears follow-up in adolescents. Archives of Pediatrics & Adolescent Medicine,153(10),1046-1054.
Kathleen, J.D., & Deirdre, L.(2000).Sociodemographic predictors of adherence to annual cervical cancer screening .Cancer Nursing,23(5),350-356.
Krejcie, R. V.,& Morgan, D. W. (1970).Determining samplesize for research activity. Education &Psych0l0gical Measurement, 30, 607-610.
Mandelblatt, J., Traxler, M., Lakin, P., Manetsky, P., Kanetsky 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(1) , 20-33
Michalas, S.P.(2000).The pap test: George N. Papanicolaou(1883-1962)A screening test for the prevention of cancer of uterine cervix. European Journal of Obstetrics & Gynecology and Reproductive Biology, 90, 135-138.
Murray, M. & Mcmillan, C.(1993).Health beliefs, locus of control, emotional control and women’s cancer screening behavior. The British Psychological Society, 32,87-100.
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.
Paskett, E.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(1),120-128.
Rosenstock, I.M., Strecher,V.J., Becker,M.H.(1988).Social Learning Theory and the Health Belief Model. Health Education Quarterly,15,175-183.
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(2),134-141.
Sheinfeld Gorin, S., & Heck, J. E.(2005).Cancer screening among Latino subgroups in United States . Preventive Medicine , 40(5),515-526.
Surveillance, Epidemiology, and End Results(SEER)(2005). SEER Age Adjusted Incidence Rates by Race Cervix Uteri Cancer, All Ages SEER 9 Registries for 1973-2002. Retrieved May 5, 2005, from http://canques.seer.cancer.gov/cgi-bin/cq_submit?dir=seer2002&db=1&rpt=LINE&sel=1^0^0^53^^^2^0&x=Year%20of%20diagnosis^6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35&y=Race^0,1,2&dec=4&title=SEER%20Age%20Adjusted%20Incidence%20Rates%20by%20Race~Cervix%20Uteri%20Cancer,%20All%20Ages~SEER%209%20Registries%20for%201973-2002
Ustun, C., & Ceber, E.(2004).Ethical issues for cancer screenings Five countries—four types of cancer. Preventive Medicine , 39(2) ,223-229.