研究生: |
黃莉芸 Huang, Li-Yun |
---|---|
論文名稱: |
以健康信念模式探討大學生接種人類乳突病毒疫苗之行為意圖及相關因素研究 Factors Associated with University Students’ Intention of Human Papillomavirus Vaccination: A Heath Belief Model Approach |
指導教授: |
張鳳琴
Chang, Fong-Ching |
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: | 2016 |
畢業學年度: | 104 |
語文別: | 中文 |
論文頁數: | 118 |
中文關鍵詞: | 健康信念模式 、人類乳突病毒疫苗 、HPV疫苗接種行為意圖 、大學生 |
英文關鍵詞: | Health belief model, HPV vaccine, HPV vaccination intention, university students |
DOI URL: | https://doi.org/10.6345/NTNU202204478 |
論文種類: | 學術論文 |
相關次數: | 點閱:313 下載:66 |
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 |
本研究旨在以健康信念模式探討大學生接種人類乳突病毒疫苗之行為意圖及相關因素。研究對象為103學年度第二學期就讀台灣北部3所大學的學生,共分析533人。以自填式問卷進行調查,重要結果如下:
一、研究對象整體對於HPV相關知識偏中上程度。HPV行動線索主要來源是從學校、媒體及衛生單位。
二、研究對象整體之HPV自覺罹患性、HPV疫苗自覺行動障礙、HPV疫苗自我效能、HPV疫苗行為意圖皆偏向中間程度。HPV自覺嚴重性、HPV自覺行動利益皆偏向中上程度。
三、女性研究對象在HPV行動線索、接種HPV疫苗健康信念之「HPV自覺罹患性」、「HPV疫苗自覺行動障礙」、「HPV疫苗行動意圖」顯著高於男性。
四、研究對象之HPV行動線索、HPV自覺罹患性、HPV疫苗自覺行動利益、HPV疫苗自我效能與HPV疫苗行動意圖呈顯著正相關。HPV疫苗自覺行動障礙與與HPV疫苗行動意圖呈顯著負相關。
五、研究對象之HPV行動線索、HPV健康信念之「HPV自覺罹患性」、「HPV疫苗自我效能」可有效預測HPV疫苗接種行為意圖。
本研究建議學校及衛生單位可增加HPV疫苗訊息的露出來強化HPV行動線索,及增加HPV相關教育活動來提升大學生自覺罹患性、HPV疫苗自我效能,增進學生HPV疫苗接種。
關鍵字:健康信念模式、人類乳突病毒疫苗、HPV疫苗接種行為意圖、大學生。
The purpose of this study was to explore factors associated with university students’ intention of human papillomavirus vaccination (HPV). The present study analyzed 533 undergraduate students from 3 northern Taiwan universities in 2015. Self-administered structured questionnaires were used. The main findings were as follows.
1.Overall, university students’ had average/high HPV knowledge scores. HPV cues to action were mainly form schools, media and healthcare providers.
2.Students’ perceived susceptibility to HPV, perceived barriers of HPV vaccination, self-efficacy, and HPV vaccination intention were at middle levels, while students’ perceived severity to HPV and perceived benefits of HPV vaccination were at middle/high levels.
3.Female studnets’ perceived susceptibility to HPV, perceived barriers of HPV vaccination, and HPV vaccination intention were significantly higher than males.
4.HPV cues to action, perceived susceptibility, perceived benefits, and self-efficacy were positively associated with HPV vaccination intention, while perceived barriers was negatively associated with HPV vaccination intention.
5.HPV cues to action, perceived susceptibility to HPV, and self-efficacy could predict HPV vaccination intention.
It was suggested that educational institutions and health sectors could increase HPV vaccine message exposure to increase cues to action and conduct HPV educational acitivities to improve students’ perceived susceptibility and self-efficacy of HPV vaccination.
Key word: Health belief model, HPV vaccine, HPV vaccination intention, university students.
中文部分
何志明(2010)。婦癌的防治。聲洋防癌之聲,130,2-8。
李守義、周碧瑟、晏涵文(1989)。健康信念模式的回顧與前瞻[Retrocpect and Procpect of Health Belief Model]。中華民國公共衛生學會雜誌,9(3),123-137。doi:10.6288/jnpharc1989-09-03-02
李金治、李思賢、陳天順、盧玉玫、林勳(2010)。金門縣婦女對接種人類乳突病毒疫苗之意圖及相關因素研究 [Factors Associated with Women Intention of the Human Papillomavirus Vaccination Study in Kinmen]。健康促進暨衛生教育雜誌,(30),1-16。
沈冠印、劉士任(2012)。人類乳突病毒(HPV)疫苗發展新知。感染控制雜誌, 22(5),243-248。
周松男(2015)。子宮頸癌疫苗綜論 [Overview of Cervical Cancer Vaccine]。婦癌醫學期刊,(41),1-8。
林敬旺、蔡文正、曾盈甄(2011)。父母對於青少女接種人類乳突病毒疫苗接受度與影響因素探討 [Factors Associated with Parental Acceptance of Human Papillomavirus Vaccination for Adolescents]。澄清醫護管理雜誌,7(2),38-50。
財團法人中華民國消費者文教基金會(2015)。子宮頸癌疫苗加減打?消基會呼籲啟動全面性調查【附件】。2015年5月12日取自http://www.consumers.org.tw/attachfile/20150512141753577.doc
陳菁徽、邱立軒、黎進三、阮芳賦、陳國彥、劉偉民、朱元祥(2014)。人類乳突病毒、子宮頸癌預防策略與性行為模式 [Human Papillomavirus, Cervical Cancer Prevention, and Sexual Behavior]。臺灣性學學刊,20(1),83-110。 doi:10.3966/160857872014052001004
張鳳琴、李景美、邱瓊慧、陳炳宏、苗迺芳、江振東…黃莉芸(2015)。大學生對醫藥科技傳播風險感知與素養之調查研究。科技部。(計畫編號:103-2511-S-003-043)。
陳曉悌、李怡娟、李汝禮(2003)。健康信念模式之理論源起與應用。臺灣醫學,7(4),632-639。
婦癌研究委員會(2011)。婦癌臨床診療指引(第二版),台北:國家衛生研究院。
溫福星(2013)。社會科學研究中使用迴歸分析的五個重要觀念 [Five Important Concepts of Using Regression Analysis in Social ScienceStudies]。管理學報,30(2),169-190。doi: 10.6504/ JOM.2013.30.02.04
溫麗芬、洪麗珍、張彩秀(2008)。青少女自費接種子宮頸癌疫苗意圖之相關因素探討 [Factors Associated with Adolescent Girls' Intention to self-paid Human Papillomavirus Vaccination]。臺灣公共衛生雜誌,27(2),133-142。doi:10.6288/tjph2008-27-02-05
葉樹人、陳慧祺、黃立民(2007)。子宮頸癌疫苗 [Cervical Cancer Vaccine]。臺灣醫學,11(6),649-654。doi:10.6320/fjm.2007.11(6).09
詹明錦、邱勝康、吳建昌、方啟泰(2013)。人類乳突病毒疫苗接種政策:公共衛生倫理觀點 [Human Papillomavirus Vaccination Policy: a Public Health Ethics Perspective]。臺灣公共衛生雜誌,32(4),309-319。doi:10.6288/tjph2013-32-04-02
衛生福利部(2015)。103年國人死因統計結果。2015年6月17日取自http://www.mohw.gov.tw/news/531349778
衛生福利部國民健康署(2015a)。子宮頸癌防治【主題文章】。2015年10月20日取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201312230004&parentid=200712250033
衛生福利部國民健康署(2015b)。HPV疫苗【問與答】。取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicQA.aspx?No=201103150001&Parentid=201103150001
英文部分
American Joint Committee on Cancer. (2009). Cancer staging refernces-Quick references. Retrieved from: https://cancerstaging.org/references-tools/quickreferences/Pages/default.aspx
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological review, 84(2), 191.
Brewer, N. T., & Fazekas, K. I. (2007). Predictors of HPV vaccine acceptability: A theory-informed, systematic review. Preventive Medicine, 45(2–3), 107-114. doi:http://dx.doi.org/10.1016/j.ypmed.2007.05.013
Canfell, K., Egger, S., Velentzis, L. S., Brown, J. D., O’Connell, D. L., Banks, E., & Sitas, F. (2015). Factors related to vaccine uptake by young adult women in the catch-up phase of the National HPV Vaccination Program in Australia: Results from an observational study. Vaccine, 33(20), 2387-2394.
Dany, M., Chidiac, A., & Nassar, A. H. (2015). Human papillomavirus vaccination: Assessing knowledge, attitudes, and intentions of college female students in Lebanon, a developing country. Vaccine, 33(8), 1001-1007. doi:http://dx.doi.org/10.1016/j.vaccine.2015.01.009
Donadiki, E. M., Jiménez-García, R., Hernández-Barrera, V., Carrasco-Garrido, P., de Andrés, A. L., & Velonakis, E. G. (2012). Human papillomavirus vaccination coverage among Greek higher education female students and predictors of vaccine uptake. Vaccine, 30(49), 6967-6970.
Donadiki, E. M., Jiménez-García, R., Hernández-Barrera, V., Sourtzi, P., Carrasco-Garrido, P., López de Andrés, A., Velonakis, E. G. (2014). Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health, 128(3), 268-273. Doi:http://dx.doi.org/10.1016/j.puhe.2013.12.004
Forster, A. S., Waller, J., Bowyer, H. L., & Marlow, L. A. (2015). Girls' explanations for being unvaccinated or under vaccinated against human papillomavirus: a content analysis of survey responses. BMC Public Health, 15(1), 1278. doi:10.1186/s12889-015-2657-6
Gerend, M. A., & Barley, J. (2009). Human papillomavirus vaccine acceptability among young adult men. Sexually transmitted diseases, 36(1), 58-62.
Gerend, M. A., Lee, S. C., & Shepherd, J. E. (2007). Predictors of human papillomavirus vaccination acceptability among underserved women. Sexually transmitted diseases, 34(7), 468-471. doi:10.1097/01.olq.0000245915.38315.bd
Giuliano, A. R., Palefsky, J. M., Goldstone, S., Moreira Jr, E. D., Penny, M. E., Aranda, C., . . . Hillman, R. (2011). Efficacy of quadrivalent HPV vaccine against HPV infection and disease in males. New England Journal of Medicine, 364(5), 401-411.
Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: theory, research, and practice (4th ed,. pp.45-62). San Francisco: John Wiley & Sons.
Harper, D. M., Franco, E. L., Wheeler, C. M., Moscicki, A.-B., Romanowski, B., Roteli-Martins, C. M., Dubin, G. (2006). Sustained efficacy up to 4· 5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. The Lancet, 367(9518), 1247-1255.
International Agency for Research on Cancer. (2012). Cancer fact sheets. Retrieved from: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx?cancer=cervix
Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education & Behavior, 11(1), 1-47.
Jones, M., & Cook, R. (2008). Intent to receive an HPV vaccine among university men and women and implications for vaccine administration. Journal of American college health, 57(1), 23-32.
Kahn, J. A., Rosenthal, S. L., Jin, Y., Huang, B., Namakydoust, A., & Zimet, G. D. (2008). Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstet Gynecol, 111. doi:10.1097/AOG.0b013e31817051fa
Kang, H. S., & Moneyham, L. (2010). Attitudes toward and intention to receive the human papilloma virus (HPV) vaccination and intention to use condoms among female Korean college students. Vaccine, 28(3), 811-816.
Kessels, S. J. M., Marshall, H. S., Watson, M., Braunack-Mayer, A. J., Reuzel, R., & Tooher, R. L. (2012). Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine, 30(24), 3546-3556. doi:http://dx.doi.org/10.1016/j.vaccine.2012.03.063
Khan, T. M., Buksh, M. A., Rehman, I. U., & Saleem, A. (2016). Knowledge, attitudes, and perception towards human papillomavirus among university students in Pakistan. Papillomavirus Research, 2, 122-127. doi:http://dx.doi.org/10.1016/j.pvr.2016.06.001
Kirscht, J. P. (1974). Research related to the modification of health beliefs. Health Education & Behavior, 2(4), 455-469.
Krawczyk, A. L., Perez, S., Lau, E., Holcroft, C. A., Amsel, R., Knäuper, B., & Rosberger, Z. (2012). Human papillomavirus vaccination intentions and uptake in college women. Health Psychology, 31(5), 685.
La Torre, G., de Waure, C., Chiaradia, G., Mannocci, A., & Ricciardi, W. (2007). HPV vaccine efficacy in preventing persistent cervical HPV infection: A systematic review and meta-analysis. Vaccine, 25(50), 8352-8358. doi:http://dx.doi.org/10.1016/j.vaccine.2007.09.027
Lu, C.-Y., & Santosham, M. (2012). Survey of national immunization programs and vaccine coverage rates in Asia Pacific countries. Vaccine, 30(13), 2250-2255.
Markowitz, L. E., Dunne, E. F., Saraiya, M., Chesson, H. W., Curtis, C. R., Julianne Gee, …Unger, E. R., (2014). Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep, 63(RR-05), 1-30.
Marlow, L. A. V., Waller, J., Evans, R. E. C., & Wardle, J. (2009). Predictors of interest in HPV vaccination: A study of British adolescents. Vaccine, 27(18), 2483-2488. doi:http://dx.doi.org/10.1016/j.vaccine.2009.02.057
Marlow, L. A. V., Zimet, G. D., McCaffery, K. J., Ostini, R., & Waller, J. (2013). Knowledge of human papillomavirus (HPV) and HPV vaccination: An international comparison. Vaccine, 31(5), 763-769. doi:http://dx.doi.org/10.1016/j.vaccine.2012.11.083
Nicol, A. F., Nuovo, G. J., & Dillner, J. (2010). A summary of the 25th International Papillomavirus Conference 2009: Vaccines, screening, epidemiology and therapeutics. Journal of Clinical Virology, 47(3), 208-215. doi:http://dx.doi.org/10.1016/j.jcv.2009.12.005
Potts, A., Sinka, K., Love, J., Gordon, R., McLean, S., Malcolm, W., . . . Donaghy, M. (2013). High uptake of HPV immunisation in Scotland–perspectives on maximising uptake. Euro Surveill, 18(39), 1-10.
Public Health England. (2014). Human Papillomavirus (HPV) Vaccine Coverage in England, 2008/09 to 2013/14 A review of the full six years of the three-dose schedule. Health Protection Report, 8(46).
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education & Behavior, 2(4), 328-335.
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education & Behavior, 15(2), 175-183.
Rosenthal, S., Weiss, T. W., Zimet, G. D., Ma, L., Good, M., & Vichnin, M. (2011). Predictors of HPV vaccine uptake among women aged 19–26: importance of a physician's recommendation. Vaccine, 29(5), 890-895. doi:10.1016/j.vaccine.2009.12.063
Pecorelli, S. (2009). Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynecology & Obstetrics, 105(2), 103-104.
Rowhani-Rahbar, A., Mao, C., Hughes, J. P., Alvarez, F. B., Bryan, J. T., Hawes, S. E., . . . Koutsky, L. A. (2009). Longer term efficacy of a prophylactic monovalent human papillomavirus type 16 vaccine. Vaccine, 27(41), 5612-5619. doi:http://dx.doi.org/10.1016/j.vaccine.2009.07.027
Slade, B. A., Leidel, L., Vellozzi, C., Woo, E. J., Hua, W., Sutherland, A., ... Markowitz, L. E. (2009). Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. Jama, 302(7), 750-757. doi:10.1001/jama.2009.1201
Stokley, S., Jeyarajah, J., Yankey, D., Cano, M., Gee, J., Roark, J., . . . Markowitz, L. (2014). Human papillomavirus vaccination coverage among adolescents, 2007-2013, and postlicensure vaccine safety monitoring, 2006-2014-United States. MMWR. Morbidity and mortality weekly report, 63(29), 620-624.
Villa, L., Costa, R., Petta, C., Andrade, R., Paavonen, J., Iversen, O., . . . Riis-Johannessen, G. (2006). High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. British Journal of Cancer, 95(11), 1459-1466.
Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., Shah, K. V., . . . Munoz, N. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. The Journal of pathology, 189(1), 12-19.
World Health Organization. (2008). Cervical cancer, human papillomavirus (HPV) and HPV vaccines: Key points for policy-makers and health professionals.
Wong, L. P. (2010). Knowledge and attitudes about HPV infection, HPV vaccination, and cervical cancer among rural southeast Asian women. International Journal of Behavioral Medicine, 18(2), 105-111. doi:10.1007/s12529-010-9104-y
Zimet, G. D., Weiss, T. W., Rosenthal, S. L., Good, M. B., & Vichnin, M. D. (2010). Reasons for non-vaccination against HPV and future vaccination intentions among 19-26 year-old women. BMC Women's Health, 10(1), 1-6. doi:10.1186/1472-6874-10-27
Zimmerman, R. S., & Vernberg, D. (1994). Models of preventive health behavior: Comparison, critique, and meta-analysis. Advances in medical sociology, 4, 45-67.