青少女自費接種子宮頸癌疫苗意向之相關因素探討

Factors Associated with Adolescent Girls' Intention to self-paid Human Papillomavirus Vaccination

溫麗芬(Li-Fen Wen) ； 洪麗珍(Li-Chen Hung) ； 張彩秀(Tsai-Hsiu Chang)

《台灣公共衛生雜誌》 27卷2期 (2008/04) Pp. 133-142

https://doi.org/10.6288/TJPH2008-27-02-05

摘要

目標：旨在探討中部地區青少女對自費接種子宮頸癌疫苗之意向及其相關影響因素。方法：採橫斷面設計，以有效問卷便利取樣809名高中、職女學生，進行人口學特質、罹患子宮頸癌易感性與嚴重性認知、行動利益及障礙與自費接種意向之資料收集。結果：1.青少女在疫苗接種意向上，67.4%的人願意（含非常願意）自費接種，可負擔之平均費用為793元。2.以逐步迴歸分析後發現，影響整體自費接種意向之重要預測因子為「障礙」與「家中經齊」(R^2=14.6%)；就高中生而言，重要預測因子為「障礙」、「家中經齊」、「吸菸」與「家人罹患子宮頸癌情形」(R^2=18.4%)；就高職生而言，重要預測因子為「障礙」與「性伴侶人數」(R^2=24.1%)；在不同的對象中「障礙」皆是最重要的預測因子。結論：透過瞭解影響青少女子宮頸癌疫苗接種之相關因素探討，於實務方面：建議社區醫療網絡日後能針對可能之障礙因素加以排除，以提高青少女接種意向。於教育方面：高中（職）相關課程中（如：軍護課或健康與護理）可再加以宣導，增加同學對子宮頸癌疫苗的瞭解，以提升接種率。

關鍵字

子宮頸癌 ； 子宮頸癌疫苗 ； 健康信念模式

並列摘要

Objectives: The aim of this research is to assess the intention of, and the factors related to, adolescent girls to pay for human papillomavirus vaccination. Methods: This cross-sectional study included 809 girls chosen by convenience sampling in Central Taiwan. A valid structured questionnaire was designed and by self write to collect data on demographic characteristics, perceived risk and severity of cervical cancer, benefits of and barriers to human papillomavirus vaccine, and the intention about pay for human papillomavirus vaccination. Results: Two-thirds (67.4%) of the girls were willing to pay for human papillomavirus vaccination up to a maximum of 793 NT dollars (about 26 US dollars). Using stepwise regression, we found barriers to vaccine (i.e. too busy, no money, too far and family don't agree to vaccine) were negative associated with intention and family economic status was positive associated with intention in the full study sample to pay for vaccination (R^2=14.6%). Among the sample subset who are senior high school students (n=416), the barriers to vaccine and smoking status were negative associated with intention, but family economic status, and family history of cervical cancer were positive associated with intention to pay for vaccination (R^2=18.%). Among vocational high school students (n=393), the barriers to vaccine were negative associated with intention and sexual partner were positive associated with intention to pay for vaccination (R^2=24.1%). Conclusions: We suggest eliminating the possible barriers to primary health care in the community. In the educational system, the curricula of military and nursing training programs should provide knowledge that will enable high school girls to increase their awareness of human papillomavirus and their willingness to pay for human papillomavirus vaccination.

並列關鍵字

cervical cancer ； human papilloma virus HPV vaccine ； health belief model

參考文獻

WHO cancer control program

國家衛生研究院癌症研究組(2004)。TCOG婦癌臨床指引。台北:國家衛生研究院。

衛生統計叢書

行政院衛生署(2007)。衛生統計資料：民國93年子宮頸抹片登記報告。台北:行政院國民健康局。

Use of Pap smears for women 18 years of age and over according to selected characteristics: United States selected years 1987-2000