青少女經痛自我照顧行為之相關因素探討

青少女經痛的盛行率偏高，是影響其未來經期健康生活的重要因素，若能增加青少女對經痛的瞭解及重視，亦可提高其學習與從事自我照顧行為的能力。本研究即是希望能了解青少女經痛自我照顧行之相關因素，並藉此作為將來護理健康教育的依據，以提供適當的護理措施，增加青少女經期間的舒適。本研究採分層隨機抽樣方式，以台南縣高中、職一至三年級女生，最近六個月內經痛兩次以上的學生為研究對象，有效樣本數共368份。研究工具為結構式問卷，包括三部份：個人基本資料、青少女經期態度量表及青少女經痛自我照顧行為量表。統計方法包括利用描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關及逐步複迴歸分析。本研究結果發現：(一)經痛青少女經期態度狀況，總量表各題平均得分為2.89，表示其經期態度趨向中立；各次量表依標準化分數之結果，由高至低依序為「對月經開放性」、「對月經接受度」、「負向感覺」、「經期生活品質」、「正向感覺」、「經期症狀」。(二)經痛青少女基本屬性中，經痛程度、就醫情形與經期態度總量表呈顯著負相關，其餘變項均無顯著相關。即經痛程度愈低、無就醫情形者，其經期態度愈正向。(三)經痛青少女自我照顧行為狀況，總量表各題平均得分為3.51，表示其對執行自我照顧行為的看法趨向50﹪同意；各次量表依標準化分數之結果，由高至低依序為「表達感受的行為」、「運用資源的行為」、「尋求知識的行為」、「尋求協助的行為」、「控制自我的行為」、「控制外在因素的行為」。(四)經痛青少女基本屬性中，年齡、經痛程度、就醫情形、接受經痛自我照顧衛教與經痛自我照顧行為呈顯著正相關，其餘變項無顯著相關，即年齡愈長、經痛程度愈高、有就醫情形及有接受經痛自我照顧衛教者，其經痛自我照顧行為執行愈多。(五)經痛態度量表之正向感覺、經期症狀、對月經開放性、經期生活品質與經期自我照顧行為有顯著相關。即經期態度之正向感覺愈強、對月經開放性愈高、對經期症狀態度愈負向和經期生活品質愈差者，其經痛自我照顧行為執行愈多。(六)經痛自我照顧行為之重要影響因子為經痛程度、就醫情形、接受經痛自我照顧行為衛教及經期態度次量表中正向感覺、對月經開放性、經期症狀、經期生活品質等，其解釋總變異量為23.6﹪。本研究結果將有助於學校教師及臨床護理人員提供合宜的青少女經痛護理服務及經期健康指導，提高青少女經期的生活品質。

關鍵字

自我照顧行為；青少女；經痛

並列摘要

The high prevalence rates of dysmenorrhea in adolescents have great effects on menstrual health life. To make the adolescents learn and own the ability in self-care behaviors, we could put more emphasis on the knowledge of adolescent dysmenorrhea. The purpose of the study was to find out the related factors of self-care behaviors about adolescent dysmenorrhea, and to offer some concrete suggestions to health education. It is also expected to develop appropriate nursing interventions to enhance the comfort of adolescents during menstruation. This study used the approach of stratified sampling. The subjects of the study were from female students in senior high and vocational high schools in Tainan. They have suffered from dysmenorrhea cramps for more than twice during the last six months and the valid sample size is 368. Three instruments were used to collect data: Personal Demographic Questionnaire, the Adolescent Menstrual Attitude Questionnaire, and the Adolescent Dysmenorrhea Self-Care Scale. Frequency distribution, t-test and one-way ANOVA, Pearson product-moment correlation, and stepwise multiple regression were used to illustrate the data. The findings of this study were as follows: (1) In the Adolescent Menstrual Attitude Questionnaire, the average score was 2.89. It showed that the menstrual attitude was neutral. The sequential order from high to low in terms of the standardize score was “Openness Toward Menarche”, “Acceptance Of Menarche”, “Negative Feelings”, “Living With Menstruation”, “Positive Feelings”, and “Menstrual Symptoms”. (2) Correlation analysis showed that subjects who suffered less dysmenorrhea pain and took no medical treatment had higher positive menstrual attitude. (3) In the Adolescent Dysmenorrhea Self-Care Scale, the average score was 3.51. It showed that the subjects’ average attitude toward dysmenorrhea self-care behaviors was 50% agreement. The sequential order from high to low in terms of the standardize score was “Behaviors Of Expressing Feelings”, “Utilizing Resources”, “Researching Knowledge”, “Seeking For Assistance”, “Self-Control”, and “Controlling External Factors”. (4) Correlation analysis showed that subjects who were elder ,suffered higher dysmenorrhea, took medical treatment, and received dysmenorrhea self-care health education had more dysmenorrhea self-care behaviors. (5) Among the menstrual attitude domains, the positive feelings, menstrual symptoms, openness toward menarche and living with menstruation were significantly correlated to menstrual self-care behaviors. The stronger positive feelings and higher openness toward menarche, the more behaviors of dysmenorrhea self-care. The more negative attitude toward menstrual symptoms and worse life qualities during menstruation, the more behaviors of dysmenorrhea self-care. (6) The significant predictors of dysmenorrhea self-care behaviors included dysmenorrhea level, taking medical treatment or not, receiving dysmenorrhea self-care health education or not, and several menstrual attitude domains containing the positive feelings, openness toward menarche, menstrual symptoms, and living with menstruation. Twenty-four percent of the variance in dysmenorrhea self-care behaviors could be explained by these seven variables. Based on this study, appropriate adolescent dysmenorrhea nursing service and menstrual health instruction can be developed. Furthermore, it can help to improve the adolescents’ quality of life during menstruation.