社會支持對不同性別中年族群預防保健服務利用之探討

Association between Social Support and Utilization of Preventive Health Care Services by Gender in the Middle-Aged Population

李麗琴(Li-Chin Lee) ； 徐慧娟(Hui-Chuan Hsu)

《護理暨健康照護研究》 7卷2期 (2011/06) Pp. 161-171

https://doi.org/10.6225/JNHR.7.2.161

摘要

背景　中年人是癌症及慢性疾病的好發族群，透過預防保健服務利用能早期發現與治療。
目的　探討社會支持對中年不同性別族群預防保健服務利用的影響。
方法　研究對象為2001年國民健康訪問調查40-65歲之樣本(n=4,868)，依變項為預防保健服務利用（男性9項，女性13項），主要自變項社會支持包括婚姻狀況、家屬同住與否、獲得朋友支持及生活資訊取得方便性。統計方法以邏輯迴歸分析與多變項複迴歸分析。
結果　中年女性比男性有較高的預防保健服務利用；有配偶同住的男性有較高的血脂肪(OR=1.40)及肝功能檢驗受檢率(OR=1.52)。有配偶同住的女性較易使用骨質密度檢查(OR=1.32)及子宮頸抹片檢查(OR=1.81)。若有較可近性訊息的取得，女性有較高的子宮頸抹片檢查（OR=1.25）、乳房超音波檢查(OR=1.43)及乳房攝影檢查(OR=1.61)。
結論　有配偶同住及訊息取得的可近性是中年族群利用預防保健服務的促進因子，特別是對女性而言。建議政府及臨床專業人員應對此族群的社會支持網絡增加宣導有關預防保健服務利用的可近性、預防成效及相關講座訊息以促進利用，進而促進其健康。

關鍵字

社會支持 ； 預防保健服務利用 ； 性別

並列摘要

Background: Those of middle-age are at relatively high risk of morbidity from cancer and chronic diseases. Preventive health care services can effectively detect and treat these diseases at an early stage.
Purpose: This study examined gender difference in factors related to preventive health care services (PHCS) utilization among middle-aged adults in Taiwan. This study focused in particular on factors related to social support and information accessibility.
Methods: Data on 40-65 year olds were obtained from the 2001 National Health Interview Survey in Taiwan. A nine-item PHCS for the past year and another four examinations for women were used as dependent variables. Social support (marital status, living with family, getting support from friends) and information access were the main predictors, by controlling predisposing, enabling, and need factors. Logistic regression and multiple linear regression were used for analysis.
Results: Women used PHCS more frequently than men, and women were more likely to check blood pressure and sugar and receive influenza vaccinations. Men who had a spouse were more likely to check lipoprotein (OR=1.40, 95% CI=1.065-1.843) and liver function (OR=1.52, 95% CI=1.158-1.987). Women who had a spouse were more likely to take bone density tests (OR=1.32, 95% CI=1.035-1.683) and use papanicolaou (pap) smears (OR=1.81, 95% CI=1.443-2.276), while those who had better information access were more likely to take pap smears (OR=1.25, 95% CI=1.010-1.535), breast ultrasonography (OR=1.43, 95% CI=1.138-1.792), and mammography (OR=1.61, 95% CI=1.226-2.100). Having a spouse and better information access were related to using more PHCS items for women.
Conclusions: Marital status and information accessibility are reinforcing factors for using PHCS in the middle-aged population. This trend is particularly pronounced in women. Government and clinical professionals should provide health education information and accessibility related to preventive care through the social networks of the target population.

並列關鍵字

social support ； preventive health care services ； gender