前言:本研究以Andersen之「醫療行為模式」為理論基礎,探討傾向因素、使能因素、需求因素、健康行為與四項癌症篩檢行為(口腔癌、大腸直腸癌、乳癌及子宮頸癌篩檢)之關係。 材料與方法:本研究是採用基隆市衛生局於民國95年12月1日至民國96年1月15日進行的「基隆市20歲以上民眾對健康篩檢服務滿意度調查」資料,研究對象為設籍於基隆市的20歲以上民眾,抽出樣本數為4011人,以一對一家戶面訪的方式進行問卷調查。完訪人數1622人,完訪率為40.44%。扣除該家戶無此人(140人)、受訪者住院或住機構於訪問期間內不會回來者(21人)、受訪者死亡(25人)、已不住於此處且不知明確搬遷地點者(501人)等狀況,應訪樣本數應為3324(=4011-687),重新計算完訪率為48.80%。本研究所使用的問卷內容包括:個人基本資料、自覺健康狀況、個人與家族疾病史、對疾病與篩檢之認知、生活型態、社會支持、醫療服務使用及篩檢行為。統計分析方面依序進行描述性統計、雙變項分析及多變項分析。 結果:調整了基隆市整合式篩檢經驗後,發現社會支持度越高者(OR=1.023)設籍於中山區的居民(OR=2.231)較可能接受口腔癌篩檢,年紀越大(OR=1.727)、已婚者(OR=2.979)與社會支持度越高者(OR=1.039)較可能接受大腸直腸癌糞便潛血檢查。已婚(OR=2.385)與有個人癌症史者(OR=4.947)越可能接受乳房攝影。曾經已婚(OR=27.968)沒有私人保險者(OR=1.916)與社會支持度越高者(OR=1.023)越可能接受子宮頸抹片檢查。 結論與建議:本研究以「醫療行為模式」為理論基礎探討四種癌症篩檢的影響因素,發現:傾向因素(婚姻狀況與教育程度)與使能因素(社會支持)與四項癌症篩檢行為有顯著的關連性。需求因素與癌症篩檢行為沒有相關性,由於需求因素常常是界定癌症高危險群者,而這些癌症高危險的篩檢率並未較高的原因為何值得研究者及相關衛生單位進ㄧ步探討。
Objective: Based on the Andersen model, this study aimed to investigate the factors influencing the utilization of cancer screening services in Keelung City. Methods: Data was collected from the project of local public health bureau“ The survey of Satisfaction that people age at 20 or more accept cancer screening in Keelung” during from December, 1, 2006 to January, 15, 2007. 4011 meeting the inclusion criteria and 1622 complete the questionnaire(with completion rate of 40.44%).To deduct people who household no subject(n=140),died(n=25)and people not live household(n=501) the new completion rate is 48.8%. The questionnaire included that demographics, self-estimated health, individual and family history of cancer, knowledge about cancer and cancer screening, lifestyles, social support, utilization of medical services and behaviors of cancer screening. Result: Higher social support score (OR=1.023) and live in Chung-Shan (OR=2.231) more likely to accept oral cancer screening. People more Older(OR=1.727), had married(OR=2.979)and higher social support score (OR=1.039) more likely to accept colon cancer screening. People had married (OR=2.385), and had history of cancer (OR=4.947) more likely to accept mammogram. People had married (OR=2.385), and had history of cancer (OR=4.947) where more likely to accept mammogram. People had married (OR=27.968), no private-insurance (OR=1.916), and higher social support score (OR=1.023) more likely to accept Pap smear. Conclusion: This study examined the factors influencing the utilization of cancer services. Finally, it found that marital status, level of Education and social support score are related to cancer screening.