- 學位論文
影響戒嚼檳榔相關因素之探討
Investigation of Factors Associated with Betel Quid Chewing Quitting
摘要
研究背景:在台灣檳榔嚼食行為盛行率為男性17% 和女性1%，約兩百五十萬人。國際癌症研究中心(IARC,2003 )指出檳榔嚼塊、甚至僅檳榔子即具人類致癌性。相較於其他東南亞國家，1991年台灣地區口腔癌發生率(10.79人/每十萬人)僅次於印度(12.76-23.19人/每十萬人)，高出泰國、菲律賓、新加坡等地區許多，究其原因主要與檳榔之消耗量逐年增加及民眾對口腔癌的認知不全有關。然而有關成功戒嚼檳榔的相關研究卻很少見，究其原因與對嚼食檳榔人口不了解有關。 研究目的: 本研究目的即是希望探討影響有嚼食檳榔經驗者其戒嚼意願和戒嚼檳榔成功與否的相關因素，以作為制訂戒斷計畫之參考。 研究方法：本研究設計是橫斷式研究設計(cross-sectional study). 配合口腔健康檢查活動對嚼食檳榔者進行問卷資料蒐集。資料蒐集自1999年9月至2000年12月止，共有效樣本326人 。 研究結果: 利用Multiple stepwise logistic regression model 分析，結果發現有嚼食檳榔經驗者教育程度越低(OR = 0.58, 95% CI = 0.34-0.98)戒嚼意願越低。曾經戒嚼檳榔者中，其工作型態為駕駛工作 (OR = 2.24, 95% CI = 1.14-4.39), 有飲酒習慣者 (OR = 2.41, 95% CI = 1.24-4.66), 與只嚼荖葉者 (OR = 4.44, 95% CI = 1.99-9.90) 較容易戒嚼失敗。有戒嚼檳榔意願者內控型健康控握信念得分越高，越不容易失敗(1-point increments, OR = 0.94, 95% CI = 0.90-0.98). 討論:總結本研究結果，本研究是探討人口學因素、心理學因素與物質使用行為對戒嚼檳榔行為影響之研究。檳榔嚼食者教育程越低，戒嚼檳榔意願就越低。除此之外，有戒嚼檳榔意願者中，若是符合下列條件之一以上，則較不容易戒嚼檳榔成功，包括：全職駕駛工作者、僅嚼檳榔嚼塊、有飲酒習慣等因素。研究結果顯示衛生教育工作者及研究人員在規劃戒嚼檳榔方案時應考慮到嚼食檳榔者的教育程度、工作型態、物質使用行為(如飲酒習慣、檳榔嚼塊種類)及健康控握信念傾向。
並列摘要
Background: It is estimated that about 2.5 million Taiwan residents (17% of the males, 1% of the females) regularly use betel quid. The International Agency for Research on Cancer (IARC) has reported that chewing betel quid with or without tobacco is carcinogenic. The rate of oropharyngeal cancer in Taiwan (10.8 per 100,000) is second only to that in India (12.8-23.2 per 100,000) and is much higher than those in Thailand, the Philippines and Singapore. These higher and increasing cancer rates are related to the yearly increase in the incidence of betel quid chewing in Taiwan. Little information, however, is available on the demonstrated success of interventions in stopping the chewing of betel quid. Part of the reason may be a lack of understanding of the characteristics of betel quid chewers. Study Objectives: The purpose of this study was to provide useful data for a future abstinence project by identifying the factors related to betel quid chewing quitting. Methods: The study was cross-sectional. Data on demographic variables, psychological factors and substance-use behaviors were collected via questionnaires from 326 participants. Results: Multiple stepwise logistic regression analysis indicated that the areca/betel quid chewers who were less educated (OR = 0.58, 95% CI = 0.34-0.98) were least likely to try to stop. Among the chewers who tried to quit, those employed as full-time drivers (OR = 2.24, 95% CI = 1.14-4.39), and had drinking habits (OR = 2.41, 95% CI = 1.24-4.66), and preferred to chew only betel quid wrapped with leaf (OR = 4.44, 95% CI = 1.99-9.90) were more likely to fail. Chewers who failed to quit had a lower internal health locus of control compared with those who successfully quit (1-point increments, OR = 0.94, 95% CI = 0.90-0.98). Conclusions: The results suggest that health educators and researchers can better influence people’s chewing behavior if the importance of chewers’ education level, job type, substance use (i.e. drinking habits, type of betel quid), and level of health locus of control are all taken into consideration when devising interventions.