有性經驗大學生保險套使用行為及相關因素之探討:跨理論模式之應用

本研究是應用跨理論模式來探討有性行為大學生保險套使用行為，研究目的為：(1)了解有性行為大學生保險套使用行為階段之分佈情形；(2)不同的個人背景因素、性經驗、性伴侶關係型態、感受保險套使用支持、保險套使用決策權衡與保險套使用自我效能在不同保險套使用行為階段的差異情形；(3)了解保險套使用行為階段之重要區辨因素。由高雄縣市15所公私立大學暨技術學院經方便取樣徵求學校同意，選取五所學校，每一樣本學校再由二至四年級每一年級抽取兩班，抽中班級之所有學生選為本研究之樣本，回收問卷為1064份，篩選其中自塡最近一年有性行為的310人為本研究探討的對象。研究工具為結構式調查問卷其內容包括基本資料、保險套使用行為階段分類、感受保險套使用支持、保險套使用決策權衡與保險套使用自我效能等量表。量表經信度及效度檢定，包括內在一致性、再測信度及專家內容效度。所得資料以次數、百分比、平均值、標準差等描述性統計及卡方檢定、單因子變異數分析、最小顯著差異事後多重比較及區辨分析來分析。研究結果發現：(1) 大學生保險套使用行為階段分佈為無意圖期11.6%，意圖期12.9%、準備期16.1%、行動期21.6%、維持期37.4%。(2)研究對象具有中等程度的感受同儕保險套使用支持及感受性伴侶保險套使用支持，中上程度的知覺保險套使用利益及中下程度的知覺保險套使用障礙，與中上程度的保險套使用自我效能。(3)大學生第一次性行為是否使用保險套在保險套使用行為階段之間具有顯著差異，而年齡、性別、家庭社經地位在保險套使用行為階段之間則無顯著差異。(4)大學生感受同儕及性伴侶保險套使用支持、保險套使用決策權衡、保險套使用自我效能在保險套使用行為階段之間具有顯著差異，保險套使用行為階段愈後面其感受保險套使用支持、決策權衡及自我效能愈好。(5)本研究中對保險套使用行為階段最具區辨力的三個因素依序為保險套使用自我效能、感受性伴侶保險套使用支持及性伴侶關係期等變項，正確預測率為42.6 %。本研究結果可作為學校及社區未來提升大學生保險套使用介入之參考。

關鍵字

保險套使用行為；跨理論模式；大學生

並列摘要

This study adopted the Transtheoretical model to explore condom use behavior of sexually experienced college students. The purposes were: (1) to understand the distribution of Stage of Change (SOC) for condom use behavior among sexually experienced college students; (2) to examine factors such as personal background, sexual experiences, relationship with sexual partner, perception of the support of condom use from peers and sexual partners, decisional balance of condom use, and self-efficacy of condom use in relation to SOC for condom use behavior; (3) to explore the important discriminative factors of SOC for condom use behavior. By conventient sampling, five colleges in Kaohsiung area were selected. In each grade of each college, from grade two to grade four ,two classes were selected. All students in the chosen classes were used as study subjects. From the 1064 respondents, a total of 310 students who had been sexually active within the past year were recruited for the study. The tool of this research was a anonymous structural questionnaire, which was composed of scales such as basic personal data, SOC for condom use behavior, perceptions of peers’ support, perceptions of sexual partners’ support, decisional balance of condom use, and self-efficacy of condom use. Internal consistency, test-retest reliability, and content validity were evaluated. The collected data were analyzed with statistics such as numbers, percentages, averages, and standard deviations, as well as Chi-square test, one-way ANOVA , LSD multiple comparisons and discriminant analysis. The results showed that: (1) The distribution of college students’ SOCs in condom use behavior was 11.6% in pre-contemplation stage, 12.9% in contemplation stage, 16.1% in preparation stage, 21.6% in action stage, and 37.4% in maintenance stage; (2) The subjects had a medium level of the perception of peer support in condom use, an upper medium level of the perceived benefits of condom use, a lower-medium level of the perceived barriers of condom use, and an upper-medium level of self-efficacy; (3) A significant relation was shown between the sexual experience and the SOC of condom use behavior while age, gender, social and economic status of the family were not; (4) Scores of perception of peers’ support , perception of sexual partners’ support, decisional balance and self-efficacy of condom use were significantly different across the SOCs for condom use. Perception of peers’ support and perception of sexual partners’ support, decisional balance and self-efficacy of condom use gradually increased across the SOCs for condom use.(5)The three most discriminative factors in the SOCs for condom use behavior were self-efficacy, perception of the sexual partners’ support of condom use, and relationship with sexual partners. The accuracy of classification was 42.6 %. The result of the study can serve as references for interventions in schools, and suggestions for improving condom use among college students.