衛生教育介入
對更年期婦女症狀、自我健康照護及生活品質之影響

目的根據統計資料顯示：自述曾有更年期身心症狀者佔18.28％，對於婦女如何度過更年期之不適，荷爾蒙的使用不是唯一方式，應積極運用健康促進的信念，來推動更年期婦女的保健與健康照護，而衛生教育是推動健康促進活動的不二法門，本研究以衛生教育介入方式，瞭解更年期婦女之人口學特徵、自我健康照護與生活品質狀況及衛生教育介入前後更年期婦女更年期症狀、自我健康照護和生活品質之影響。方法本研究採類實驗設計法（quasi-experimental design），並配合問卷調查（questionnaire survey），研究樣本採方便取樣，選取台中地區45至55歲之更年期婦女為研究對象，分介入組與對照組，介入組提供衛生活動，對照組則無任何介入措施。本研究之研究工具經五位專家內容效度及預測信度分析（Cronbach’s α）編製而成的結構式問卷，問卷內容包含基本資料、更年期症狀評量表、更年期自我健康照護管理評量及台灣簡明版世界衛生組織生活品質量表等四部份。結果研究結果顯示：1.更年期婦女之人口學特徵：教育程度以高中職為多佔37.2％、已婚者佔86.4％、信仰佛教佔37.7％、職業婦女與家庭主婦約各半、86.4％與子女同住、有83.8％未曾使用荷爾蒙。2.更年期之症狀以皮膚乾燥或增加皺紋最多，依序為容易疲倦、健忘或注意力不集中、性慾減退及背痛。3.更年期之生活品質，以生理健康範疇最佳，最差為心理健康範疇。4.更年期生活品質與更年期自我健康照護有顯著正相關，與更年期症狀有顯著負相關。5.衛生教育介入後，對更年期症狀、更年期自我健康照護與更年期生活品質前後有顯著差異。6.基本屬性與症狀、自我照護和生活品質之關係，以家庭主婦、有慢性病、曾服用荷爾蒙等更年期症狀較明顯，而學歷及家庭月平均收入較高者和曾服用荷爾蒙，更年期自我照護較好，更年期生活品質以職業婦女顯著優於家庭主婦。結論與建議衛生教育之目的在於改變知識、態度與行為，從研究結果顯示，衛生教育之介入對更年期婦女自我照護提升、症狀與生活品質改善有顯著之成效，為達全民均健之目標，婦女健康應予重視，建議應辦理衛生教育，提供婦女支持環境、舉辦講座、衛教手冊提供等，以提昇婦女更年期之相關知能，降低更年期婦女之身心不適情形。

關鍵字

更年期；衛生教育；介入；生活品質

並列摘要

Objective According to the statistics, it showed that 18.28% of subjects claimed to suffer from physio-psychological symptoms during menopausal period. As regards how women get through their menopausal disturbances, taking hormone is not the only method. The concept of health promotion should be applied actively to promote health protection and health care for menopausal women; and health education is the one and only way to promote health promotion activities. In this study, health education intervention was administered to understand menopausal women’s demographic features, self-care, life quality, and the influence of health education intervention on their menopausal symptoms, self-care, and life quality. Methods This study employed quasi-experimental designs, together with questionnaire survey. The sampling method used was ‘Convenience Sampling’. Menopausal women aged 45-55 in Taichuang were recruited and divided into the ‘intervention’ and ‘controlled’ groups. The intervention group was provided with health education program while the controlled group was not provided with any intervention. The research tool adopted in this study is the structured questionnaire compiled by 5 experts who analyzed the content validity and reliability (using Cronbach’s α); it contained 4 sections - basic information, menopausal symptoms evaluation scales, self-care assessment during menopause and WHO Quality of Life Scale-Brief Version (WHOQOL-BREF). Results The results showed that: 1. demographic features in menopausal women - 37.2% were educated at high school or vocational school level, 86.4% were married, 37.7% were Buddhist, about 50% were working women and housewives respectively, 86.4% still lived with their children, and 83.8% never took hormone; 2. the most common symptom occurred during menopause is dry skin or increase in wrinkle formation, and then exhausted easily, obliviousness, attention deficit, reduction in sexual desire, and backache in order; 3. regarding to life quality during menopause, the aspect of physiological health was the best and the aspect of mental health is the worst; 4. there existed positive correlation between menopausal life quality and menopausal self-care but negative correlation between menopausal life quality and menopausal symptoms; 5. there was significant difference on menopausal symptoms, menopausal self-care, and menopausal life quality before and after the intervention of health education; 6. regarding to the relation between basic properties and symptoms, and self-care and life quality, menopausal symptoms in housewives, subjects with chronic diseases, and subjects taking hormone were more significant; and subjects having higher educational background and family monthly average income and taking hormone had better self-care, and working women had better menopausal life quality than housewives. Conclusion and Suggestion The purpose of health education is to change knowledge, attitudes and behavior. According to the study results, it showed that health education intervention would greatly improve menopausal women’s self-care, symptoms, and life quality. In order to achieve the aim of ‘Health for All’, women’s health should be valued. It was suggested to implement health education, provide women with a supportive environment , hold seminars and lectures, and provide health education brochures to improve women’s relevant menopausal knowledge and decrease menopuausl women’s physical and mental disturbances.