探討某醫療機構之門診民眾對B型肝炎的認知及其篩檢行為的影響因素

The Impact of Hepatitis B Knowledge on Screening Behavior Factors in Outpatients

呂舒雯(Shu-Wen Lu) ； 戴美玲(Meei-Lin Dai)

《護理雜誌》 60卷3期 (2013/06) Pp. 51-63

https://doi.org/10.6224/JN.60.3.51

摘要

背景　2011年衛生署資料顯示，肝癌位居國人癌症死因第二位，世界衛生組織也指出每年約有60萬人死於B肝病毒感染的相關合併症，由國內外現況可知B肝病毒感染是不容忽視的公共衛生議題。目的　了解民眾對B型肝炎的認知程度與執行篩檢之現況、並探討影響民眾執行B型肝炎篩檢行為的相關因素。方法　以方便取樣方式、選取282位門診民眾為對象，以描述性統計、獨立t檢定、單因子變異數分析、Spearman相關及複迴歸分析等方法分析。結果　55.7%民眾曾接受過篩檢且B型肝炎認知之平均得分為9.38、總平均答對率72.2%；而「親友是否罹患肝炎」、「B型肝炎認知」、「障礙性認知」及「行動線索」等變項對於篩檢行為的解釋力為12.3%，其中「障礙性認知」為最重要的預測因子。結論／實務應用　民眾B型肝炎認知有中上程度，但篩檢率不盡理想，結果發現「障礙性認知」是影響篩檢行為的關鍵因素，故建議未來可設立獨立門診進行有關B型肝炎篩檢的服務，減少民眾候診時間、增加便利性，也建議政策單位將篩檢費用列入考量，以提升民眾篩檢行為的動力。

關鍵字

B型肝炎 ； 認知 ； 篩檢行為 ； 健康信念模式

並列摘要

Background: According to Taiwan Department of Health and World Health Organization statistics, hepatic tumors are the second leading cause of death from malignant disease in Taiwan, with 600,000 deaths from HBV (hepatitis B virus ) infected complication annually. Hepatitis B virus infection is thus an important issue in public health policy. Purpose: The aims of this study were to investigate hepatitis B knowledge and screening behavior and then identify significant prediction factors of hepatitis B screening behavior. Methods: A cross-sectional survey and convenience sampling were used to investigate 282 outpatients at the one target hospital. Descriptive statistics, independent t test, one-way ANOVA, Spearman relation, and multiple regression were used to analyze impact factors. Results: Slightly over half (55.7%) of the participants had received HBV screening. The average hepatitis B knowledge score was 9.38, with an average correct rate of 72.2%. ”Whether friends and relatives suffer from hepatitis B”, ”knowledge of hepatitis B”, ”perceived barriers to action”, and ”cue for action” explained 12.3% of total variance. Of these, ”perceived barriers of action” was the most important predictor of hepatitis B screening behavior. Conclusions: Although participant knowledge of hepatitis B was relatively good, the screening rate was less than ideal. Results point to ”perceived barriers of action” as a key factor affecting screening behavior. We suggest establishing an independent outpatient service to offer screening for hepatitis B in order to reduce waiting time and provide greater convenience. We also suggest the implementation of a policy to unify charges to raise public motivation to undergo screening.

並列關鍵字

hepatitis B ； knowledge ； screening behavior ； health belief model

參考文獻

林敬旺、蔡文正、曾盈甄（2011）．父母對於青少女接種 人類乳突病毒疫苗接受度與影響因素探討．澄清醫護 管理雜誌，7（2），38－50。[Lin, J. W., Tsai, W. C., & Tseng, Y. C. (2011). Factors associated with parental acceptance of adolescent human papillomavirus vaccination. Cheng Ching Medical Journal, 7(2), 38－50.]

陳淑華、蔡來蔭、黃雅芬、蕭世槐（2008）．參與社區篩 檢婦女骨質疏鬆症威脅認知之探討．志為護理—慈濟 護理雜誌，7（4），80－88。[Chen, S. H., Tsai, L. Y., Huang, Y. F., & Hsiao, S. H. (2008). Disease threat recognition among women participating in community health screening. Tzu Chi Nursing Journal, 7(4), 80－88.]

葉云、胡益進（2011）．台北市某國中學生預防齲齒行為 之研究－健康信念模式之應用．學校衛生，58，45－ 68。[Yeh, C. Y., & Hu, Y. J. (2011). Preventive behavior of dental caries among junior high school students in Taipei City based on the health belief model. Chinese Journal of School Health, 58, 45－68.]

閩嘉娜、姜逸群、許權振、謝武勳、王俊毅（2006）．健康 信念在產婦參加新生兒聽力篩檢之應用．護理雜誌， 53（2），30－40。doi:10.6224/JN.53.2.30 [Min, C. N., Chiang, I. C., Hsu, C. J., Hsieh, W. S., & Wang, J. J. (2006). Applying health beliefs to mothers who join in newborn hearing screening. The Journal of Nursing, 53(2), 30－ 40.]

蔣婷婷、戴千淑、林碧珠（2011）．以健康信念模式探討 女性醫事人員乳癌篩檢行為及影響因素．榮總護理， 28（2），130－138。[Chiang, T. T., Tai, C. S., & Lin, P. C. (2011). To survey the implementation of breast cancer screening behaviors of female medical personnel-based on health belief model. VGH Nursing, 28(2), 130－138.]