臺北市子宮頸抹片檢查陽性個案求醫行為相關因素之探討

Factors Related to the Medical Seeking Behavior of Women with Positive Findings in Papnicolaou Smears in Taipei

楊鎧玉(Kai-Yu Yang) ； 陳靜敏(Ching-Min Chen) ； 林佳靜(Chia-Chin Lin) ； 李龍騰(Long-Teng Lee)

《腫瘤護理雜誌》 3卷2期 (2004/06) Pp. 1-18

https://doi.org/10.6880/TJON.200406_3(2).01

摘要

本研究旨在探討臺北市子宮頭抹片檢查陽性婦女對子宮頸癌與抹片的認知、行動線索、自覺症狀嚴重程度、健康控握信念和求醫行為之相關因素。本研究採用橫斷式相關性研究設計，以隨機分層取樣法選取臺北市30歲以上抹片結果CIN I以上陽性個案，以結構式問卷郵寄553份問卷，實得有效問卷135份（回收率26%）。研究結果以SPSS 10.0進行統計分析。研究對象平均年齡為47.43歲，經濟狀況中上，以高中以上、有宗教信仰、已婚、家管者居多；對子宮頸癌與抹片相關認知率可達73%；平均接受到3.41類訊息來源而決定去求醫；以自覺陰道分泌物（白帶）的婦科症狀盛行率最高，但並不覺得嚴重；在健康控握信念方面，以內控信念得分最高(M=3.75, SD=0.38)。平均接獲抹片報告時問約一週，而抹片結果有七成以上為「發現異常細胞」，因此幾乎所有的人(97.8%)皆選擇接受治療，其中有69.7%皆在一週內就開始治療，且以西醫最多（130人），而選擇該類型治療的理由以「治療的技術與效果」為主。
由相關性分析得知，婦女的社會人口學特性與其對子宮頸癌及抹片的相關知識、行動線索、自覺症狀嚴重程度皆無顯著相關；但健康控握信念之內控信念會因宗教信仰有顯著差異，權威外控與結婚與否，機運外控與經濟狀況有顯著相關，而年齡也與前兩者呈現正相關，表示年齡越大，越傾向是外控型人格特質。已求醫者在接獲抹片報告後選擇去治療的時間與宗教信仰有關。而治療類型（純西醫或其他治療）與知識得分及求醫時間有顯著相關。研究結果顯示有求醫者才較有意願填答並回寄問卷，因此如何針對未就醫族群，進行進一步介入性措施研究探討，應可作為建構我國婦女保健預防政策之重要參考。

關鍵字

抹片陽性 ； 認知 ； 行動線索 ； 自覺症狀 ； 健康控握信念

並列摘要

The aim of this study was to explore the factors related to the medical seeking behavior of Papnicolaou smear positive clients in Taipei. The major purpose was to describe and explore the Pap (Papnicolaou) smear positive women's current knowledge, action clue, severity of gynecologic symptoms, health locus of control and medical seeking behavior.
Correlative research design was used in this study. The stratified random sampling was applied to select women 30 years old and over with Pap positive finding in 11 districts of Taipei. The structured questionnaire has been mailed to 553 qualified correspondences for their self-report. The 135 effective questionnaires were returned (26% response rates).
The majority of the subjects were high school graduated, married, housewife, with religious belief, medium high economic status and mean age of 47.43. Their knowledge toward cervical cancer and Pap was relatively high (73%), and action clue received to seek treatment were also a lot (3.41 sources). The most common gynecologic symptom is vaginal discharge (n=73), and the majority of the subjects belong to the internal locus of control. The majority of women received their Pap smear results as ”found abnormal cells” within 7 days after examination. As the result, 132 subjects sought medical care within 7 days (69.7%), selected modern western medicine. The main reason for it was ”the effectiveness of the treatment”.
This study found that there was no significant difference in subject's geographic variables with knowledge, action clue and gynecologic symptoms. Types of religion were associated with the speed of seeking care and internal locus of control. Marriage status and economic level were associated with external locus of control behavior. Subject's age revealed the external locus of control. Women's knowledge of Pap and cervical cancer was significantly different by type of therapies they selected. Logistic regression analyses revealed that not a single independent variable could predict either the speed of seeking care or type of therapy. With such a high prevalence of seeking care among Pap smear positive subjects (97.8%), this study indicated a high self- selection bias that women seeking care were more willing to return questionnaires. Intervention on how to reach and promote noncompliance women would need further investigation.

並列關鍵字

Pap smear positive subject ； knowledge ； action clue ； gynecologic symptom ； health locus of control