以健康信念模式探討北部某醫院女性員工子宮頸抹片檢查與子宮頸癌疫苗接種行為及影響相關因素

子宮頸癌(Cervical Cancer, CC)是影響全球婦女健康的主要因素，死亡率在全世界婦女癌症排名第四，世界衛生組織(World Health Organization's International Agency, [WHO], 2020)公告2018年全球癌症統計每年約57萬餘人罹患子宮頸癌。台灣107年癌症登記報告癌症新增116,131人，比106年增加4,447人。國民健康署(2020)建議定期接受子宮頸抹片檢查、自費接種HPV疫苗，降低子宮頸癌的發生。107年最新資料統計子宮頸抹片篩檢率為49%仍偏低，蔡(2017)研究顯示護理人員僅42.4%曾施打過人類乳突病毒疫苗。本研究目的為探討某醫院女性員工，子宮頸癌疾病認知和其健康信念模式相關性，以了解執行子宮頸抹片檢查和施打HPV疫苗困難之原因。研究方法採便利性取樣及問卷調查收集資料，研究對象以某地區醫院女性員工為收案對象，發放100份問卷，回收率達100%，資料以SPSS 24版進行分析。結果顯示女性員工平均年齡為33.53+8.9歲，子宮頸癌疾病認知與預防認知平均得分5.5+1.4分。子宮頸抹片檢查和年齡、婚姻、性經驗、生育經驗有顯著差異。子宮頸抹片檢查和施打HPV疫苗與健康信念中自覺行動障礙、行動線索和自我效能，統計上達顯著差異。子宮頸抹片檢查以年齡、婚姻狀況和生育經驗為重要預測因子。施打HPV疫苗和人口學變項皆無顯著相關。整體而言，子宮頸抹片檢查與人口學變項有顯著相關，而施打HPV疫苗與人口學變項皆無顯著相關。但子宮頸抹片檢查和施打HPV疫苗與健康信念中自覺行動障礙、行動線索和自我效能有顯著相關。未來建議可跨院區或多家醫療院所收案，以增加施打HPV疫苗的相關性。

關鍵字

子宮頸抹片檢查；人類乳突病毒疫苗；健康信念模式

並列摘要

Cervical cancer (CC) affects global women’s health and is ranked 4th in global cancer deaths in women. The 2018 World Health Organization [WHO] (2020) report estimates that around 570,000 people develop cervical cancer every year around the world. The Taiwan Cancer Registry reported 116,131 new cancer patients in 2018, which was an increase of 4,447 people compared with 2017. The Health Promotion Administration (2020) recommends that women undergo periodic Pap smear exams and self-pay for the human papillomavirus (HPV) vaccine to decrease the occurrence of cervical cancer. However, the latest statistics show that the pap smear screening rate is still low (49%). Furthermore, the study of Tsai (2017) shows that only 42.4% of nurses had previously received the HPV vaccine. This study aims to explore the correlation between cervical cancer awareness and related health belief models in female staff in a hospital. Therefore, there is a need to understand the difficulties in Pap smear and received the HPV vaccine. The method of this study convenience sampling and questionnaires were used in a local community hospital in northern Taiwan. A total of 100 questionnaires were distributed, and 100 valid questionnaires were collected. The recovery rate reached 100% and SPSS 24 was used for data analysis. Convenience sampling and questionnaires were used in a local community hospital in northern Taiwan, and 100 female employees were recruited in the hospital. Structured questionnaires were used for a survey, and questionnaire content included a cervical cancer awareness survey, Pap smear health belief model, and HPV vaccine health belief model. The results showed that the average age of female employees was 33.53+8.9 years old, and the average score of cervical cancer awareness and prevention awareness was 5.5+1.4. Pap smear shows significant differences by age, marital status, sexual experience, and childbearing experience. In addition, Pap smear and HPV vaccination showed significant statistical differences in perceived barriers, cues to action, and self-efficacy in health beliefs. Age, marital status, and sexual experience are important predictors of Pap smear. There was no significant correlation between HPV vaccination and demographic variables. Overall, Pap smear was significantly correlated with demographic variables, while HPV vaccination did not show a significant correlation with demographic variables. However, Pap smear and HPV vaccination were significantly correlated to perceived barriers, cues to action, and self-efficacy in health beliefs. Therefore, we recommend that enrollment be carried out across hospital branches and multiple medical institutions in future studies to increase the correlation with HPV vaccination.