影響婦女進行子宮頸抹片篩檢之相關因素探討

Factors associated with the women receiving Pap smear screening

王鈺惇(Yu-Tun Wang)

指導教授 ： 李亞欣

中山醫學大學/健康管理學院/醫療產業科技管理學系碩士班/碩士(2012年)

https://doi.org/10.6834/CSMU.2012.00152

摘要

台灣自民國84年健保開辦之後，將30歲以上婦女子宮頸抹片檢查列為給付項目，希望能降低子宮頸癌的發生率及死亡率。近年來子宮頸抹片篩檢率逐漸提昇，但仍舊無法達到期望的目標；因此確認哪些因素是影響婦女持續接受子宮頸抹片篩檢，便成為一項很重要的公共健康議題。本研究利用PRECEDE模式探討影響婦女進行子宮頸抺片之因素。希望了解台灣地區子宮頸癌預防篩檢的情形，比較不同篩檢利用率及頻率之婦女，對於子宮頸癌的知識及認知之差異，進一步找出相關影響因素。
本研究採自擬問卷，包括傾向因素、促成因素、增強因素及抺片使用相關資料調查，針對中部地區配合之醫療院所，婦產科門診之35歲以上婦女，進行問卷訪談，於101年2月至101年4月止，共回收350份問卷。
整體分析後發現，高齡者及年輕族群、無工作者、未婚者、不知道政府提供30歲以上婦女免費進行抹片、未收到通知做抹片的電話或是通知信函者，抹片檢查利用率及頻率皆較低，同時也發現到子宮頸抹片知識及態度會影響婦女進行子宮頸抹片的意願及頻率。而有接受過其他預防性醫療者，以及有固定醫療院所及醫師者，接受抹片的意願及頻率也愈高。雖然有媒體宣導，但是未進行抹片者其行動力不足。而影響婦女進行子宮頸抹片頻率之因素為傾向因素及促成因素，影響婦女是否接受過子宮頸抹片行為之因素為增強因素。

關鍵字

子宮頸癌 ； 子宮頸抹片檢查 ； 頻率 ； PRECEDE模式

並列摘要

The NIH in Taiwan had included Pap smear screening for cervical cancer for women aged 30 or above since 1995 in order to lower the incidence and mortality from cervical cancer. In recent years, the screening rate has raised gradually but still couldn’t meet the expectation. Therefore, it’s became an important public health issue to understand the factors that influence the willingness to receive continuous Pap smear. Our study discuss the factors that affect women to receive Pap smear using the PRECEDE model. The goal of the study is to understand the current condition of the Pap smear screening in Taiwan by comparing the differences among the knowledge and cognition for cervical cancer between women who has different screening frequency and usage.
Self-designed structured questionnaires were used for this study which includes predisposing factors, enabling factors, reinforcing factors and characteristics of Pap smear usage. Women aged 35 and above who visited Gynecology clinics in middle-Taiwan were interviewed. From Feb 2012 to April 2012, a total of 350 questionnaires were collected and analyzed.
After analysis, the screening rate and screening frequency were both low among women who were elder, younger, unemployed, single, those unnotified by phone or letter, and those who don’t know the health policy of cervical cancer screening. At the same time, the knowledge and attitude towards Pap smear influence the willingness and frequency greatly. Women who have received other preventive medical intervention or who have specific caregivers have higher willingness and frequency for cervical cancer screening. The propagation through the media didn’t enhance the motivation to receive a Pap smear. The factors that influence the frequency of Pap smear screening were the predisposing factor and the enabling factors; while the reinforcing factor influence the willingness to receive cervical cancer screening.

並列關鍵字

Cervical cancer ； Pap smear screening ； frequency ； PRECEDE model

參考文獻

葉季森(2002)•烏日鄉已婚婦女接受子宮頸抹片檢查影響因素研究•中台學報，13，1-12。

行政院衛生署國民健康局(2010)。中華民國97年癌症登記報告，台北。

行政院衛生署國民健康局(2012)。中華民國98年癌症登記報告，台北。

行政院衛生署國民健康局(2010)。中華民國98年子宮頸癌篩檢登記報告，台北。

黃月桂、葉明義、林勤豐(1998)。全民健康保險子宮頸抹片檢查之利用度研究•中華衛誌，17(1)，28-35。