子宮頸癌及子宮頸抹片檢查團體衛生教育介入之成效-以國二學生為例

The effects of well-designed group health education of cervical cancer and Pap test for junior high school students

張雪雲(Hsueh-Yun Chang)

指導教授 ： 郭鐘隆

國立臺灣師範大學/教育學院/衛生教育學系/碩士(2003年)

摘要

本研究主要是針對國二學生設計一「子宮頸癌及子宮頸抹片檢查團體衛生教育介入」課程，並進而探討「子宮頸癌及子宮頸抹片檢查團體衛生教育介入」對國二學生其對子宮頸癌及子宮頸抹片檢查之「知識」、「態度」與「行為意向」的影響成效。本研究採準實驗設計，以苗栗縣某二所國中二年級學生共635人為研究對象，研究者任教學校為實驗組，另一所國中則為對照組，實驗組實施兩節「六分鐘護一生、遠離子宮頸癌」的課程及學習單的介入，對照組則不予任何介入。
「子宮頸癌及子宮頸抹片檢查團體衛生教育介入」前後兩組皆實施前後測，實驗組在後測實施同時一併實施過程評量，且收集學習單上婦女自陳子宮頸抹片檢查的行為資料，在教育介入一個月後對三個女生和二個男生進行質性訪談，以了解團體衛生教育介入的成效。
本研究的主要發現為：
一、團體衛生教育介入後，在控制前測成績下，實驗組學生對子宮頸癌及子宮頸抹片檢查「知識」的得分高於對照組學生，且達顯著性差異。
二、團體衛生教育介入後，在控制前測成績下，實驗組對照組學生對子宮頸抹片檢查「態度」的得分未達顯著性差異。
三、團體衛生教育介入後，在控制前測成績下，實驗組學生對子宮頸抹片檢查「行為意向」的得分高於對照組，且達顯著性差異。
四、61.2%的實驗組學生喜歡此次團體衛生教育介入課程，而85.1%的人認為課程對其是有幫助的，88.6%的學生認為投影片對其學習是有幫助的。
五、在團體衛生教育介入課程之前，會詢問婦女親友有無作過子宮頸抹片檢查的女生有43.5%，男生佔22.3%；在介入課程期間則有76.0%女生和41.4%的男生會詢問，在介入課程後，男女生會詢問的比例均有顯著增加，且在介入課程前、後會詢問婦女親友的女生比例均顯著高於男生。
六、在團體衛生教育介入期間，有33.1%的男生和58.8%的女生會鼓勵婦女接受子宮頸抹片檢查。
七、在團體衛生教育介入期間，有40.9%的男生和75.3%的女生會和婦女分享「認識子宮頸癌」學習單，有42.3%的男生和77.9%的女生會和婦女分享「六分鐘護一生」學習單，有78.7%的學生覺得學習單對其婦女親友是有幫助的。
八、實驗組學生婦女親友在自陳目前接受子宮頸抹片檢查的情況則分別是：8位（5.2%）是「從沒想過」，13位（8.4%）是「曾經想過但沒做過」，而有134位（86.4%）是「曾經做過」的。
九、實驗組學生婦女親友有5.2%對於接受子宮頸抹片檢查的行為階段是停留在無意圖期，27.1%對於接受子宮頸抹片檢查的行為階段是停留在意圖期，有34.8%是停留在準備期，有32.9%的婦女則是停留在行動期。
十、研究對象對於團體衛生教育介入課程、師資、教材、上課方式大都持有正向的評價。
本研究發現，雖然子宮頸癌是婦女特有的疾病，子宮頸抹片檢查是和婦女健康相關的篩檢，然而透過團體衛生教育介入的實施，均可促使男女生更關心婦女健康，他們願意主動詢問婦女親友是否曾做過子宮頸抹片檢查，且增加其知識及行為意向得分，因此，未來相關女性健康主題的教育介入應可以採取本研究團體衛生教育介入結合社區公共衛生服務的模式，以促使男生也可以更關心婦女親友的健康。本研究的貢獻可提供國二學生在「子宮頸癌及子宮頸抹片檢查團體衛生教育介入」的參考建議，未來研究者可在本研究的基礎下，進一步以更嚴謹的縱貫性研究來進行介入以探討其適用範圍與成效。

關鍵字

子宮頸癌 ； 子宮頸抹片檢查 ； 團體衛生教育 ； 學習單

並列摘要

The main purpose of this study was to evaluate the effects of well-designed group health education of cervical cancer and Pap test for junior high school students. The study focused on improving students’ knowledge, attitudes and behavioral intention regarding cervical cancer and Pap test.
A quasi-experimental design was employed in this study. The subjects were consisted of 635 junior high school students. The interventions for experimental group included 2-hour structured course and learning worksheets. On the contrary, the control group did not receive any intervention. Both groups were assessed by the questionnaires before and after interventions. Three female and two male students were interviewed to collect the qualitative data regarding course process evaluation.
The main findings in this study were as follows：
1.There was a significant impact in improving knowledge score of cervical cancer and Pap test for subjects in the experimental group compared those in the control group.
2. There was no significant impact in improving the attitude score of Pap test for subjects in the experimental group compared those in the control group.
3.There was a significant impact in improving the behavioral intention score of Pap test for subjects in the experimental group compared those in the control group.
4.There were 61.2% subjects liked this intervention, 85.1% felt it was useful and 88.6% felt these was helpful to learning .
5.There were 43.5% females and 22.3% males have asked their female relatives if receieveing a Pap test before group health education intervention, and 76.0% females and 41.4% males did after. There was a significant impact in improving the percentage for female subjects before intervention compared those in males. So is the case for after intervention.
6.There were 58.8% females and 33.1% males have urged their female relatives on receieveing a Pap test after group health education intervention.
7.There were 75.3% females and 40.9% males have shared their female relatives on learning workseet 1, and 77.9% females and 42.3% males did on learning workseet 2 after group health education intervention. There were 78.7% subjects felt these wre helpful to their female relatives.
8.Acording to the learning worksheets, there were 5.2% of experimental group’s female relatives have never thinking about receiving a Pap test, 8.4% have thinking about Pap test but did not receive it, and 86.4% have received a Pap test. There were 5.2% in precontemplation stage for receiving Pap test, 27.1% in contemplation stage, 34.8% in preparation stage, and 38.0% in action stage.
Based on the results, this study suggests that future study can explore the longitudinal effects of cervical cancer and Pap test education intervention to verify its effectiveness. Health education teachers can deliver such a program to adult students and other health subjects in order to help them and improve their health. Health education providers can deliver such a group health education intervention about females’ health to males and females.

並列關鍵字

cervical cancer ； Pap test ； group health education ； learning worksheet

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