影響男性選擇自費雷射攝護腺肥大手術治療服務之因素研究

A Study of Key Factors of Select Self-paid for Laser Surgery in Male Prostate Hypertrophy

杜滄進(Chang-Chin Tu)

指導教授 ： 楊東震

義守大學/管理學院/管理碩博士班/碩士(2016年)

摘要

攝護腺肥大已是男性的長壽病，當男人的年紀愈逐漸老化時，其攝護腺細胞也跟著在逐漸增生，因而造成體積變大壓迫到尿道，造成泌尿系統的問題。就目前的手術治療方式有：經尿道攝護腺切除術、經尿道攝護腺切開術、經尿道攝護腺電燒汽化術及開腹式攝護腺摘除。這些手術在國民健康保險均有給付。
近10年來隨著醫療科技的進步已將雷射導入攝護腺肥大的治療，利用汽化或切割的方式將肥大的攝護腺移除，研究發現雷射治療攝護腺肥大手術其優點有出血少、縮短住院時間、降低合併術後之併發症等，適用於高風險（如高血壓、心臟病）或不適合麻醉及開刀之病患。台灣地區目前引進有綠光雷射、銩雷射、鈥雷射、釹釔雅鉻雷射等。由於雷射成本較高，目前未列入健保給付，所以當病患選擇雷射治療方式時需自費一筆金額不算小的材料費。
本文之研究計畫以計畫行為理論作為模型，提出問卷設計，以40歲以上之男性為研究對象，探討分析男性選擇自費雷射攝護腺肥大手術之治療行為態度、主觀規範、知覺行為控制、行為意向及行為等。並分析年齡、婚姻狀況、工作職業、居住地、教育程度、家庭年收入、家中成員是否具有醫療背景及本身健保之外是否還有其他商業保險等，與各變項因素之影響關係。假設意向愈正向影響其「行為意向」會愈正向。
依據研究結果驗證計畫行為理論是可以預測影響男性選擇自費雷射攝護腺肥大手術治療因素並解釋其行為，對此提出研究建議，供政府主管機關、醫療衛生機構、民眾及未來研究者等對於選擇自費醫療行為之參考。

關鍵字

攝護腺肥大 ； 經尿道攝護腺刮除術 ； 綠光雷射 ； 銩雷射 ； 計畫行為理論

並列摘要

Prostate hypertrophy is male longevity disease. When a man is getting older, the prostate cells are also followed gradually hyperplasia. Resulting in larger volume oppression to the urethra, it causes urinary tract problems. On the current surgical treatment are: Transurethral resection of the prostate, transurethral incision of the prostate, transurethral electrovaporization of the prostate and open prostatectomy. These surgeries are paid by the National Health Insurance.
The progress of medical technology have been introduced into the laser treatment on prostate hypertrophy in decades, utilizing vaporization or cutting to remove hypertrophy of the prostate. The researches indicate that laser treatment of prostate hypertrophy surgery has the advantages of less bleeding, shorter hospital stays, merger to reduce postoperative complications, for high risk (such as high blood pressure, heart disease) or the patient is not suitable for anesthesia and surgery. The lasers introduced to Taiwan currently include greenlight laser, thulium laser, holmium laser, Nd-YAG laser and so on. Due to the high cost of laser, it is not included in health insurance payments currently. When the patients choose laser treatment, they must afford higher expense for materials fee.
This project is based on the model of planned behavior theory. A questionnaire is designed to the study on the men over the age of 40, analysis of men to choose self-paid laser surgery for prostate hypertrophy behavior attitude, subjective norm, perceived behavioral control, behavioral intentions, and behavior. It also analyzes the age, marital status, job occupation , place of residence , education level, household income , family members who have medical background and commerce insurance beyond the national health insurance or not, affecting the relationship with each variable factors . To assume the more positive effect, behavioral intention will be more positive
According to the research result, the theory of planned behavior is predictable to affect men choose to pay for laser surgery for prostate hypertrophy factors and explain their behavior. This study provided recommendations for government authorities, medical and health institutions, public people and future researchers as the references for choosing self-paid medical behavior.

並列關鍵字

prostate hypertrophy ； transurethral resection of the prostate ； greenlight laser ； thulium laser ； theory of planned behavior

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