以健康信念模式探討女大學生執行乳房自我檢查認知與行為—以中部某大學大一為例

A Study of Female College Freshmen’s Perceptions and Actual Behaviors of Breast Self-Examination in the Health Belief Model

周宜慧(YI-HUI CHOU)

指導教授 ： 藍守仁

亞洲大學/健康學院/健康管理研究所/碩士(2008年)

摘要

台灣女性乳癌的發生率逐年上升但年齡卻逐年下降，近年來已躍居女性十大癌症的第二位，僅次於子宮頸癌，但在女性癌症死因中，乳癌的排名卻在子宮頸癌之前，根據行政院衛生署九十五年最新統計乳癌躍居女性癌症死亡率第四位，發生率及死亡率皆呈現上升趨勢。本研究之目的是想瞭解大學日間部大一女學生對於乳房自我檢查的相關認知行為與健康信念模式運用的分佈情形，及兩者之間的相關性，以提供未來進行教育介入提高大一女學生執行乳房自我檢查的比例和加強乳癌防治的觀念及行為之參考。
本研究設計採橫斷式調查研究設計，以自編之結構式問卷針對中部某大學大一女學生進行全面性普查施測。從民國九十六年十二月至民國九十七年一月進行問卷收集，總共發出1049份問卷，回收955份，回收率達91%，無效問卷共122份，有效問卷共833份，有效率達79%。回收之樣本經由描述性統計分析、t-檢定(t-test)、單因子變異數分析(one-way ANOVA)、皮爾森積差相關(Pearson’s product-moment correlation)、複迴歸(multiple regression)等，來探討社會人口變項因素及健康信念因素對於乳房自我檢查觀念及行為的影響。
研究重要結果發現：
一、健康學院女生之BSE知識、自覺行動利益皆顯著高於非健康學院的
女生。
二、有近八成的學生均感罹患乳癌是很嚴重的事情；有近九成的學生肯
定採取BSE的行動利益，尤其是能夠早期發現腫塊；有近六成的學
生自覺採取BSE的行動障礙，尤其是判別乳房異常結構；有近六成
的學生採取BSE的正確步驟是沒有把握的。
三、學生乳房自我檢查訊息大眾媒體方面來源主要為電視媒體，其次為
相關衛教單張或手冊及網路資訊(包括電子郵件)；而人際關係面來
源主要為老師，其次為醫護人員及家人/親戚為主要的訊息來源。
四、有近四成的學生曾執行過BSE，其了解程度大多數為「知道但不詳
細」，而不曾執行的最主要原因是忘記，有五成的學生對於未來一
年內採取BSE都傾向不確定，有四成的學生是可能及非常可能採取
BSE。
五、知識與自覺行動利益及自我效能呈正相關，與自覺行動障礙呈負相
關；自覺嚴重性與自覺行動利益及自覺行動障礙呈顯著正相關；自
我效能與自覺行動利益及行動線索呈顯著正相關，與自覺行動障礙
呈顯著負相關。
六、執行BSE行為的最主要預測因子為浴室設備、教育課程、BSE經驗、
老師及自覺行動利益五個變項，共可解釋11.6%的變異量。
根據本研究結果，建議在未來的校園衛生宣導中對女性學生舉辦相關教育介入活動，並可由健康學院發起種子小老師的活動，加強知識及技術教育，配合衛生機關及大眾傳播媒體共同宣導，提升年輕女性對於乳癌自覺罹患性認知，增加行動線索，並降低年輕女性對於乳癌自覺嚴重性及乳房自我檢查自覺行動障礙，以促使乳房自我檢查行為之發生。

關鍵字

健康信念、乳房自我檢查、行為意向、知識

並列摘要

According to Department of Health, Executive Yuan, the latest statistics in 2006 revealed a growing number of female breast cancer patients in Taiwan(only second to cervical cancer patients).Breast cancer occurrence rate has been ranked the fourth among females and more young groups are facing the situation.With an increasing number of breast cancer patients, the purpose of this study is intended to figure out the relationship between female college freshmen’s cognitive behaviors and health belief model practice with regard to breast self-examinations (BSE), hoping to promote related preventive measures in BSE.
Self-designed questionnaires (compatible with horizontal research method) are the primary means in this study. A total of 1,049 questionnaires (from December 2007 to January 2008) were distributed among female college freshmen at one university in central Taiwan.Of all, 833 copies were valid for statistical analysis (the validity ratio is 79%).Analytical measures included descriptive analysis, T-test, one-way ANOVA, Pearson’s product -moment correlation and multiple regression.
The findings showed the following results.
First, students from College of Health Science performed better in awareness of BSE than their counterparts from other colleges.
Second, nearly 80 percent of students considered breast cancer serious and were positive about BSE; however, 60 percent of students were not as confident in properly recognizing early signs of breast cancer.
Third, students’ knowledge about BSE was primarily from mass media, followed by relevant health flyers, pamphlets or Internet.Also, teachers, physicians and family members were also sources of BSE knowledge.
Fourth, nearly half of the students either knew but had insufficient knowledge about BSE or were not sure about applying BSE.Only forty percent of students were firm about practicing BSE.
Fifth, perceived benefits of taking action have a positive correlation with self-efficacy.A negative correlation was revealed between perceived benefits of taking action and perceived barriers of taking action.
Finally, the major variables that led to practicing BSE were bathroom facilities, educational curriculums, BSE experiences, teachers and self-awareness.
Research implications highlight the importance of promoting female students’ self-awareness of BSE through hands-on workshops on campus, related health bureaus and mass media.In so doing, female students will be more likely to pay attention to BSE and its practical application, thus reducing their own lack of knowledge and uncertainty.

並列關鍵字

Health Belief Model, Breast Self-Examination, Behaviors,Knowledge

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