應用健康信念模式探討南投地區婦女利用乳房攝影篩檢相關因素

The Application Health Belief Model Faith Pattern Discusses the Nantou Area Woman to Sieve Using the Breast Mammography Examines the Correlation Factor

陳秋珍(CHIU-CHEN CHEN)

指導教授 ： 董和銳

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2009年)

摘要

台灣地區乳癌發生率在近年來有急遽上升的趨勢，目前女性乳癌佔女性癌症發病率中的第二位，為台灣地區所有癌症死亡原因第四名，也是女性癌症死亡原因第四名，每十萬人口死亡率11.36％增加13.5％（行政院衛生署，2007)，由其乳癌好發年齡的高峰為47歲(45-50歲），相較歐美國家女性乳癌好發年齡的高峰為60歲，台灣女性乳癌好發年齡有年輕化現象，歐美許多研究報告均指出，利用乳房攝影篩檢乳癌可有效降低乳癌死亡率約25-35％。2004年7月起健保局辦理50-69歲婦女，每2-3年接受一次免費乳房攝影篩檢，定期乳癌篩檢是防治乳癌的第一步；本研究主要目的是應用健康信念模式探討南投地區婦女利用乳房攝影篩檢的相關因素，本研究對象以南投縣使用本院醫療資源之女性民眾為研究對象，由2009年3月至2009年5月進行問卷收集，共回收366份有效問卷，醫院組民眾問卷有175份，社區組民眾問卷有191份。以SPSS 12.0統計軟體以敘述性分析、卡方分析、獨立t檢定，來探討南投地區女性對乳房攝影篩檢相關認知。研究結果發現，在兩組民眾基本資料方面「年齡」、「教育程度」、「宗教信仰」、「月收入」等有明顯相關，文獻中所提60歲以上的民眾做乳癌篩檢呈現很少的比例；生活型態包含「葷素飲食」、「抽煙習慣」、「喝酒習慣」有不同差異，但藉由攝取高纖低脂的食物，減少飲酒等來降低罹患乳癌的機率；健康狀況包含「慢性病史」與平均年齡較高有關，社區組健康狀況與「親人有乳癌病史」、「定期健康檢查」與教育程度較高及週遭親人有乳癌經驗有關，則會有很高的機率進行乳房攝影篩檢；社會支持變項「工作」與平均年齡有關；醫院組民眾對於「乳房攝影篩檢的認知」，因透過行政部門執行疾病預防性工作，在各地方提供民眾不同的篩檢服務；在健康信念方面，醫院組與社區組雖然只有「自覺罹病性」、「自覺利益性」等二項因素與有明顯的相關，醫院組民眾在衛生所人員協助安排就醫，也讓民眾「自覺嚴重性」認知增加，以及醫院安排專車接送的情況下，也有全民健保支付制度下，民眾就醫幾乎沒有任何障礙，會降低「自覺障礙性」，資訊來源方面，醫院可加強「醫療院所衛教資料」、「醫護人員建議」，顯示醫療院所衛教資料在民眾心中具有一定之專業性，而日常生活中最熟悉的傳播媒體「專題報導」、「報章雜誌專題文章」可善加利用，醫院在有乳房疾病史患者加強追蹤管理，定期的乳癌篩檢，才能對乳癌早期發現早期治療，得到最好的治療效果，進而降低其死亡率及減少治療的成本。

關鍵字

乳癌 ； 乳房攝影 ； 健康信念模式

並列摘要

Abstract
The incidence of breast cancer in Taiwan has rapidly increased in recent years the trend of female breast cancer is currently the incidence of cancer among women accounting for the second place, all in Taiwan the fourth leading cause of cancer deaths and is the fourth leading cause of cancer deaths for women were per 100,000 population increased 11.36% mortality rate 13.5% (Department of Health, 2007), breast cancer by the age of peak incidence for the 47-year-old (45-50 years), female breast cancer compared to Europe and the United States made a good age peak for the 60-year-old female breast cancer incidence in Taiwan have a younger age phenomenon, many European and American studies have shown that the use of screening mammography can reduce breast cancer mortality rate of about 25-35% of breast cancer.
Starting in July 2004 Bureau of National Health Insurance for 50-69 year-old woman, once every 2-3 years free mammography screening, breast cancer, regular screening is the first step in prevention and treatment of breast cancer; the main purpose of this study is the application of health belief model to explore areas in Nantou women's use of screening mammography-related factors, the present study, Nantou County to use medical resources of our people for the study of women, from March 2009 to May 2009 a questionnaire collection, recycling a total of 366 valid questionnaires, the Hospital Section 175 of the questionnaire public, community groups questionnaires were 191 people. SPSS 12.0 statistical software in order to descriptive analysis, chi-square analysis, independent t-test, to explore women Nantou areas related to cognitive screening mammography.
The results showed that two groups of people in the basic information "age", "educational attainment", "religious belief", " income" and so obviously related to the literature referred to the people over the age of 60 do breast cancer screening a small proportion of the seizure; life contains " diet", "smoking ", "drinking " have different differences, but by high-fiber low-fat food intake, reduce alcohol to lower breast cancer, etc. chance; health conditions include "the history of chronic disease" and is related to their higher average age, health status of community groups and the "history of their relatives have breast cancer", "regular health check-ups" and a higher level of education and experience surrounding their relatives have breast cancer, and then there will be a very high probability for screening mammography; Social support variables "work" with the average age-related; hospital group of people for the "cognitive screening mammography," because the executive branch through the implementation of disease prevention work, provide people in all different screening services; in regard to health belief Hospital group and community group, though only "conscious of the disease", "conscious of the interests", etc. There are two obvious factors associated with the hospital group in the public health personnel to assist in arranging for medical treatment, and let people "own the seriousness of" increased awareness , and arrange special vehicles to the hospital, it is also under the national health insurance payment system, the public is virtually no barriers to medical treatment, would reduce the "conscious of the obstacles," sources of information, the Hospital will enhance the "health education information on medical institutions," "health care staff recommendation "to show the information of medical education institutions in the hearts of the people of a certain professional, and everyday life are most familiar with the media" story "," feature articles in newspapers and magazines "can be put to good use, the hospital in breast disease strengthen the management of patients with a history tracking and regular breast cancer screening, early detection of breast cancer to early treatment, the best therapeutic effect, thereby reducing its mortality rate and reduce the cost of treatment.

並列關鍵字

Breast Cancer ； Mammography ； Health Belief Model

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