更年期婦女對荷爾蒙療法及保健食品之風險知覺與使用

Risk Perception and Use of Hormone Replacement Therapy and Dietary Supplements among Menopausal Women

王育群(Yu-Chun Wang)

指導教授 ： 張玨

國立臺灣大學/公共衛生學院/衛生政策與管理研究所/碩士(2006年)

https://doi.org/10.6342/NTU.2006.02750

摘要

本研究的目的是欲了解國內更年期婦女使用荷爾蒙與保健食品的情形外，並深入探討更年期婦女對荷爾蒙及保健食品的風險知覺與使用關連。因此研究方法除採用次級資料分析外，尚應用質性訪談方式深入了解專業人員與更年期婦女對補充荷爾蒙及保健食品的看法。量性資料來源為「國民健康局九十二年台灣婦女更年期健康調查」之統計資料檔，共1942位介於40-60歲婦女，以描述性統計、卡方檢定及二元邏輯斯迴歸進行分析；在質性資料方面，則深入訪談更年期婦女20位、醫療專業人員10位。
量性研究結果發現：（1）更年期婦女有使用保健食品者佔60.6%，較非更年期婦女高，並達統計顯著。（2）使用種數平均為1.8種，最低為單一種使用、最高同時使用9種。（3）教育程度高、自覺健康較差、有因更年期問題就醫與有使用荷爾蒙的更年期婦女，其使用保健食品的情形也較高。
在質性訪談中發現，2002年WHI的研究發表後對於荷爾蒙的風險知覺影響極大。身體性風險知覺是更年期婦女考慮是否使用荷爾蒙與保健食品的主要原因、其次為心理性/社會性風險，週遭的人是否使用及親友的意見也是影響婦女使用的原因。在保健食品方面，一般婦女容易被字面上的意涵誤導，認為「保健食品」就是有「保健」的效果；且大多數婦女認為保健食品僅是補充品，在沒有特別期待的情況下，對功能性風險的覺察也會降低。
根據本研究結果建議實務上醫療專業人員應了解更年期婦女使用保健食品的情形，並尊重其自主選擇的權利，但須提供食品與萃取成藥丸形式的保健食品內涵的風險；而婦女本身也應養成有紀錄和諮詢習慣，此外有必要在媒體經常性的提醒風險或副作用：如在國民健康局之「更年期賀爾蒙指導手冊」中加入保健食品風險觀念。未來研究可擬定適合更年期婦女使用保健食品的問卷做較直接的推論，並可考慮以縱貫性的研究設計來看不同階段的更年期婦女其使用保健食品的行為有何變化。

關鍵字

更年期 ； 荷爾蒙療法 ； 保健食品 ； 風險知覺

並列摘要

Purpose of this study was to explore the relationships between risk perception and use of hormone replacement therapy (HRT) and dietary supplements among menopausal women. This study was designed to triangulate Quantitative and Qualitative methods. Quantitative research was analyzed secondary data entitled Survey of Menopausal Women’s health in Taiwan (2003). Subjects were 1942 menopausal women aged 40-60. Applied statistical methods included Descriptive Statistics, Chi-Square, and Binary Logistic Regression. Qualitative research was conducted with 20 menopausers and 10 medical professors via individual interview.
Quantitative results showed: (1) 60.6% of the menopausal sample taking dietary supplements, higher than non-menopausal controls; (2) the mean of dietary supplement use is 1.8, range 1-9; (3) menopausal women with a higher educational degree manifesting lower self-perceived health status, using medical care and hormone replacement therapy, as well as tending to use dietary supplements.
Qualitative results showed The Women’s Health Initiative (WHI) published as of 2002, along with Hormone Replacement Therapy (HRT) research. Such findings have tremendous impact on risk perception. Physical risk was the main reason that the menopausal women consider using hormone replacement therapy or dietary supplements; psychosocial risk ranked second. Relatives and friends influenced these women to use them. Generally speaking, women are easily misled as to the meaning of the term, thinking dietary supplements healthy. And most think of dietary supplements as a mere food supplement. Having no special expectations will reduce the performance risk.
Results suggest medical professors should know women’s condition of using dietary supplements, to estimate correct self-choice, and to afford the risk information about food and pill extraction of dietary supplements. Women should develop the habit of recording and consulting. It must remind of risk or adverse effect by mass media everywhen.The HRT guidebook of Bureau of health promotion can augment the risk conception. Future studies can explore or develop suitable questionnaires to make accurate conclusions. Longitudinal research is recommended, since it can observe changes at different menopausal stages of such usage behavior.

並列關鍵字

menopause ； Hormone Replacement Therapy ； Dietary Supplements ； Risk perception

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