Title

有伴侶女性性功能障礙和性治療意向的預測因子之研究

Translated Titles

A study on predictors of partnered female sexual dysfunction and sexual treatment intention

Authors

周吟柔

Key Words

女性性功能障礙 ; 性治療意願 ; 健康信念模式 ; 結構方程模組 ; Female sexual dysfunction ; Sexual treatment intention ; Health belief model ; Structural equation modeling

PublicationName

樹德科技大學人類性學研究所學位論文

Volume or Term/Year and Month of Publication

2020年

Academic Degree Category

博士

Advisor

施俊名

Content Language

繁體中文

Chinese Abstract

研究背景:一般女性性功能障礙盛行率約16.7-28.0%,而癌症女性性功能障礙盛行率更高約40-93.5%,只有46-60%有意願尋求治療,目前很少有大型研究著重在婦癌和其他生物-心理-社會因子預測女性性功能障礙和尋求性治療的意願。 研究目的: (1)探討女性性功能障礙之預測因子、(2)以健康信念模式來探討罹患性功能障礙的有伴侶女性,其尋求性治療意願之預測因子、(3)婦癌有伴侶女性的性功能障礙盛行率、性治療意願以及健康信念是否不同於健康女性。 研究方法:此研究為橫斷性及醫院為主的調查,自2013年10月到2019年09月在南臺灣四家婦產科門診以及社區,招募一年內具有單一性伴侶的20歲以上女性,依對象分成三種自填問卷:性慾低下的健康停經前女性、一般停經後女性、以及婦癌治療完成至少一年且無復發的女性,統計分析採取多元階層迴歸和結構方程模組。 研究結果:共招募696位,完成問卷者647位,平均年齡為42.3歲(21.8-68.1)、69.9%符合DSM-5性功能障礙(n=452)。(1)女性性功能障礙的顯著預測因子包括性苦惱(β=0 .39)、婦癌(β= -0.37)、自然停經(β= -0.26)、性相關醫療處置(β= 0.13)、以及年齡(β= 0.05);(2)448位罹患性功能障礙女性中,平均年齡為42.0歲、59.8%感到輕度苦惱、78.8%具有性心理因素、52.2%具有伴侶因素、以及57.8%具有性治療意願。結構方程模式以年齡、教育程度、和性頻率做為控制變項後,自覺疾病嚴重性、自覺治療利益性、自覺治療障礙性、行動線索、和自我效能為顯著預測因子,可以解釋9%的治療意願,婦癌不是有效預測因子,自我效能為最強預測因子,直接預測性治療意願(p= .003)、自覺疾病嚴重性為第二強預測因子,直接和間接預測性治療意願(p= .030 和 p= .002)、自覺治療利益性、自覺治療障礙性、以及行動線索都是間接預測性治療意願(p= .002, p= .001, 和 p= .002)。 結論與建議: 高齡、未停經、無罹患婦癌、曾接受性相關醫療處置、和有性苦惱可以顯著預測女性有更高比率的性功能障礙,以健康信念模式來預測女性的性治療意願是有效的,因此改變認知信念將能增強女性的性治療意願,可惜只能解釋少部分的治療意向行為,未來需要更多的前瞻性研究探索其他的預測因子。 關鍵字: 女性性功能障礙、性治療意願、健康信念模式、結構方程模組

English Abstract

Backgound: The prevalence of female sexual dysfunction in general was 16.7-28%, however, the prevalence of female cancer survivors with sexual dysfunction was 40-93.5%. Only 46–60% of women reported intention to seek help. Few large-scale studies have focused on the effect of gynecologic cancer and other biopsychosocial factors on female sexual dysfunction and their intention to seek treatment. Aim: Aim 1 was to explore the predictors of female sexual dysfunction. Aim 2 was to devise an optimal health belief model (HBM) to predict treatment intention of partnered women with sexual dysfunction. Aim 3 was to compare sexual dysfunction prevalence, sexual intention, and health beliefs between gynecologic survivors and healthy control. Methods: The present study was a cross-sectional, hospital-based survey conducted from October 2013 to September 2019. Women aged 20 years or older who had been in a monogamous relationship for at least 12 months were enrolled in the gynecologic departments or community in southern Taiwan. There were three kinds of self- administered questionnaires including healthy premenopausal women with low sexual desire, healthy postmenopausal women and gynecologic cancer women who had completed cancer treatment without recurrence at least 12 months. Data were analyzed with multiple regression and structural equation modeling. Results: Out of 696 women, 685 met with eligibility criteria and 647 completed questionnaire. The mean age was 42.3 years (21.8-68.1 range). 69.9% of women (n=452) met DSM-5 sexual dysfunction. (1) The significant predictors of female sexual dysfunction included sexual distress (β=0.39, p= .000)、gynecologic cancer (β= -0.37, p= .000)、natural menopause (β= -0.26, p= .000)、sex-related medical procedures (β= 0.13, p= .022)、and age (β= 0.05, p= .024). (2) Among 448 women with sexual dysfunction, the mean age was 42.0 years. 59.8% of women reported mild sexual distress, 78.8% reported sex-psychologic factors and 52.2% reported partner factors. 57.8% of those reported sexual treatment intention. After adjusting for age, education and sexual frequency, the model disclosed perceived severity of disease, perceived benefits of treatment, perceived barriers to treatment, cue to action, and self- efficacy were significant predictors accounting for 9% of the variance in treatment intention. Age, education, sexual frequency and gynecologic cancer were not significant predictors. Self-efficacy was the strongest predictor, which directly affected treatment intention (p= .003). Perceived severity was the second strongest predictor, directly and indirectly affecting treatment intention (p= .030 and p= .002). Treatment intention was indirectly influenced by perceived benefits, cue to action and perceived barriers (p= .002, p= .001, and p= .002). Conclusion & Suggestion: Old age, premenopause, no gynecologic cancer, ever receiving sex- related medical procedure and sexual distress could significantly predict higher possibility of female sexual dysfunction. The ability of the HBM to predict intention to treat FSD was validated. Changing cognition belief will be expected to strengthen women’s treatment intention. It was a pity that HBM only explained small proportion of treatment motivation behavior. Further prospective research testing other predictors would be favorable. Keywords: Female sexual dysfunction, Sexual treatment intention, Health belief model, Structural equation modeling

Topic Category 人文學 > 人類學及族群研究
應用社會學院 > 人類性學研究所
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