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  • 學位論文

經痛健康素養概念與測量發展

Developing the Concept and Measurement for Dysmenorrhea’s Health Literacy.

指導教授 : 張菊惠

摘要


經痛為女性常見的健康困擾,亦是導致女性曠課、請假及企業工時損失的重要原因。一般女性習以忍耐或止痛藥物因應經痛,中西醫觀點差異性讓少數選擇就醫的女性喪失身體自主性,網路資訊爆炸世代中消費者的資訊近用、媒體識讀益發重要。健康素養被泛指為個人獲取知識、個人技巧及有信心採取行動,透過改變個人的生活型態與生活條件以提升個人與社區健康。此概念在國外已廣泛運用於衛教介入評價指標,並衍生發展多項特殊健康議題的健康素養測量。本研究欲突破傳統從認知與態度視角理解月經和經痛的不足,使用具積極行動意涵的健康素養,發展經痛健康素養概念與測量,以做為經痛健康促進推動的基礎。 本研究採用多階段多元方法設計,第一階段將應用Walker和Avant概念分析方法,確立經痛健康素養概念型定義、構面與構面之定義;第二階段使用專家效度確認經痛健康素養之概念與各構面定義;第三階段使用層級分析法確認概念與構面間的權重,並以專家效度完成題項之發展。 研究結果以Nubeam所發展之基本/功能健康素養、互動/溝通健康素養與批判性健康素養三層次概念推導出經痛健康素養定義,演譯並歸納專家對經痛健康素養之意見,定義「經痛健康素養」為:認識並了解女性生殖系統相關字詞,對月經週期與經痛原因、緩解經痛處理方法有基本的理解能力;進而能向他人陳述自身月經週期的變化情形,了解經痛相關疾病與緩解或預防經痛方式之原理,並能從不同管道蒐集經痛資訊用以改善月經健康;能理解並判讀不同經痛處理資訊的科學實證性、中西醫理論依據與多元的保健方法,並根據自己的身體狀況、所收集資料與醫療人員互動討論,選擇緩解經痛最佳方式。基本/功能素養包含經期健康閱讀能力、月經週期計算能力、經痛病理基本認知;互動/溝通性素養包含進階經痛健康認知、經痛健康覺察、中西醫經痛藥物認知、醫病溝通、資訊媒體的運用;批判性素養包含經痛健康充權、資訊判讀、就醫批判性等共計十一構面。透過層級分析法來決定這11構面權重,整體層級分析結果分別為經痛基本認知(0.225)>經痛健康覺察(0.123)>月經週期計算能力(0.109)>經期健康閱讀能力(0.095)>經痛健康充權(0.091)>進階經痛健康認知(0.076)>醫病溝通(0.073)>資訊媒體的運用(0.064)>資訊判讀(0.063)>中西醫經痛藥物認知(0.046)>就醫批判性(0.035),其整體C.I.=0.00、C.R.=0.00,達一致性。再依其構面發展題項,共六十七題。 本研究所發展之經痛健康素養概念與測量,能全面性地評估與了解女性對經痛的知識力、資訊力、行動力與批判性,可供現行九年一貫健康與體育教育課綱之評估與性別平等政策綱領推動經期健康促進之依據。

並列摘要


Dysmenorrheal is common health problems for women, it caused female absent in class, and work. Most of woman learning to be patient or used pain relieve medication in response of dysmenorrheal.The internet information increasingly important for consumer information access, and difference treatment perspective between Chinese medicine and Western makes few women choose medical treatment loss her own body autonomy. Health literacy means an individual how to obtain knowledge, personal skills and confidence to take action. These could change personal lifestyles and living conditions to improve individual and community health. The concept of health literacy has been widely used in foreign countries involved in health education intervention evaluation, and has developed a number of special health issues of health literacy measurement. This study intends to break through the traditional cognition and attitude perspective and to understand inadequate use of menstruation and dysmenorrheal, applying positive action with implications for health literacy, health literacy development through the pain concepts and measurements to health promotion push through the pain as the foundation. Multiple stage and multiple method design were applied in this study, the first stage will be applied Walker and Avant concept analysis method to establish the concept of health literacy through the pain type definitions, dimensions and facets of the definitions; validity of the second phase of the use of expert confirmed the concept of health literacy through the pain with each dimension defined; third stage confirmed using Analytic Hierarchy Process, AHP between concepts and constructs weights and expert validity of the questions to complete the development. The result of study developed three level concept in Nubeam basic / functional health literacy, interactive / communication health literacy and critical health literacy , and derived through the pain of health literacy definition and summarizing the expert interpretation of health literacy on dysmenorrheal. The definition of Health literacy through the pain as the awareness and understanding of the female reproductive system related terms, the menstrual cycle and causes dysmenorrheal, relieve dysmenorrheal treatment methods have a basic understanding; thus able to state their menstrual cycle to another, the variations, understanding menstrual pain-related diseases and mitigation or prevention of menstrual pain way of principle, and from different pipes to collect menstrual pain information to improve the menstrual health; able to understand and interpret different menstrual pain treatment information science empirical, integrative theoretical basis with diverse health practices. According to their physical condition, the information collected interactive discussion with professional to select the best way to relieve menstrual pain. Total of eleven dimensions in this study, these including: basic / functional literacy includes menstrual health reading ability, menstrual cycle calculation skill, basic knowledge of menstrual pain pathology ; interactive / communicative literacy include advanced cognition of dysmenorrheal, health awareness of dysmenorrheal, awareness of Chinese and Western menstrual pain drugs, doctor-patient communication, information media use ; critical literacy including dysmenorrheal health empowerment, information interpretation, medical care judgment. Through the AHP to determine the weights of 11 dimensions, the overall level of analysis results were dysmenorrheal basic knowledge (0.225)> health awareness of dysmenorrheal (0.123)> menstrual cycle calculation skill (0.109)> menstrual health reading ability (0.095)> Health empowerment of dysmenorrheal (0.091)> Advanced health Awareness of dysmenorrheal (0.076)> patient communication (0.073)> information and media use (0.064)> information interpretation (0.063)> Medicine dysmenorrheal medications cognition (0.046)> medical critical (0.035 ), the overall CI = 0.00, CR = 0.00, up consistency. Further development of the questions according to their dimensions, a total of 67. This study developed the concept of health literacy through the pain and measurement, to a comprehensive assessment and understanding of women's dysmenorrheal ability of knowledge , information ability, mobility and critically, for the current nine-year health and physical education classes assessment and programme to promote gender equality policy basis for health promotion period.

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