臺灣博碩士論文加值系統

本研究目的在了解乳癌婦女延遲就醫、診斷、及治療之現況及其相關影響因子。研究工具為自編問卷，經文獻探討、深度訪談及專家效度修改後預試編修而成。研究方法採面對面問卷訪談法，考慮回溯性誤差故僅收集診斷二年內之乳癌婦女。
本研究於民國88年2月至6月間訪視收集成大醫學院附設醫院乳癌婦女133位，其中延遲就醫者佔36.8％，、延遲診斷者58.6％，延遲治療者53.4％。影響延遲就醫因素最常是患者以為是正常組織(34.7%)或以為是良性腫瘤(32.7%);延遲診斷的最主要因素包括病人的因素為檢查為良性，但未繼續追蹤檢查(29.1%)，醫院的因素為無法確立診斷(40.0%); 延遲治療最主要原因，則是病患更換醫院治療(33.9%)及家庭有事(27.4%)以及醫院需等病床(16.1%)和醫師(16.1%)。進一步分析社會人口變項、對疾病相關認識程度、及家庭支持等因素之影響發現，婦女是否感到配偶支持是影響延遲治療之重要因子(p=0.037)。
本研究結果顯示乳癌婦女延遲情形極為普遍，有賴相關單位加強宣導相關疾病之知識和警覺性並加強婦女乳房自我檢查及推廣定期乳癌篩檢，同時亦應宣導家庭成員特別是配偶之關心及注意婦女乳房健康，以達早期發現，早期治療之效。

This study aimed on the factors associated with medical-seeking delay, diagnostic delay and therapeutic delay of women with breast cancer in a medical center in southern Taiwan. A questionnaire was developed by referring past studies, previous deep interviews, and expert reviews. Data was collected by face to face interview. Considering recall bias, only women with breast cancer less than two years were recruited as study subjects.
A total of 133 women with breast cancer were recruited from the Outpatient Department, National Cheng Kung University Hospital. Results showed that 36.8% women had delayed seeking doctors when they first noticed the tumor, 58.6% having delayed diagnosis after they sought a doctor, and 54.3% having delayed treatment after they were diagnosed with breast cancer. The major factors related to medical-seeking delay were subjects thought that tumor is normal tissue or benign. The major factors related to diagnostic delay were patients did not continually follow up after being diagnosed as benign and physicians could not make sure the diagnosis. Similarly, the major factors related to therapeutic delay were patients change hospitals or being busy at home; and hospital beds were unavailable. Further analysis indicated that spouse support were the most important factors related to patients'' therapeutic delay, respectively.
In conclusion, delay behaviors are common in women with breast cancer. This study provides information related to these three kinds of delay and suggests increase public awareness of breast cancer,breast self-examination, and breast cancer screening. In addition, family support, especially spouse support, is also important to reduce such delays.

頁數
授權書
中文摘要 I
英文摘要 II
誌謝
目錄 III
IV
表目錄
圖目錄 VI
VII
第一章 緒論
第一節 研究動機及重要性 1
第二節 研究目的 3
第三節 名詞解釋 4
第二章 文獻探討
第一節 乳癌疾病之介紹 7
第二節 乳癌婦女延遲求醫之狀況及影響 11
第三節 乳癌婦女延遲求醫因素研究 15
第四節 社會支持對求醫行為之影響 19
第三章 研究方法與步驟
第一節 研究設計與研究樣本 21
第二節 研究工具 21
第三節 研究程序 22
第四章 研究結果
第一節 基本資料之描述 24
第二節 延遲行為現況 24
第三節 乳癌婦女對疾病認知情形 26
第四節 影響延遲的相關因子 27
第五章 討論 28
第六章 結論與建議 33
參考文獻 35
圖表 42
附錄 51
自述 57
表目錄
頁數
表一 樣本的社會人口變項 42
表二 乳癌婦女發現症狀時情形 43
表三 延遲就醫情形與相關因素 44
表四 延遲診斷情形及原因 45
表五 延遲治療情形與因素 46
表六 乳癌婦女對疾病認知情形 47
表七 延遲就醫與社會人口變項之卡方檢定 48
表八 延遲治療與社會人口變項之卡方檢定 49
表九 延遲就醫與患者之社會支持之卡方檢定 50
表十 延遲治療與患者之社會支持之卡方檢定 50
圖目錄
頁數
圖一 歷年臺灣婦女乳癌發生率 5
圖二 歷年臺灣婦女乳癌死亡率 5
圖三 乳癌婦女求醫過程流程圖 6

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