臺灣博碩士論文加值系統

根據衛生署統計，目前惡性腫瘤仍是國人十大死因榜首，而男性癌症中，攝護腺癌發生率排名第六位，死亡率排名第七位，有逐年上升的趨勢。因此期望透過篩檢，及早發現疾病並早期治療，本研究目的將利用健康信念模式初探影響中老年人參與攝護腺癌篩檢的因素。
本研究對象為雲林縣某榮民之家住民及台中市某些社區男性民眾。於2007年10月於榮民之家及12月於中部三個社區進行攝護腺癌免費篩檢活動，及安排6天訪問篩檢者及未篩檢者。共有208份有效問卷，包括參與篩檢107位，未參與篩檢101位。資料分析方法有描述性分析、卡方檢定、單因子變異數分析及羅吉斯迴歸分析。羅吉斯迴歸分析將探討中老年人之人口學變項因素及健康信念對參與攝護腺癌篩檢的影響。
研究結果發現：
(一) 研究對象平均年齡為74歲，有宗教信仰、會重視自己的健康狀況、現在沒有工作、非獨居、知道攝護腺癌篩檢目的、知道PSA可以篩檢攝護腺癌、知道PSA正常值的研究對象參與的比例較多。
(二)行動線索以「此次活動宣傳海報」為最多，其次是親友告知。
(三)自覺罹患性、自覺嚴重性及自覺利益性(p<.001)對有無參與攝護腺癌篩檢
具統計上顯著意義(p<.001)，其平均得分有顯著差異。
(四)多數參與篩檢組的攝護腺癌篩檢健康信念，經事後比較是較未參與篩檢組
高。
(五)由羅吉斯迴歸分析得知：獨居、知道攝護腺癌篩檢目的與自覺罹患性對參
與攝護腺癌篩檢具有預測能力。
此研究結果將有助於公共衛生醫療人員及機構醫護人員作為未來各種預防篩檢活動等衛生教育計畫的參考。另外，為提高民眾篩檢動機、疾病認知及參與篩檢之接受度，建議衛生主管機關可以將攝護腺癌篩檢納入全民篩檢計畫，並透過大眾媒體，讓民眾認識攝護腺癌及篩檢步驟，進而有更好的健康促進行為。


關鍵詞：攝護腺癌篩檢、健康信念模式

According to statistics from the Department of Health, malignant tumor has been the top ten leading causes of death for more than 30 years and prostate cancer is the sixth highest in incidence rate and seventh in mortality rate for male cancers in Taiwan. Early detection is the key for treating cancer. The purpose of this study is to investigate factors related to participating in prostate cancer screening among community-dwelling adults aged 45 and over in central Taiwan.
　　The subjects of study were from participants of free prostate cancer screening activities were held in Oct and Dec 2007 and scheduled another 6 days to survey. Totally 208 questionnaires had been completed that included 107 participators and 101 non-participators of the free screening. The data were analyzed with descriptive statistics, Chi-square test, one-way ANOVA and logistic regression. Logistic regression analysis was used to explore the potential predictors of participating in a free screening, including demographics and four constructs of the health belief model.
　　The results of the study were as following:
(1)The average age of this sample of elders was 74. Most of them had religious belief, paid much attention to healthy status, had no job, not lived alone, knew purpose of prostate cancer screen, knew PSA test was a method of screen and knew PSA normal ranges.
(2)When asked why they participated in the free screening, the poster of screen advertising came first. Heard from relatives and friends was the second.
(3)The difference between perceived susceptibility, perceived severity and perceived benefits(p<.001) correlated with participating in prostate cancer screening.
(4)The majority of the participtors scored higher in healthy belief when compared to the non-participtors.
(5)Logistic regression models indicate that not lived alone, knew purpose of prostate cancer screen and perceived susceptibility were significant predictors of participating in prostate cancer screening.
　　The findings of the study will provide public health officials crucial information for developing future screening programs. In order to enhancing people’s motives to disease screening, this study suggests that prostate cancer screening can be covered by the national health program and using media to propagate the knowledge of prostate cancer and screening method are important strategies in promoting prostate cancer screening.


Key words：Prostate Cancer Screen, Health Belief Model

第一章 緒論
第一節　研究背景與動機 1
第二節　研究目的 3
第三節　研究名詞定義 3
第二章 文獻查證
第一節　攝護腺癌及篩檢工具之簡介 4
第二節　健康信念模式 9
第三節　影響男性接受攝護腺癌篩檢的因素 12
第三章 研究方法
第一節　研究架構 17
第二節　研究設計 18
第三節　研究問題 19
第四節　研究對象 19
第五節　研究工具及信效度 20
第六節　資料整理及統計分析 36
第四章 研究結果
第一節　樣本特性 37
第二節　研究對象人口學與參與攝護腺癌篩檢之關係 48
第三節 研究對象參與攝護腺癌篩檢之健康信念差異及各構面相關情形 56
第四節　研究對象參與攝護腺癌篩檢之預測因素 122
第五章 討論
第一節　本研究的定位與價值 125
第二節　樣本特性和參與攝護腺篩檢的關係 126
第三節　樣本特性和與健康信念的關係 128
第四節　健康信念和參與攝護腺篩檢的關係 130
第六章 結論、建議與限制
第一節　研究結論 131
第二節　研究限制 132
第三節　應用與建議 132

參考文獻 134

附錄
附錄一　研究同意書 139
附錄二　研究問卷 148
附錄三　國際前列腺症狀評分表 152
附錄四　量表效度專家名單 154

參考文獻
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書籍
Irwin M. Rosenstock（1990）. The health belief model: Explaining health behavior through expectancies, Health behavior and health education （1sted.,pp.39-62）.St. California：Jossey-Bass Inc.
Karen Glanz, Frances M. Lewis, and Barbra K. Rimer.（2002）. Health Behavior and Health and Education： theory, research, and practice. In Victor J. Strecher & Irwin M. Rosenstock（Ed.）, The Health Belief Mode（pp. 41-59）.San Francisco： jossey-Bass Pulishers.


網路部分
衛生署統計資料網(無日期)．衛生統計系列．2008年3月20日取自
http://www.doh.gov.tw/statistic/index.htm
陶聲洋防癌基金會(無日期)．攝護腺癌．2008年4月10日取自
http://www.sydao.org.tw/cure/cancer_21.html
World Health Organization(無日期) ．Screening and early detection
of cancer．2008年4月10日取自http://www.who.int/cancer/detection/en/
財團法人癌症基金會(無日期)．台灣常見的癌症--攝護腺癌 Prostate Cancer．2008年6月5日取自
http://www.canceraway.org.tw/Sitepage_Show.asp?AppCode=SITEPAGES&ID=178
陳哲嘉、林惠生、劉怡妏(無日期)．國人之健康行為初探．2008年4月10日取自 http://www.bhp.doh.gov.tw/people/pdf
歐宴泉(無日期)．成人健檢沒問題怎麼還會得攝護腺癌．2008年4月10日取自http://www3.vghtc.gov.tw/pdc/new_page_16.htm
歐宴泉(無日期)．定期篩檢及早治療潛在攝護腺疾病．2008年4月10日取自http://www3.vghtc.gov.tw/pdc/new_page_24.htm