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研究生:江雪美
研究生(外文):CHIANG, HSUEH-MEI
論文名稱:探討停經婦女陰道症狀困擾及其自我處理的經驗
論文名稱(外文):The experience of disturbance and self-management of vaginal symptoms among menopausal women
指導教授:曹麗英曹麗英引用關係
指導教授(外文):Tsao, Lee-Ing
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:90
中文關鍵詞:自我處理陰道症狀三角交叉檢視法停經
外文關鍵詞:self-managementvaginal symptomstriangulation researchmenopause
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陰道症狀是個人隱私健康問題,國內探討停經婦女陰道症狀困擾及其自我處理經驗的研究仍較少見。本研究目的為探討停經婦女陰道症狀之困擾、頻率及其自我處理情況,以及婦女歷經此陰道症狀的主觀經驗。以期作為協助停經婦女於陰道症狀困擾照護之重要參考資料。
本研究利用三角交叉(Triangulation)檢視法,採質量性並行的研究方式。以立意取樣及利用滾雪球方式於96年12月至97年6月北區某區域教學醫院,對停經一年以上並有陰道症狀困擾婦女進行資料收集。量性方面:以停經婦女陰道症狀量表、自我處理陰道症狀及自覺成效量表,共收集51位婦女;此外,在51位婦女中,有19位婦女接受深入訪談其陰道症狀之主觀經驗。量性資料以SPSS16.0進行描述性統計分析,質性資料以內容分析法進行資料分析。
一、量性研究結果顯示:本研究對象平均年齡56.94歲,平均距最後一次月經時間為6.58年,有陰道症狀平均為2.64年;陰道症狀發生頻率及困擾為接近偶爾發生及輕度困擾;婦女常用之自我處理的方式,前6名依序為:只用清水洗滌,使用陰道保濕潤滑劑,穿100%純棉質內褲,吃食品改善體質,使用口服荷爾蒙製劑,穿寬鬆內褲。而這些方式之自覺成效為介於稍微有效和有效之間,其有效程度之前6名為:純棉質內褲、口服荷爾蒙製劑、寬鬆內褲、不含荷爾蒙的陰道軟膏、陰道保濕潤滑劑及清水洗滌。
二、質性研究結果顯示六大類屬及其次類屬為:(一)、自覺陰部不適感:刺痛感、閉合及乾癢感、疼痛感。(二)、不便啟齒的私密與內心感受:不輕易與人分享、自我私下處理、學習忍耐、害怕與無助。(三)、就醫求診意願低:曝露隱私的尷尬、拒絕只開荷爾蒙的醫生、症狀不嚴重到影響日常活動。(四)、日常生活的困擾:不敢公開抓癢會陰部、羞於公然購買會陰產品、出門無法簡便。(五)、自我尋求資源處理:求助專業人員、透過報章媒體獲得知識、嘗試自我處理陰部變化、參加團體尋求資源。(六)、性生活的衝擊與因應:對性生活意願低、與伴侶取得對性生活共識。
以上研究結果顯示停經婦女於陰道症狀困擾上的健康需求,婦女不輕易說出或求醫,影響性關係,但礙於隱私而選擇自我處置,卻無足夠資訊能供選擇等,醫療人員應主動察覺並提供有陰道症狀困擾之停經婦女對陰道症狀及自我處理方式的相關訊息,以增進婦女自我保健。
Vaginal symptoms are common health problems. However, these symptoms are involved with privacy for menopausal women who often treat them by self-management. Few studies about disturbance and self-management of vaginal symptoms among menopausal women were conducted in Taiwan. The purposes of this study were to explore the following issues:
1. Disturbance, frequency and self-management of vaginal symptoms among menopausal women
2. The subjective experiences of vaginal symptoms among menopausal women
In this study, triangulation research design was used. It was conducted by quantitative and qualitative approach. Data collected by purpose sampling and snowball from 2007 Dec to 2008 Jun in Taipei City. In quantitative approach, fifty-one women aged from 48 to 68 were recruited by questionnaires of menopausal vaginal symptoms scale, self-management and the effectiveness of management in vaginal symptoms. Nineteen of 51 women were interviewed for their subjective experiences of vaginal symptoms. The collected data were analyzed by the statistical software, SPSS 16.0 for quantitative data and content analysis for qualitative data.
The Results showed as follows:
1.Quantitative Research:
The mean age of the women was 56.9 years. The mean period after last menstrual period was 6.58 years. The mean duration of vaginal symptoms was 2.64 years. In terms of frequency, most vaginal symptoms occurred occasionally. The disturbance of vaginal symptoms were mild degree. The first six methods ranked by frequency in women's self-management for vaginal symptoms were washing vaginal area with water, using vaginal lubricants , wearing 100% cotton quality underwear, eating healthy food to improve body constitution, taking oral hormone therapy and wearing loose pants. The first six managements ranked by effectiveness were wearing 100% cotton quality underwear, taking oral hormone therapy, wearing loose pants, applying non-hormonal vaginal cream, vaginal lubricants moisture and washing vaginal area with water.
2.Qualitative research:
Six categories and their sub-categories as listed as follows:(1). self-awareness of the of vaginal symptoms included stinging pain, dryness and itchiness and soreness;(2). hestate to share with this private issues and feelings included no sharing with others, self-management, learning to endure, fear and helplessness; (3). unwillingness to visit physicians because of shyness to expose the private area, disapproval to take HRT and symptoms not so serious to influence daily life;(4). disturbances in daily life included avoiding touching the itching vagina in public, shyness to buy vaginal products, inconvenience outdoors; (5) self-seeking resources to deal with symtpoms included ask for help of health professionals or supporting club, seeking knowledge from newspapers and trying self-management;(6). impact and coping style on sexual life including of low willingness of sexual life, try to obtain consensus with sexual partners.
Vaginal symptoms had impacts on the distress of physical, mental and sexual life for menopausal women. However, these symptoms are private issues for women. Most women would choose self manage instead of seeking for medical help. Health providers should be more alert to vaginal symptoms in menopausal women and more aggressive to provide health education for awareness and self-management about vaginal symptoms in such women.
目 次
誌謝...............................................................I
中文摘要..........................................................II
英文摘要......................................................... IV
目次.............................................................VII
表次...............................................................X
圖次..............................................................XI
第一章 緒論.......................................................1
第一節 研究動機與重要性.......................................1
第二節 研究目的及意義.........................................4
第三節 研究問題...............................................5
第四節 名詞界定...............................................6
第二章 文獻探討...................................................7
第一節 陰道對女性的意義.......................................7
第二節 停經婦女陰道症狀及症狀困擾之相關研究...................9
第三節 停經婦女自我處理其健康問題相關研究....................13
第三章 研究方法..................................................16
第一節 研究設計..............................................16
第二節 研究對象..............................................17
第三節 研究工具..............................................18
第四節 參與者之權利維護......................................20
第五節 資料收集與分析........................................21
第六節 嚴謹度................................................24
第七節 準備性研究............................................26
第四章 資料分析與結果............................................28
第一節 停經婦女陰道症狀之困擾及其頻率和自我處理之效能........28
第二節 停經婦女對於陰道症狀之困擾及其自我處理情況的主觀經驗..35
第五章 討論......................................................56
第一節 停經婦女陰道症狀之困擾及其頻率和自我處理之效能........56
第二節 停經婦女對於陰道症狀之困擾及其自我處理情況的主觀經驗..61
第六章 結論與建議................................................67
第一節 結論..................................................67
第二節 應用與建議............................................69
第三節 研究限制..............................................75
參考文獻..........................................................76
附錄一、參與錄音訪談同意書........................................82
附錄二、參與問卷調查研究同意書參與問卷調查研究同意書.... .........83
附錄三、訪談指引..................................................85
附錄四、訪談指引修訂版..............................................86
附錄五、專家效度名單...............................................87
附錄六、停經婦女陰道症狀量表、自我處理陰道症狀及自覺成效量表.......88
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