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研究生:吳昀臻
研究生(外文):Yun-Jhen
論文名稱:基隆市30歲以上婦女定期接受子宮頸抹片篩檢之相關因素探討
論文名稱(外文):Factors associated with regular periodical papanicolaus smear screening in Keelung City women
指導教授:陸玓玲陸玓玲引用關係
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:公共衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:54
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目的:本研究探討基隆市30歲以上婦女定期接受子宮頸抹片篩檢與「基隆市社區闔家歡健康篩檢」經驗之關係,並針對有參加「基隆市社區闔家歡健康篩檢」者分析定期接受子宮頸抹片篩檢的因素。
材料與方法:以民國89年到民國96年基隆市闔家歡健康篩檢(以下簡稱KCIS)資料為主,並連結國民健康局子宮頸抹片篩檢名冊中,30歲以上婦女接受子宮頸抹片篩檢的紀錄,觀察接受子宮頸抹片篩檢的情形。先分析國民健康局子宮頸抹片篩檢名冊中90382位婦女的KCIS經驗與接受子宮頸抹片篩檢之關係,再針對曾經接受KCIS的23533位婦女,探討社會人口學變項與定期接受子宮頸抹片篩檢之關係,最後探討18574位資料完整的婦女其影響疾病史及健康行為與定期子宮頸抹片篩檢行為的因素為何。本研究以SAS 9.1版套裝統計軟體進行描述性統計、雙變項分析及邏輯斯回歸分析。
研究結果:1.以基隆市子宮頸抹片篩檢名冊中,曾經做過子宮頸抹片篩檢的婦女為對象分析,結果發現曾接受KCIS篩檢的婦女定期接受子宮頸抹片篩檢的百分比較未曾接受KCIS的婦女高。2.以有接受KCIS的婦女為對象分析,與定期抹片篩檢相關之社會人口學變項,教育程度較高者、有偶的婦女較會定期做子宮頸抹片篩檢;但設籍七堵區的婦女較不會定期做子宮頸抹片篩檢。3. 以有接受KCIS的民眾、在疾病史與健康行為資料中無遺漏值的婦女為對象分析,發現有家族癌症病史及有家族慢性病史的婦女較會定期做子宮頸抹片篩檢,但有個人慢性病史的婦女較不會定期去做子宮頸抹片篩檢;在健康行為中,曾經有吸菸習慣的婦女較不會定期做子宮頸抹片篩檢,有運動習慣的婦女較會定期去做子宮頸抹片篩檢。
結論與建議:本研究發現有接受KCIS的婦女,教育程度較高、有偶、有家族癌症病史、有家族慢性病使、無個人慢性病史、從未吸菸及有運動習慣者,較會定期去接受子宮頸抹片篩檢。若能提升KCIS的參與率,相信能有效提升婦女定期參加子宮頸抹片篩檢的行為;並針對未能定期參加子宮頸抹片篩檢的高危險群,提供相關的宣導策略,提升定期篩檢率。


Objectives: The purpose of this study was to analysis the relationship between regular papanicolaus (pap) smear screening and the experience of the "Keelung Community-based Integrated Screening" (KCIS) in Keelung City women over 30 years.

Methods: The data of this study were draw from 2000 to 2007 Keelung Community-based Integrated Screening (KCIS) and records of pap smear in the Bureau of Health Promotion. 90,382 records were included. The dependent variable was behavior of regular papanicolaus (pap) smear screening. The independents included social-demographic variables, family disease history, personal disease history, and health behaviors. The main statistic method was logistic regression, using SAS 9.1 version package.

Results: Women who had experience of KCIS had higher rate of regular pap smear screening than who had not. In KCIS participants, women who were higher levels education and have a spouse, had family disease history, never smoking, and exercise behavior more likely to have regular pap smear screening.

Conclusion: The study found that women who had experience of KCIS, highly educated, have a spouse, have a family disease history, have no individual history of chronic illness, never smoking and have exercise behavior were more likely to receive regular pap smear screening. Encourage women to participate KCIS may could effectively promote women to receive regularly pap smear screening in addition to health education and advocacy strategies.

目錄
第一章 前言………………………………………………………………………………………………1
第一節 研究動機……………………………………………………………………………….1
第二節 研究目的……………………………………………………………………………….3
第二章 文獻探討……………………………………………………………………………………...4
第一節 子宮頸癌以及子宮頸抹片篩檢………………………………………….4
第二節 影響婦女參加子宮頸抹片篩檢的相關因素……………………..7
第三節 影響婦女定期參加子宮頸抹片篩檢的相關因素…………..12
第四節 小結……………………………………………………………………………………..16
第三章 材料與方法………………………………………………………………………………..17
第一節 研究對象來源…………………………………………………………………….17
第二節 資料收集方法……………………………………………………………………..18
第三節 研究架構……………………………………………………………………………..24
第四節 變項定義……………………………………………………………………………..25
第五節 統計方法……………………………………………………………………………..27
第四章 結果……………………………………………………………………………………………28
第一節 KCIS經驗與子宮頸抹片篩檢行為間的關係………………..28
第二節 社會人口學變項與定期子宮頸抹片篩檢行為間的關係
……………………………………………………………………………………………..29
第三節 疾病史和健康行為與定期子宮頸抹片篩檢行為間的關係
…………………………………………………………………………………………….32
第五章 討論…………………………………………………………………………………………….37
第一節 KCIS經驗與定期子宮頸抹片篩檢行為的關係……………..37
第二節 定期子宮頸抹片篩檢之相關因素探討…………………………...38
第三節 研究對象的調整……………………………………………………………….41
第四節 研究限制……………………………………………………………………………..43
第六章 結論與建議………………………………………………………………………………..44
第一節 結論……………………………………………………………………………………44
第二節 建議……………………………………………………………………………………45
參考文獻……………………………………………………………………………………………………46

表目錄
表一 影響婦女參加子宮頸抹片篩檢的相關因素整理……………………..10
表二 影響婦女定期參加子宮頸抹片篩檢的相關因素整理……………..15
表三 民國89年至94年KCIS資料與國民健康局之民國89年至96年子宮頸抹片篩檢名冊連結結果………………………………………………19
表四 有KCIS經驗婦女之第一次篩檢結果與篩檢間隔之雙變項分析(N=43035) ……………………………………………………………………………………..23
表五 疾病史與健康行為中完整樣本與有遺漏值樣本之雙變項分析(N=23533) ……………………………………………………………………………………..23
表六 KCIS經驗與子宮頸抹片篩檢行為之雙變項分析(N=90382) …28
表七 子宮頸抹片篩檢行為與社會人口學變項之雙變項分析
(N=23533) ……………………………………………………………………………………..30
表八 定期篩檢者與不定期篩檢者之邏輯斯回歸分析(N=23533) …..31
表九 疾病史、健康行為與定期子宮頸抹片篩檢行為之雙變項分析(N=18574) ……………………………………………………………………………………..34
表十 定期篩檢者與不定期篩檢者疾病史及健康行為之邏輯斯回歸分析(N=18574) ……………………………………………………………………………..36

圖目錄
圖一 研究對象子宮頸抹片篩檢及KCIS經驗分組示意圖………………20
圖二 研究架構………………………………………………………………………………………..24


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1. 王本仁、黃心苑、周穎政、李丞華、張鴻仁:全民健保子宮頸抹片檢查受檢情形影響因數分析-個體時間序列資料之實證研究,1997~2000。台灣衛誌,2005;24(1):33-42。
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