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研究生:陳仕凡
研究生(外文):Chen, Shih-Fan
論文名稱:肢體障礙者子宮頸抹片篩檢:個案認知、利用情形及相關因素研究
論文名稱(外文):Perception, Utilization and Associated Factors of Pap Smear Screening in Women With Physical Disabilities
指導教授:林金定林金定引用關係
指導教授(外文):Lin, Jin-Ding
口試委員:林金定羅慶徽徐尚為
口試委員(外文):Lin, Jin-DingLoh, Ching-HuiHsu, Shang-Wei
口試日期:2011-05-12
學位類別:碩士
校院名稱:國防醫學院
系所名稱:公共衛生學研究所
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:2011
畢業學年度:99
語文別:中文
論文頁數:177
中文關鍵詞:身心障礙者肢體障礙者子宮頸抹片篩檢女性預防保健服務
外文關鍵詞:disabilitiesphysical disabilitiesPap smear screeningwomen preventive health care
相關次數:
  • 被引用被引用:0
  • 點閱點閱:346
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  • 下載下載:33
  • 收藏至我的研究室書目清單書目收藏:4
身心障礙者因先天或後天因素導致他們的健康狀況較一般人差,且罹患疾病的機率也較高,其中肢體障礙者為所有身心障礙類別中人數最多且就醫人數最多的一群,但他們因肢體功能限制,導致利用醫療或預防保健服務時常會遇到阻礙。目前子宮頸癌是威脅女性健康的重要疾病之一,但可透過子宮頸抹片篩檢來預防,且若能及早發現其治癒率非常高。因此本研究想了解女性肢體障礙者子宮頸抹片篩檢的認知、利用情形及相關因素,問卷設計是以Andersen’s Behavioral Model為基礎的結構式問卷。研究母群體為某縣市領有身心障礙手冊且年滿15歲以上的女性肢體障礙者,使用年齡分層等比例方式選取3,910名樣本後,以郵寄方式進行調查,共回收521份問卷後以SPSS 18.0版統計套裝軟體行資料處理與分析。由結果可知有71.5%的女性肢體障礙者曾經接受過子宮頸抹片篩檢,約有28.5%從未接受過子宮頸抹片篩檢,近一年內接受過子抹檢查有41%、近三年內有接受子抹檢查佔52.3%、有定期接受檢查者有28.1%。在影響女性肢障者曾經接受子抹檢查主要因素之羅吉斯迴歸分析中發現,小於60歲(OR=5.26)、已婚(OR=11.83)、對子抹檢查的認知較正確(OR=2.93)、較不重視醫療服務品質的可用性(OR=0.39)、以及若改善子抹資源後接受意願較高(OR=4.74)的女性肢障者較會接受子抹檢查。且於探討子抹檢查相關認知情形的羅吉斯迴歸分析中發現,已婚(OR=6.4)、對子抹檢查經驗(OR=2.39)及對醫療服務品質持續性與完整性的滿意度較高(OR=3.62)的女性肢障者較熟悉子抹檢查資源。因此本研究將建議分為篩檢前、篩檢中及篩檢後進行探討,以作為未來擬定促進身心障礙者利用子宮頸抹片篩檢之衛生政策的依據。
People with disabilities have poorer health and higher incidence of diseases than general population, they are often encounter obstacles as using health care or preventive health services. The main purposes of the present study were to explore the perception, utilization and associated factors of Pap smear screening in women with physical disabilities. Based on Andersen’s Behavioral Model, a structured questionnaire was conducted via a post-mail survey in the study. There were there were 521 subjects whose aged 15 years and more participated in the study. Results found that there were 71.5% subjects had ever used the Pap smear tests and 28.5% subjects had never ever used the screening. The use rate of Pap screening within 1 year and within 3 years were 41% and 52.3% respectively, and 27.1% cases reported they used the screening regularly. Logistic regression model for the use of Pap smear test indicated that women whose age less than 60 years (OR=5.26), married women (OR=11.83), with high cognitive level toward Pap smear information (OR=2.93), pay less attention to the availability of hospital services (OR=0.39), and have higher willing level to use Pap smear as improving medical resources (OR=4.74) were the factors to affect the use of Pap smear among the study participants. Another logistic regression model revealed that the factors of married women (OR=6.4), high satisfaction of Pap smear experience (OR=2.39), and high satisfaction with the continuity and comprehensiveness of hospital services (OR=3.62) can significantly predicted the participants had high familiarity with Pap smear resources. The study will suggest the Pap smear screening policy in different stages of before-screening, in-screening, and after-screening in the content.
目錄

摘要 IX
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機 2
第三節 研究之必要性與重要性 3
第四節 研究目的 3
第二章 文獻探討 4
第一節 肢體障礙者的基本人口特性 4
第二節 肢體障礙者的健康狀況 7
第三節 肢體障礙者的就醫問題 8
第四節 女性肢障者子宮頸抹片篩檢之利用情形與影響因素 10
第三章 研究方法與步驟 18
第一節 研究架構 18
第二節 研究假設 20
第三節 名詞解釋 20
第四節 研究對象 21
第五節 研究工具 22
第六節 研究變項操作行定義 23
第七節 樣本回收情形 26
第八節 資料處理與分析 27
第四章 研究結果 29
第一節 女性肢障者基本特性與子宮頸抹片篩檢情形之描述分析 29
第二節 女性肢障者子抹檢查利用情形之相關因素分析 34
第三節 女性肢障者對子抹檢查與相關資訊認知情形之相關因素分析 43
第五章 討論 49
第一節 女性肢障者子宮頸抹片篩檢之利用情形 49
第二節 女性肢障者接受子宮頸抹片篩檢之相關因素 55
第三節 女性肢障者對子抹檢查之相關認知情形 60
第四節 女性肢障者對子抹檢查認知情形之相關因素 62
第五節 研究限制 64
第六章 結論與建議 65
第一節 結論 65
第二節 建議 67
第七章 參考文獻 74
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林淑菁、伍月琴、陳麗美、吳秀麗、王仁星(2009)。提昇30歲以上女性的子宮頸抹片篩檢率之專案。安泰醫護雜誌,15,177-190。
林惠賢、王琳華、劉淑敏、康啟杰(2003)。屏東地區女性接受子宮頸抹片檢查之相關因素。臺灣公共衛生雜誌,22,127-133。
林麗珠(2003)。衛生教育介入對女性參與子宮頸抹片檢查意願與行為影響之研究-以台南縣後壁鄉為例。高雄醫學大學公共衛生學研究所碩士論文,高雄市。
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徐瑋宏、郭平欣(2008)。子宮頸抹片篩檢「認知」與「利用」的影響因素分析-雙元普羅比模型之實證研究。臺灣公共衛生雜誌,27,232-242。
翁慧卿(2006)。大高雄地區醫學中心門診病人預防保健行為利用概況與相關因素之研究。福爾摩莎醫管雜誌,2,19-27。
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陳依琪、李弘暉、林宜柏、林雅雯、羅雅齡、呂怡佩、柯虹茜、鐘怡君(2008)。影響婦女進行子宮頸抹片篩檢之因素探討-以三重新莊地區為例。亞東學報,28,47-56。
陳雲絹、張遠萍、許玲女(1998)。某醫學中心女性做子宮頸抹片檢查與其影響因素之探討。長庚護理,9,22-32。
陳慈怡、李嬿如、游山林、陳建仁、謝長堯、陳素秋(2005)。全民健保實施前後影響子宮頸抹片篩檢之因素及成果。臺灣公共衛生雜誌,24,440-451。
陳錫中、周碧瑟(1995)。台灣鄉村女性對“子宮頸防癌抹片檢查”的認知及參與之調查研究。中華公共衛生雜誌,14,494-501。
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黃玉燕、陳秀月、劉珍如(2009)。提昇某區域教學醫院子宮頸抹片篩檢人數之改善專案。高雄護理雜誌,26,23-34。
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1. 盧孳艷、阮月清(2003)。子宮頸抹片篩檢政策之身體政治。護理雜誌,50,10-15。
2. 簡大任、季瑋珠(1995)。台北市有偶女性接受子宮頸抹片篩檢影響因素之探討。中華公共衛生雜誌,14,118-128。
3. 鄭丞傑(2006)。子宮頸抹片也可以DIY嗎?中華民國內膜異位症女性協會會刊,13,13-14。
4. 張靖梅、林獻鋒(2009)。女性未曾接受子宮頸抹片檢查之質性研究。護理暨健康照護研究,5,211-219。
5. 黃秀梨、張媚(2000)。兩種教育方案介入對工作場所女性接受子宮頸抹片檢查之知識、健康信念及行爲的影響。護理研究,8,111-123。
6. 黃月桂、葉明義、林勤豐(1998)。全民健康保險子宮頸抹片檢查之利用度研究。中華公共衛生雜誌,17,28-35。
7. 陳錫中、周碧瑟(1995)。台灣鄉村女性對“子宮頸防癌抹片檢查”的認知及參與之調查研究。中華公共衛生雜誌,14,494-501。
8. 陳慈怡、李嬿如、游山林、陳建仁、謝長堯、陳素秋(2005)。全民健保實施前後影響子宮頸抹片篩檢之因素及成果。臺灣公共衛生雜誌,24,440-451。
9. 陳雲絹、張遠萍、許玲女(1998)。某醫學中心女性做子宮頸抹片檢查與其影響因素之探討。長庚護理,9,22-32。
10. 陳依琪、李弘暉、林宜柏、林雅雯、羅雅齡、呂怡佩、柯虹茜、鐘怡君(2008)。影響婦女進行子宮頸抹片篩檢之因素探討-以三重新莊地區為例。亞東學報,28,47-56。
11. 翁慧卿(2006)。大高雄地區醫學中心門診病人預防保健行為利用概況與相關因素之研究。福爾摩莎醫管雜誌,2,19-27。
12. 徐瑋宏、郭平欣(2008)。子宮頸抹片篩檢「認知」與「利用」的影響因素分析-雙元普羅比模型之實證研究。臺灣公共衛生雜誌,27,232-242。
13. 林惠賢、王琳華、劉淑敏、康啟杰(2003)。屏東地區女性接受子宮頸抹片檢查之相關因素。臺灣公共衛生雜誌,22,127-133。
14. 林淑菁、伍月琴、陳麗美、吳秀麗、王仁星(2009)。提昇30歲以上女性的子宮頸抹片篩檢率之專案。安泰醫護雜誌,15,177-190。
15. 林晏如、陳欽賢、劉彩卿(2006)。保險對預防保健服務之影響:全民健保下之女性抹片檢查。保險專刊,22,1-20。