影響職業衛生護理人員於職場推動四癌篩檢相關因素分析之研究

Abstract

衛生福利部國民健康署提供民眾免費四癌篩檢（子宮頸抹片檢查、乳房X光攝影檢查、糞便潛血檢查及口腔黏膜檢查）做為癌症防治策略，期能改善患者癒後狀況及提高存活率。然而民眾的四癌篩檢率並非百分之百，擴展四癌篩檢管道為一提升民眾篩檢率的可行方法，透過職場健康管理中的新興角色—職業衛生護理人員，在職場中辦理四癌篩檢，對提升民眾四癌篩檢率將有所助益。為瞭解職業衛生護理人員在職場辦理四癌篩檢的現況及可能影響因素，本研究運用計畫行為理論為研究架構，結合質性與量性研究方法，第一階段以立意取樣及滾雪球取樣方式招募6名具辦理四癌篩檢經驗之現任職業衛生護理人員進行訪談，以更全面瞭解可能影響職業衛生護理人員於職場辦理四癌篩檢之相關因素。接著分析質性訪談結果，再修正以計畫行為理論建構之結構式問卷，以現任之專職／特約職業衛生護理人員為研究對象，有效樣本數為351人。以描述性統計、獨立樣本T檢定、皮爾森積差相關、多元階層迴歸分析及路徑分析進行統計分析。研究結果如下：一、研究對象對於在職場辦理四癌篩檢的意向因不同的年資（p<.01）、教育程度（p<.05）、聘用別（p<.01）、職場規模（p<.001）、員工性別分布（p<.01）及行業別（p<.001）而有所不同。 二、研究對象對在職場辦理四癌篩檢的態度、主觀規範及知覺行為控制因其意向不同而有差異（p<.001）。 三、研究對象未來「半年內」在職場辦理四癌篩檢的「行為意向」會受到「態度」、「主觀規範」間接影響及「知覺行為控制」直接影響，三者的總效果分別為0.343、0.345及0.567；而研究對象未來「一年內」在職場辦理四癌篩檢的「行為意向」同樣會受到「態度」、「主觀規範」間接影響及「知覺行為控制」直接影響，三者的總效果分別為0.344、0.346及0.569。 四、研究對象的「背景變項」、「態度」、「主觀規範」及「知覺行為控制」對未來「半年內」及「一年內」在職場辦理四癌篩檢意向的整體解釋力分別達49%及49.1%。

The Health Promotion Administration provides four-cancer screening for free (Cervical cancer screening, Breast cancer screening, Colorectal cancer screening, and Oral cancer screening) as a cancer prevention strategy, aiming to improve patient outcomes and increase survival rates. However, the screening rates for these four-cancers is not 100%. Expanding the screening channels for four cancers is a feasible way to increase the screening rate of the public, and it will be helpful to increase the screening rate of four cancers in the workplace through the emerging role of occupational health care workers in workplace health management.To explore the current practices and potential influencing factors of occupational health nurses in conducting four cancer screenings in the workplace, this study employs the Theory of Planned Behavior as its conceptual framework and integrates both qualitative and quantitative research methodologies. In the first stage, we recruited in-depth interviews with current occupational health nurses who have the experience of four-cancer screening in workplace by means of purposive sampling and snowball sampling, in order to have a more comprehensive understanding of the factors that may affect the occupational health nurses to promote four-cancer screening in the workplace. And then, according to results of qualitative interviews were analyzed, and the structured questionnaire constructed by the theory of planned behavior was modified to include current full-time/contracted occupational health nurses as the target population. A total of 351 valid samples were obtained.Data analysis included descriptive statistics, independent sample T-test, Pearson's correlation coefficients, hierarchical regression and path analysis. The results of the study showed that: 1. The participant's behavior intention to undergo four-cancer screening in the workplace varied according to their job tenure (p<.01), education level (p<.05), employment category (p<.01), size of the workplace (p<.001), gender distribution of the employees (p<.01) and industry (p<.001). 2. Attitudes, subjective norms, and perceived behavioral control of the study participants towardsfour-cancer screening in the workplace varied according to their behavior intention (p<.001). 3. Attitude and subjective norms had an indirectly influences on behavior intention. The total effect of behavior intention to undergo four-cancer screening in the workplace within six months are 0.343 and 0.345. The perceptual behavioral control had a directly influences on behavior intention. The total effect of behavior intention to undergo four-cancer screening in the workplace within six months is 0.567. The "behavioral intention" of the study participants to undergo screening forfour-cancer in the coming"one year" was also affected by "attitude", "subjective norms" and "perceptual behavioral control", and the total effects of the three were 0.344, 0.346 and 0.569 respectively. 4. Occupational health nurse's background variable, attitudes, subjective norms, and perceived behavioral control toward behavior explained 49 to 49.1% of the variance of behavior intention.