運用健康信念模式探討民眾加選大腸鏡檢查之信念及相關因素

Abstract

運用健康信念模式探討民眾加選大腸鏡檢查之信念及相關因素 摘要 目的：自1994年起，大腸直腸癌一直位居國人十大癌症死因第三位，2013年是發生個案總數最高的癌症。除了推廣以糞便潛血反應篩檢，安排大腸鏡檢查是診斷與治療大腸直腸瘜肉或早期癌瘤最好的工具。本研究旨在運用健康信念模式探討影響民眾接受大腸鏡檢查的信念及相關因素。 方法：採問卷調查法進行，以台北市某自費健康檢查中心之大腸鏡檢查受檢者為研究對象，有效樣本數202人；依據檢查經費來源區分為個人自付組及公司補助組，探討其健康信念模式變項、行動線索、自我效能及修飾因子對於定期追蹤大腸鏡的相關性及二組的差異性。 結果：對於定期追蹤大腸鏡檢查可能性的預測力，整體研究對象以自覺行動利益、行動線索、自我效能為顯著；個人自付組：自覺行動利益及自我效能；公司補助組：自我效能。解釋變異量:整體36.39%、個人自付組38.52%、公司補助組41.6%。 結論：自費健康檢查受檢者的「自覺罹患性」低，整體或二組研究對象的「自我效能」對於定期追蹤大腸鏡檢查的可能性最具顯著影響力；建議運用健康信念模式設計有效衛生教育專案，提醒高風險族群定期追蹤大腸鏡檢查，降低國人罹患大腸癌的比率。 關鍵字：大腸直腸癌、健康信念模式、大腸鏡檢查Application of the Health Belief Model to Explore the Beliefs and Related Factors of Selected Colonoscopy Screening Abstract Aim: In Taiwan, the colorectal cancer (CRC) ranked the third cancer-caused death from 1994 and the highest number of new diagnosed patients at 2013. In addition to fecal occult blood test for CRC screening, the colonoscopy is conducted to diagnose and treat colorectal polyps or carcinoma. We applied the Health Belief Model (HBM) in exploration of the beliefs and its related factors about selected colonoscopy for CRC screening. Methods: The study questionnaire was adopted after the colonoscopy subjects (sample numbers = 202) at a self-paid health examination center in Taipei city. The data were divided into two groups: the personal self-paid group and the corporate subsidy group. To explore the correlation of HBM variables, Cues to action, Self-efficacy, modifying factor and demographic characteristics to the likelihood of follow-up colonoscopy and the difference between the two groups were studied. Results: For all participants, perceived benefits, Cues to action and Self-efficacy were the significant predictors to the likelihood of follow-up colonoscopy and accounting for 36.39% of the variance. In the personal self-paid group, perceived benefits and Self-efficacy were the significant predictors and accounting for 38.52% of the variance. Whereas, Self-efficacy was the significant predictors and accounting for 41.6% of the variance in the corporate subsidy group.