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

Determinants of Awareness and Use of Pap-smear Screening: The Bivariate Probit Model Study

10.6288/TJPH2008-27-03-05

徐瑋宏(Wei-Hong Shu)；郭平欣(Ping-Sing Kuo)

子宮頸抹片檢查 ； 雙元普羅比模型 ； 認知 ； cervical screening ； bivariate probit model ； awareness

台灣公共衛生雜誌

27卷3期（2008 / 06 / 01）

232 - 242

繁體中文

目標：本研究旨在探討影響台灣婦女對子宮頸抹片檢查認知(Awareness)與行為之社經因素。方法：研究資料為行政院衛生署國民健康局「民國91年台灣地區國民健康促進知識、態度與行為調查問卷」，使用雙元普羅比模型(bivariate Probit model)考量「認知」因素後，探討社經特性及其他因素對婦女抹片認知與檢查行為的影響。結果：模型估計結果顯示，抹片檢查的認知和行為兩條迴歸式之間有顯著的高度正相關，因此研究影響檢查行為的社經因素，必須同時考慮影響認知的社經因素。在認知迴歸式中，影響婦女對抹片檢查認知的顯著因素有：年齡、大學以上教育程度、已婚、良好自我健康狀況評估與預防保健服務利用。在檢查行為迴歸式中，影響婦女作抹片檢查的顯著因素有：年齡、高中(職)教育程度、都市化程度低、南部地區、已婚、宗教信仰與預防保健服務利用。結論：本文以雙元普羅比模型顯示，「認知」是婦女作子宮頸抹片檢查的重要影響因素，並推估出影響婦女認知與從事檢查的重要社經因素，可以提供相關單位作為擬定更有效率的抹片檢查推廣政策之參考。

Objectives: The purpose of this study was to investigate the impact of cervical-screening awareness on the cervical-screening behavior of women in Taiwan. Methods: The bivariate probit model and data from the ”Survey of the Health Promotion Knowledge, Attitudes, and Behavior of Taiwan Citizens” conducted by the Bureau of Health Promotion in 2002 were used to investigate the socioeconomic factors in cervical-screening awareness and compliance of women in Taiwan. Results: The estimation results of the bivariate probit model indicated a significant and strong positive correlation between awareness and screening, supporting the role of ”awareness” in cervical-screening behavior of women in Taiwan. Age, education level (college or above), married status, better self-assessment of health condition, and regular use of preventive health-care services were significant factors in women’s awareness of Pap-smear screening. Age, education level (senior high school or above), lower degree of urbanization, residence in the southern areas of Taiwan, married status, religious beliefs, and regular use of preventive health-care services were significant factors in use of Pap-smear screening. Conclusions: The role of awareness in cervical-screening behavior, as well as socioeconomic factors in both awareness and compliance, must be taken into account in the design of cost-effective cervical cancer prevention policies and programs in Taiwan.

1. 王本仁、黃心苑、周穎政、李丞華、張鴻仁(2005)。全民健保子宮頸抹片檢查受檢情形影響因子分析－個體時間序列資料之實證研究，1997~2000。台灣衛誌，24，33-42。
   連結：
2. Eaker S,Adami H,Sparen P(2001).Reasons women do not attend screening for cervical cancer: a populationbased study in Sweden.Prev Med,32,482-491.
3. Guzick DS(1978).Efficacy of screening for cervical cancer: a review.Am J Public Health,68,125-134.
4. Hancock L,Sanson FR,Perkins J,Corkrey R,Burton R,Reid S(2001).Effect of community action intervention on cervical screening rates in rural Australian towns: the CART project.Prev Med,32,109-117.
5. Hsia J,Kemper E,Kiefe C,Zapka J(2000).The importance of health insurance as a determinant of cancer screening: evidence from the women`s health initiative.Prev Med,31,261-270.
6. Kenkel DS(1990).Consumer health information and the demand for medical care.Rev Econ Stat,72,587-586.
7. Kenkel DS(1991).Health behavior, health knowledge and schooling.J Polit Econ,99,287-385.
8. Meng CL,Schmidt P(1985).On the cost of partial observ-ability in the bivariate Probit model.Int Econ Rev,26,71-86.
9. Rochelle B,Denzil G,Marion H,Rosalie V(2006).Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer.Health Econ,15,33-47.
10. Ronco G,Segnan N,Ponti A(1991).Who has Pap tests? Variables associated with the use of Pap tests in absence of screening program.Int J Epidemiol,20,349-353.
11. Slattery ML,Robison LM,Schuman KL(1989).Cigarette smoking and exposure to passive smoke are risk factors for cervical cancer.JAMA,261,1593-1598.
12. Zambrana RE,Breen N,Fox SA,Gutierrze-Mohamed ML(1999).Use of cancer screening practices by Hispanic women: analyses by subgroup.Prev Med,29,466-467.
13. 民國九十一年育齡婦女總生育率
14. 民國九十年癌症登記報告
15. 民國九十二年衛生統計指標－保健類
16. 李翠鳳、郭旭崧、陳錫中、陳天順、周碧瑟(1997)。金門縣婦女子宮頸防癌抹片檢查的影響因素。中華衛誌，16，198-209。
17. 林晏如、陳欽賢、劉彩卿(2006)。保險對預防保健服務之影響－全民健保下之婦女抹片檢查。保險專刊，22，45-64。
18. 陳錫中、周碧瑟(1995)。台灣鄉村婦女對「子宮頸防癌抹片檢查」的認知及參與之調查。中華衛誌，14，494-501。
19. 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。中華衛誌，17，28-35。
20. 葉季森、周碧瑟(1987)。以健康信念模式分析桃園縣婦女的抹片檢查行為。衛生教育，8，58-77。
21. 蔡明芸(2005)。碩士論文(碩士論文)。花蓮，私立慈濟大學公共衛生研究所。
22. 簡大任、季瑋珠(1995)。台北市有偶婦女接受子宮頸抹片檢查影響因素之探討。中華衛誌，14，111-128。

1. 蔡炯青、陳效君、林國甯(2018)。母親接受子宮頸抹片篩檢及女兒接種HPV疫苗之相關因素分析—以桃園市育有12-17歲青少女之母親為例。臺灣公共衛生雜誌，37(2)，220-235。
2. 陳怡君、林爲森、吳坤和(2010)。高雄地區民眾大腸癌篩檢行爲及其影響因子。嘉南學報（人文類），36，291-301。