Applying the Health Belief Model to Analyze Intention to Participate in Preventive Pulmonary Tuberculosis Chest X-Ray Examinations among Indigenous Nursing Students

運用健康信念模式分析原住民護理學生參與肺結核防治胸部X光檢查之意向研究

張麗春(Li-Chun Chang)；洪麗玲(Li-Ling Hung)；周郁文(Yu-Wen Chou)；林麗美(Li-May Ling)

原住民護理學生 ； 肺結核知識 ； 肺結核知覺 ； 意向 ； indigenous nursing student ； tuberculosis knowledge ； perceptions of TB ； intention

The Journal of Nursing Research

15卷1期（2007 / 03 / 01）

78 - 87

英文

本研究之目的是調查原住民護理學生之肺結核知識、肺結核之知覺以及參與每年胸部X光檢查意向。方便取樣北部某技術學院五專部原住民護理學生，該校共有超過150個班級，總人數超過7千人，其中原住民學生佔20%-25%。依據前趨研究之檢力檢定得知樣本數需達485人。以隨機方式選取50班，針對選取班級之原住民學生進行調查。以每班約有20名原住民學生計算，共發出1000份問卷，回收865份有效問卷，有效回收率達86.5%。本研究為橫斷性調查研究，於2003年2月至2003年6月進行調查，以紙筆自我填答問卷方式，研究工具包含肺結核知覺與參與胸部X光檢查意向。研究結果顯示，原住民護理學生肺結核知識屬於一般程度、對於傳染方式與途徑有錯誤觀念、罹患肺結核知覺較低。知識與知覺障礙與利益有顯著相關。罹患肺結核可能性與嚴重性之知覺較高、以及知覺對抗肺結核障礙較低者其每年參與胸部X光檢查之可能性較高，建議護理學校應針對不同年齡與群體設計肺結核相關教育課程，衛生教育工作者也應設計衛生教育活動以導正錯誤之肺結核認知，提升對於罹患肺結核可能性與嚴重性之知覺，以增進採行防治行為之可能性。

The purpose of this study was to investigate knowledge, perceptions of tuberculosis (TB) and intent to receive chest X-ray screening among indigenous (Taiwanese of ethnic Malayo-Polynesian descent) nursing students in Taiwan. A convenience sample was chosen from an technical institute in northern Taiwan that maintained admission quotas and provided scholarships for indigenous students. This school had over 150 classes and around 7,000 students, about 20%-25% of whom were ethnically indigenous. A power analysis based on a pilot study showed that a large effect size required a minimum sample of 485. To attain this number, 50 classes from years one through five were randomly selected based on an expected sampling of 20 students per classroom. In all, 1,000 questionnaires were distributed and 865 returned, for a response rate of 86.5%. A cross-sectional study design was used, and this study was run between the months of February and June 2003. Survey responses were self-reported in two questionnaires that gathered information on respondent knowledge and perceptions regarding TB and intent to take chest X-ray tests. Study results showed a moderate level of general knowledge about TB, misunderstandings regarding transmission vectors, and low perceptions regarding susceptibility. The knowledge score was associated with perceived benefits and barriers to preventing TB. Different places of residence influenced perceived barriers to preventing and treating TB. Age was negatively associated with the perceived benefits of receiving a chest X-ray exam for TB. Indigenous nursing students with higher perceptions of susceptibility and severity and lower perception of barriers on preventing TB had a higher level of intent to take the X-ray exam. Nursing schools must address the subject of TB in-depth and design age-specific curricula that incorporate multifaceted strategies for different students. Additionally, health educators should design health education programs targeted to dispel misconceptions and improve both knowledge and levels of awareness of tuberculosis among the indigenous population in order to enhance their willingness and ability to detect TB.

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