智能障礙者利用子宮頸抹片篩檢：研究架構之發展

Pap Smear Screening for Women with Intellectual Disabilities: Study Framework Development

10.30072/JDR.200909.0002

林金定(Jin-Ding Lin)

子宮頸抹片篩檢 ； 智能障礙者 ； Andersen's behavioral model ； Andersen's behavioral model ； intellectual disability ； Pap smear screen ； Pap smear

身心障礙研究季刊

7卷3期（2009 / 09 / 01）

182 - 190

繁體中文

子宮頸癌目前是國內婦女癌症發生率的第一位，可以說是婦女健康的隱形殺手，因此子宮頸抹片檢查是女性預防保健服務重要的項目之一，若能定期抹片即可早期發現早期治療，即有效可降低死亡率。國外研究顯示女性智能障礙者接受子宮頸抹片檢查主要的障礙因素包括一般醫療行政問題、家庭醫師之可近性、專業人員對個案的認知、檢查同意書的確認困難、主要照顧者之態度、個案本身的信念與經驗、健康訊息缺乏與個案本身行動的限制等。但國內缺乏針對此群體相關的生育健康研究研究，以致於女性智障者的子宮頸抹片檢查的利用情形與影響因素（需求面）、現有子宮頸抹片檢查醫療資源（供給面）、需求面與供給面之主要差距與合適的智能障礙者子宮頸抹片檢查之具體策咯資訊較為缺乏。本論文以Andersen的行為模式為基礎，嘗試研擬針對智能障礙者群體進行子宮頸抹片檢查需求與供給的分析，以有效界定子宮頸抹片檢查需求與供給的差距，以作為未來改善智能障礙者利用子宮頸片月檢查之具體方案之基礎。

Among preventive health services, several previous studies have identified that intellectual disability was always used as a reason for primary care physicians to remove them from the screening list, even though they are eligible for screening in health authority guidance. Therefore, access to primary care physicians and assumptions made by healthcare professionals about women with intellectual disabilities were vital factors that affect them to access cervical screening. To ensure Pap smear screening right of women with intellectual disabilities, it is necessary to examine the perception and experience of primary care physicians in the screening service toward women with intellectual disabilities in health care system. However, evidence-based screening recommendations and comprehensive study framework are lacking in this group of population in Taiwan. The present paper aims to present an integrated study framework based on Andersen’s behavioral model, to examine the Pap smear utilization and determinants (need side) among women with intellectual disabilities, and to describe the Pap smear service provision (supply side) in current healthcare system. Finally, the future health plan of Pap smear for women with intellectual disabilities will be developed based on the identified gap between health need and supply.

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