台灣北部地區中高齡者的大腸直腸癌篩檢行為意向

Behavioral Intentions of Middle-Aged and Older Adults toward Colorectal Cancer Screening in Northern Taiwan

高潔純(Chieh-Chun Kao)；徐怡婷(Yi-Ting Hsu)；魯志薇(Chih-Wei Lu)；黃憶琳(Yi-Lin Huang)

大腸直腸癌 ； 健康信念模式 ； 中老年人 ； 癌症篩檢 ； Colorectal cancer ； Health belief model ； Middle-aged and older adults ； Cancer screening

醫學與健康期刊

7卷1期（2018 / 03 / 01）

41 - 52

繁體中文

目的：運用健康信念模式，了解台灣北部地區中高齡者的大腸直腸癌篩檢現況、篩檢行為意向及影響因素。方法：於2015年6至11月間，以方便取樣取得台北及基隆地區176名50歲以上門診病人為研究對象，運用結構式問卷進行調查，所蒐集到的資料再以SPSS 20.0電腦統計套裝軟體進行描述性統計與複迴歸分析。結果：僅42.6%中高齡者有大腸直腸癌篩檢經驗，影響篩檢行為意向的因子是「婚姻狀況」、「全家月收入」、「自覺行動利益」及「行動線索」，解釋力共為34.7%(R^2=0.347)，其中「行動線索」是最重要的影響因子。結論：超過半數的研究對象，未曾執行大腸直腸癌篩檢，建議健康單位主管，宜針對已婚、全家月收入低者，再加強篩檢的行動利益說明，並運用更多元化的傳播管道提供篩檢訊息，以促進中高齡者的大腸直腸癌篩檢行為。

Objectives. This study used the health belief model to examine participation in colorectal cancer (CRC) screening among middle-aged and older adults living in northern Taiwan, as well as investigate the factors influencing their intentions to participate in this screening. Methods. In the convenience sampling we conducted from June to November 2016, we recruited 176 outpatients aged 50 years or older living in the Taipei-Keelung region. A structured questionnaire was used to survey the participants, and SPSS 20.0 was used perform all statistical operations. Results. Only 42.6% participants had actually undergone the screening before. ＂Marital status,＂ ＂monthly family income,＂ ＂perceived benefits,＂ and ＂cues to action＂ explained 34.7% (R^2=0.347) of the variance in the aforementioned behavioral intentions. ＂Cues to action＂ was the most influential of all factors. Conclusion. More than half of the middle-aged and older adult population living in Northern Taiwan has never participated in CRC screening. Therefore, health care authorities may want to advocate the benefits of this screening to married couples and people with low monthly family incomes. In addition, such authorities are suggested to provide related information through more diversified communication channels to encourage middle-aged and older adults to participate in CRC screening.

1. 陳怡君、吳坤和、林為森(2010)。高雄地區民眾大腸癌篩檢行為及其影響因子。嘉南學報（科技類），36，291-301。
   連結：
2. 劉易承、宋鴻樟、謝玲玲、唐瑞平、葉志清(2008)。大腸直腸癌之風險預測模式與風險指標。臺灣公共衛生雜誌，27，1-12。
   連結：
3. Champion, VL,Skinner, CS(2008).Health Behavior and Health Education: Theory, Research and Practice.San Francisco:Jossey-Bass Press.
4. Galal, YS,Amin, TT,Alarfaj, AK(2016).Colon cancer among older saudis: Awareness of risk factors and early signs, and perceived barriers to screening.Asian Pac J Cancer Prev,17,1837-46.
5. Gilmore, G(2011).Needs and Capacity Assessment Strategies for Health Education and Health Promotion.Jones & Bartlett Publishers Press.
6. Martin, LR,Haskard-Zolnierek, KB,DiMatteo, MR(2010).Health Behavior Change and Treatment Adherence: Evidence-based Guidelines for Improving Healthcare.Oxford University Press.
7. Ng, S,Wong, S(2013).Colorectal cancer screening in Asia.Br Med Bull,105,29-42.
8. Palmer, RC,Chhabra, D,McKinney, S(2011).Colorectal cancer screening adherence in African-American men and women 50 years of age and older living in Maryland.Journal of Community Health,36,517-24.
9. Wong, RK,Wong, ML,Chan, YH,Feng, Z,Waiand, CT,Yeoh, KG(2013).Gender differences in predictors of colorectal cancer screening uptake: A national cross sectional study based on the health belief model.BMC Pub Health,13,677.
10. Zubaidi, AM,AlSubaie, NM,AlHumaid, AA,Shaik, SA,AlKhayal, KA,Alobeed, OA(2015).Public awareness of colorectal cancer in Saudi Arabia: A survey of 1070 participants in Riyadh.Saudi J Gastroenterol,21,78-83.
11. 邱瀚模(2008)。早期大腸癌的篩檢、診斷與治療。中華民國癌症醫學會雜誌，24，148-56。
12. 倪玉齡、吳桑妮、張純純、周郁文(2014)。提昇門診說明大腸癌篩檢轉介單之正確率。長庚科技學刊，21，151-60。
13. 殷杰、鄭尚新、高杰(2011)。門診患者大腸癌篩檢意願相關因素及腸鏡檢查障礙的調查。第二軍醫大學學報，32，500-03。
14. 翁昭旼(2014)。大腸直腸癌的防治。聲洋防癌之聲，145，7-9。
15. 財團法人資訊工業策進會：市場情報。取自http://www.ithome.com.tw/news/97479。引用05/31/2017。Institute for Information Industry: Market intelligence. Available at: http://www.ithome.com.tw/news/97479.Accessed May 31, 2017. [In Chinese]
16. 張珮涵、陳婷婷、江美鳳(2013)。提昇大腸癌篩檢陽性個案追蹤完成率之專案。護理雜誌，60，76-83。
17. 陳哲民、李熹昌、林光洋(2006)。大腸直腸癌篩檢。北市醫學雜誌，3，1-10。
18. 曾屏輝、林鴻儒、邱瀚模、李百卿、吳明賢、陳明豐(2009)。從實證醫學角度看自費健康撿查。內科學誌，20，532-43。
19. 歐吉性、余方榮、許文鴻、王聖雯、吳登強、胡晃鳴(2012)。大腸直腸癌的篩檢與監測及台灣施行現況。台灣醫界，55，124-27。
20. 蔡哲福、阮祺文、姜明凱(2011)。大腸癌篩檢與健康行為相關因素之研究─以中部某區域醫院為例。醫療品質雜誌，4，39-49。
21. 衛生福利部：104年主要死因統計結果分析。http://dep.mohw.gov.tw/DOS/lp-1777-113.html。引用05/31/2017。Ministry of Health and Welfare: Analysis of the ten leading causes of death in Taiwan in 2015. Available at: http://dep.mohw.gov.tw/DOS/lp-1777-113.html. Accessed May 31, 2017. [In Chinese]
22. 衛生福利部國民健康署：第1次大腸癌期別5年存活率統計。http://www.bhp.doh.gov.tw/BHPnet/Porta1/PressShow.aspx? No=201 00827000。引用05/31/2017。Health promotion Administration, Ministry of Health and Welfare: The first 5-year survival rate of colorectal cancer statistics. Available at: http://www.bhp.doh.gov.tw/BHPnet/Porta1/PressShow.aspx? No=201 00827000. Accessed May 31, 2017. [In Chinese]
23. 衛生福利部國民健康署：第二期國家癌症防治計畫-癌症篩檢（99-102年）。http://wd.vghtpe.gov.tw/cancer/Image/doc/law2.pdf。引用05/31/2017。Health promotion Administration, Ministry of Health and Welfare: The second phase of the national cancer prevention program - cancer screening (2000-2013). Available at: http://wd.vghtpe.gov.tw/cancer/Image/doc/law2.pdf. Accessed May 31, 2017. [In Chinese]

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