臺灣初次懷孕婦女生產方式意願調查

A Survey of Intention toward Childbirth Delivery Options among Taiwanese Primigravida

10.6518/TJOM.202004_(61).0001

戴君倚(Chun-Yi TAI)；黃莉婷(Li-Ting HUANG)；李昭暉(Chao-Hui LEE)；戴宏達(Hung-Da DAI)

生產方式意願 ； 剖腹產 ； 醫病共享決策

助產雜誌

61期（2020 / 04 / 01）

1 - 11

繁體中文

背景：臺灣剖腹產率居高不下一直被認為是懷孕婦女本身對採取剖腹方式來分娩有高度意願所導致的結果，為了呼應世界衛生組織（WHO）提出重新檢視高剖腹產率之相關議題和打破產科知識被視為鐵板一塊的分析模式，廣納各方醫護專業研究結果實有其必要性。目的：本研究旨在調查臺灣初次懷孕婦女對於其生產方式的意願傾向，以期豐富此議題在改革時之參考。方法：本研究以橫斷面研究法來收集人口學基本特性資料和研究者自行研發關於懷孕婦女對於其生產方式意願的調查題目，以7分李克特量表從-3（非常不同意）到3（非常同意）來計分。資料以IBM SPSS statistics 21來進行統計分析。結果：本研究共收案305位初產婦，平均年齡為32.52歲，平均妊娠週數為27.27週，以閩南人（78.0%）、大學畢業（50.8%）和沒有宗教信仰（61.4%）居多。在懷孕婦女的生產方式意願傾向調查結果發現婦女對於經陰道的分娩方式抱持著強烈的認同並對於採取剖腹方式來分娩抱持著些許不認同。結論：透過本研究結果改變對於懷孕婦女其生產方式的意願傾向之認識，期能藉此減少醫療團隊與懷孕婦女和其家庭成員在醫病共享決策過程中受到既有印象的影響。

1. Kuan, C. I.(2010).A reinterpretation of maternal requests for cesarean sections in Taiwan.Journal of Archaeology and Anthropology,72,97-136.
   連結：
2. 黃元德,黃瓊瑩,馬作鏹,郝宏恕(2007)。本國籍和外國籍產婦生產方式之差異及探討。台灣公共衛生雜誌，26(3)，169-176。
   連結：
3. 韓幸紋,連賢明(2010)。加倍自然產支付能否降低部腹產比例？。台灣公共衛生雜誌，29(3)，218-227。
   連結：
4. 羅紀琼(2003)。良辰吉時與剖腹生產。台灣公共衛生雜誌，22(2)，134-140。
   連結：
5. Aali, B. S.,Motamedi, B.(2005).Women’s knowledge and attitude towards modes of delivery in Kerman, Islamic Republic of Iran.Eastern Mediterranean Health Journal,11(4),663-672.
6. Ajzen, I.(1991).The theory of planned behavior.Organizational Behavior and Human Decision Processes,50(2),179-211.
7. Angeja, A. C.,Washington, A. E.,Vargas, J. E.,Gomez, R.,Rojas, I.,Caughey, A. B.(2006).Chilean women’s preferences regarding mode of delivery: Which do they prefer and why?.BJOG: An International Journal of Obstetrics and Gynaecology,113(11),1253-1258.
8. Béhague, D. P.,Victora, C. G.,Barros, F. C.(2002).Consumer demand for caesarean sections in Brazil: Informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods.British Medical Journal,324(7343),942.
9. Betran, A. P.,Torloni, M. R.,Zhang, J. J.,Gulmezoglu, A. M.,W. H. O. Working Group on Caesarean Section(2016).WHO Statement on Caesarean Section Rates.BJOG: An International Journal of Obstetrics & Gynaecology,123(5),667-670.
10. Cappell, J.,Pukall, C. F.(2018).Perceptions of the effects of childbirth on sexuality among nulliparous individuals.Birth,45(1),55-63.
11. Chu, K. H.,Tai, C. J.,Hsu, C. S.,Yeh, M. C.,Chien, L. Y.(2010).Women’s preference for cesarean delivery and differences between Taiwanese women undergoing different modes of delivery.BMC Health Services Research,10(1),138.
12. Courneya, K. S.,Conner, M.,Rhodes, R. E.(2006).Effects of different measurement scales on the variability and predictive validity of the “two-component” model of the theory of planned behavior in the exercise domain.Psychology & Health,21(5),557-570.
13. D’Souza, R(2013).Caesarean section on maternal request for non-medical reasons: Putting the UK National Institute of Health and Clinical Excellence guidelines in perspective.Best Practice & Research Clinical Obstetrics and Gynaecology,27(2),165-177.
14. Fishbein, M.,Ajzen, I.(1975).Belief, attitude, intention and behavior: An introduction to theory and research.Reading, MA:Addison-Wesley.
15. Francis, J. J.,Eccles, M. P.,Johnston, M.,Walker, A.,Grimshaw, J.,Foy, R.,Bonetti, D.(2004).Constructing questionnaires based on the theory of planned behaviour-A manual for health services researchers.
16. Gibbons, L.,Belizan, J. M.,Lauer, J. A.,Betran, A. P.,Merialdi, M.,Althabe, F.(2012).Inequities in the use of cesarean section deliveries in the world.American Journal of Obstetrics and Gynecology,206(4),e331-319.
17. Hong, Y. C.,Linn, G. C.(2012).Financial incentives and use of Cesarean delivery: Taiwan birth data 2003 to 2007.The American Journal of Managed Care,18(1),e35-41.
18. Kareev, Y.(2000).Seven (indeed, plus or minus two) and the detection of correlations.Psychological Review,107(2),397-402.
19. Klein, K.,Worda, C.,Leipold, H.,Gruber, C.,Husslein, P.,Wenzl, R.(2009).Does the mode of delivery influence sexual function after childbirth?.Journal of Women’s Health,18(8),1227-1231.
20. Kuhl, J.(Ed.),Beckmann, J.(Ed.)(1985).Action-control: From cognition to behavior.Heidelberg, Germany:Springer.
21. Lavender, T.,Hofmeyr, G. J.,Neilson, J. P.,Kingdon, C.,Gyte, G. M. L.(2012).Caesarean section for non-medical reasons at term.Cochrane Database of Systematic Reviews,14(3),CD004660.
22. Lin, H. C.,Xirasagar, S.,Tung, Y. C.(2006).Impact of a cultural belief about ghost month on delivery mode in Taiwan.Journal of Epidemiology and Community Health,60(6),522-526.
23. Liu, N. H.,Mazzoni, A.,Zamberlin, N.,Colomar, M.,Chang, O. H.,Arnaud, L.,Belizan, J. M.(2013).Preferences for mode of delivery in nulliparous Argentinean women: A qualitative study.Reproductive Health,10(1),2.
24. Lo, J. C.(2003).Patients’ attitudes vs. physicians’ determination: Implications for cesarean sections.Social Science & Medicine,57(1),91-96.
25. Lumbiganon, P.,Laopaiboon, M.,Gülmezoglu, A. M.,Souza, J. P.,Taneepanichskul, S.,Ruyan, P.,Villar, J.(2010).Method of delivery and pregnancy outcomes in Asia: The WHO global survey on maternal and perinatal health 2007–08.The Lancet,375(9713),490-499.
26. Mazzoni, A.,Althabe, F.,Liu, N. H.,Bonotti, A. M.,Gibbons, L.,Sanchez, A. J.,Belizan, J. M.(2011).Women’s preference for caesarean section: A systematic review and meta-analysis of observational studies.BJOG: An International Journal of Obstetrics and Gynaecology,118(4),391-399.
27. McDonald, E. A.,Brown, S. J.(2013).Does method of birth make a difference to when women resume sex after childbirth?.BJOG: An International Journal of Obstetrics and Gynaecology,120(7),823-830.
28. McKennell, A. C.(1974).Surveying attitude structures: A discussion of principles and procedures.Quality and Quantity,7(2),203-294.
29. Miller, G. A.(1956).The magical number seven plus or minus two: Some limits on our capacity for processing information.Psychological Review,63(2),81-97.
30. Saleh, D. M.,Hosam, F.,Mohamed, T. M.(2019).Effect of mode of delivery on female sexual function: A cross-sectional study.Journal of Obstetrics and Gynaecology Research,45(6),1143-1147.
31. Souza, J. P.,Gulmezoglu, A. M.,Lumbiganon, P.,Laopaiboon, M.,Carroli, G.,Fawole, B.,W. H. O. Global Survey on Maternal Perinatal Health Research Group.(2010).Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: The 2004-2008 WHO Global Survey on Maternal and Perinatal Health.BMC Medicine,8,71-80.
32. Zhang, J.,Troendle, J.,Reddy, U. M.,Laughon, S. K.,Branch, D. W.,Burkman, R.,Consortium on Safe Labor(2010).Contemporary cesarean delivery practice in the United States.American Journal of Obstetrics and Gynecology,203(4),e321-326.
33. 中華民國內政部統計處（2019）．108年第19週內政統計通報─新生兒生母狀況．取自https://www.moi.gov.tw/stat/node.aspx?cate_sn=-1&belong_sn=7887&sn=8171
34. 中華民國衛生福利部中央健康保險署（2013）．102年4月全民健康保險業務執行報告．取自http://www.nhi.gov.tw/resource/Webdata/23745_1_5%20102%E5%B9%B44%E6%9C%88%E4%BB%BD%E5%9F%B7%E8%A1%8C%E5%A0%B1%E5%91%8A%E5%85%A8%E6%96%87%E6%AA%94.pdf
35. 中華民國衛生福利部中央健康保險署（2019）．108年3月份全民健康保險業務執行季報告．取自https://www.tma.tw/NhiLumpSum/fiilesCo/1080426_108%E5%B9%B43%E6%9C%88%E4%BB%BD%E5%85%A8%E6%B0%91%E5%81%A5%E5%BA%B7%E4%BF%9D%E9%9A%AA%E6%A5%AD%E5%8B%99%E5%9F%B7%E8%A1%8C%E5%AD%A3%E5%A0%B1%E5%91%8A.pdf
36. 中華民國衛生福利部中央健康保險署（2011）．99年12月全民健康保險業務執行報告．取自http://www.nhi.gov.tw/Resource/webdata/Attach_17399_2_188%E5%9F%B7%E8%A1%8C%E5%A0%B1%E5%91%8A12%E6%9C%88(%E5%BD%9999.7.20%E9%96%8B%E6%9C%83%E4%BF%AE%E6%A0%BC%E5%BC%8F).pdf
37. 吳嘉苓(2010)。臨床因素的消失：台灣剖腹產研究的知識生產政治。臺灣社會學刊，45，1-62。
38. 黃俊元,楊銘欽,陳維昭(1997)。產婦特性與採用剖腹產：以台大醫院為例。中華公共衛生雜誌，16(4)，309-318。