社區民眾接受大腸癌篩檢之相關因素探討

To Explore the Related Factors of Colorectal Cancer Screening in the Community

黃于玲

大腸癌篩檢 ； 因素 ； 社區 ； 成人 ； colorectal cancer screening ； factor ； community ； adult

長榮大學護理學系(所)學位論文

2016年

碩士

黃芷苓

繁體中文

背景： 台灣近幾年大腸癌蟬聯癌症十大死因第三名，研究指出篩檢可以大幅降低大腸癌死亡率，而台灣糞便潛血檢查比率僅40.7%，明顯低於子宮頸癌及口腔癌篩檢，目前國內針對民眾接受大腸癌篩檢行為的相關研究仍顯不足。 目的：探討影響民眾接受大腸癌篩檢之相關因素。 方法：本研究為橫斷式相關性研究，收案期間為2015年10月至2016年1月，收案對象為居住在南部某社區的民眾共200位，選樣條件為年齡於50-74歲之民眾、居住於社區、聽力與口語表達不妨礙溝通者和可以國台語表達者。排除條件為過去病史中曾被診斷嚴重精神疾病患者；被診斷為失智症，或以姓名、出生年月日及地址做簡易的認知功能評估，無法通過此評估者；已經確診為大腸癌患者。以面對面訪談方式收集資料，研究工具為結構式問卷，問卷內容包括社區民眾社會人口學資料、個人及家族健康狀態、居住地醫療資源、對疾病的認知、態度及對篩檢的擔憂，統計方法為描述性統計、t檢定、卡方檢定、邏輯式回歸分析。 結果：本研究結果發現，過去一年參加全身性檢康檢查[AOR = 5.55，95% confidence interval (CI)：2.65-12.05]、就診時醫生或護理人員會按檢查時間或會定期收到通知單提醒應該做篩檢（AOR = 5.41，95% CI：1.64-22.11）、篩檢態度總分（AOR = 1.17，95% CI：1.05-1.32）是影響社區民眾接受大腸癌篩檢的重要因素。 結論：本研究結果可提供醫療院所及衛生單位推動大腸癌篩檢計畫介入措施之參考，建議衛生福利部中央健保署在制定成人健康檢查政策時，可同時將大腸癌篩檢列入檢查項目；建議社區護理師在推動大腸癌篩檢業務擬定相關策略時可利用各項管道提醒民眾受檢，另外針對大腸癌篩檢態度方面可加強衛生教育，使民眾有正確及正向態度，藉此提升社區民眾大腸癌篩檢率。

Background: In recent years, colorectal cancer has been the third leading cause of death for cancer in Taiwan. Previous studies indicated that colorectal cancer screening can tremendously reduce the mortality of. In Taiwan, the rate of the fecal occult blood test is only 40.7%, which is lower than the rates of cervical cancer screening and oral cancer screening. Few studies focused on the behaviors of colorectal cancer screening in Taiwan. Objective: This study is to aim at the related factors of the colorectal cancer screening. Method: This is a cross-sectional correlation study. Two hundred subjects were recruited in the community in southern Taiwan. The data was collected from October 2015 to January 2016. The inclusion criteria were: adults age 50–75; living in the community; and being able to communicate in Taiwanese/Mandarin The exclusion criteria were: people who had been diagnosed as severe mental illness patients in the past medical history; people who did not pass the simple cognitive assessment, such as name, date of birth and home address, or had been diagnosed to have dementia; and people who are currently the colorectal cancer patients. The structured questionnaire included socio-demographic data, individuals and family health status, nearby medical resources, the related knowledge of the disease, and attitudes and concerns about taking colorectal cancer screening. The statistical methods were descriptive statistics, t-test, chi-square test, and logical regression analysis. Results: There are major factors influencing participants taking the colorectal cancer screening: (1) have had full physical examination last year (AOR = 5.55,95% confidence interval (CI):2.65-12.05), (2) receiving the reminder or notice from doctor or nurse personnel (AOR = 5.41，95% CI：1.64-22.11), (3) attitude (AOR = 1.17，95% CI：1.05-1.32). Conclusion: The results of this study may provide suggestions to administrators of hospitals and health departments to promote colorectal cancer screening program. National Health Insurance Administration, Ministry of Health and Welfare could add colorectal cancer screening in the periodic adult heath examination. Community nurses could apply remaindering methods to promote colorectal cancer screening, as well as implement health education specific to attitudes of colorectal cancer screening to enhance the rate of colorectal cancer screening.

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