Abstract
Cervical cancer occurs very frequently in Taiwan, and it is also a cancer with a high death rate, thus making it most suitable for screening and prevention. Since the overall Taiwanese women?s reception of cervical smear screen is comparatively lower than other countries, this study tries to investigate the factors that will help to enhance the screen rate. This research used Andersen?s medical service utilization behavioral mode as a research framework, and the data were from the ?Database of the investigation of the promotional knowledge, attitudes and behaviors of citizen?s health in Taiwan in 2002 published by the Health Bureau of Executive Yuan for analysis, The main objectives are to understand the factors that influence the utilization of the preventive and health service of cervical smear screen for the women in Taiwan, analyze demographically the variables related to the degree of satisfaction for the Taiwanese women who have utilized the cervical smear screening, and to understand the reasons for the people who did not utilize the preventive and health service of cervical smear screen. The results from statistic data analysis using the statistic software SPSS15.0 for descriptive statistics, chi-square evaluation, laddered logistic regression, factors analysis, credibility analysis, variables analysis, and multiple comparison are as follows:
I. An analysis of the prominently related variables with whether or not to receive cervical smear screen of tendency factors, enabling factors and needs factors by using the logistic regression model was
performed.: 6 variables of tendency factors with predictive value as to whether a woman receive cervical smear screen or not include age, marital status (having a spouse or single ), educational level, family structure, religion, and the knowledge of free smear examination offered by mandatory citizen health insurance; 4 variables with enabling factors with predictive value include average monthly income, district, whether receiving telephone or letter notices in the past year, and the degree of convenience of the examination location. One variable of needs factors with predictive value: is the suitability of the
examination time notified. The accuracy rate of laddered logistic regression model built by this research was 74.1%.
II. For the service satisfaction by the examinees of the smear screen, this research measured 6 aspects, namely, time needed for the examination, the comfortableness of the examination environment, the cleanness of the examining tools, the comfortableness of the examination process, the attitude of the medical personnel, and the privacy of the examination. After analysis of the 6 aspects which were grouped as the same dimension and good credibility, all the satisfaction scores were between 3.5 to 4.5, with the average satisfaction score of the 6 areas being 4.03 (the range of score is from 1 to 5).The highest score received, 4.30, was in the area of the time needed for examination, while the next highest score received, 4.22, was in the area of the attitude of the medical personnel. Some of the he demographic variables include: educational level, native place, group of jobs, religions, knowledge of cost free cervical smear covered by mandatory citizen health insurance, district, whether the patients received telephone or letter notices in the past year, the convenience of the examination location notified, the suitability of the
examination time notified, and the health condition perceived by oneself, and circumstances of the examination notified. An analysis of these demographic variables showed that many were all related significantly with the examinees? satisfaction level with the service provided.
III. The study has shown that the reasons not to receive cervical smear examination include the self- perception of a healthy physical condition, being afraid of internal examination or shyness,, being busy and other factors. Other reasons for patients not to accept cervical screening include unmarried women or
those without sexual behaviors, not having an uterus or the examination being unnecessary for old people.
Key words: Cervical Smear, Screen
