應用健康信念模式探討影響乳癌高危險群婦女執行乳癌篩檢行為之
因素
Determining Factors of Breast Cancer Screening Behaviors among High Risk Women Using Health Belief Model
中文摘要
台灣乳癌發生率及死亡率逐年增加中，對婦女健康已造成威脅，然而乳癌若能早 期發現早期治療，五年存活率相當高。已知危險因子中，家族史為一重要因素，
但這些高危險群婦女執行乳癌篩檢的比例卻與一般婦女相似，甚至還低的趨勢。
本研究為一相關性研究，旨以健康信念模式 7 個基本概念，即罹患性、嚴重性、
行動利益、行動障礙、行動線索、健康動機及自我效能，來分析影響乳癌高危險 群婦女執行乳癌篩檢行為之因素。採方便取樣，以結構式問卷收集北市乳癌支持 團體病友之一等女性血親之乳癌健康信念，及執行乳癌篩檢行為的現況。研究工 具採專家效度，信度採 Cronbach''s a，資料分析以描述性統計分析及 chi-square、logistic regression、stepwise logistic regression 推論性統計。共收集 158 位符合收案條件之乳癌病友之一等女性血親。
研究結果顯示（一）20(含)歲以上乳癌高危群婦女，能夠每月定期執行乳房自我 檢查為 27.2%；35 歲(含)以上之乳癌高危群婦女，能夠每年定期執行乳房攝影檢 查及臨床乳房檢查各為 33.7%，39.4%。(二)自我效能
、年齡、定期執行乳房自我檢查及乳癌知識，能影響乳癌高危險群婦女曾經、定 期或預期執行乳房自我檢查。(三)健康動機均能預測 35 歲(含)以上之乳癌高危群 婦女，曾經、定期或者預期執行乳房攝影檢查及臨床乳房檢查。(四)乳房攝影檢 查及臨床乳房檢查之篩檢行為，呈顯著相關性。
本研究結果可了解影響乳癌高危險群婦女執行乳癌篩檢行為之因素，以提供護理 人員擬定乳癌照護計劃之參考，使能早期診斷，早期治療，以降低乳癌對婦女健 康的威脅性。
關鍵字：家族史、高危險群、乳癌篩檢、健康信念
英文摘要
In Taiwan, breast cancer incidence rate and mortality rate had been increased
remarkably. However, five-year survival rate is very high if it could be early detected and treated. Family history is the most important risk factor of breast cancer. But breast cancer screening behaviors among high risk women were not different with general population, some studies even demonstrated less breast cancer screening behaviors.
This study was conducted by cross-sectional design and the purpose was to utilize
seven basic concepts of Health Belief Model; perceived seriousness, perceived
susceptibility, perceived benefits, perceived barriers, cues to action, health motivation, self efficacy to determine factors associated with breast cancer screening behaviors among high risk women. A structured questionnaire was utilized to collect data on a convenience sample. Instrument was evaluated by content validity and Cronbach’s a .The descriptive statistic,
chisquare, logistic regression, stepwise logistic regression were used for the study.
Data gathered from 158 first—degree female relatives of breast cancer patients.
The findings of the study as followed (1) Only 27.2% of high risk women aged 20 or above performed monthly breast self examination, 33.7% of high risk women aged 35 or above performed yearly mammography, and 39.4% of high risk women aged 35 or above performed yearly clinical breast examination . (2) Self efficacy, age, breast self examination regularly and knowledge of breast cancer were correlated with breast self examination. (3) Health motivation was correlated with mammography and clinical breast examination.(4)Breast self examination was significant correlated with mammography and clinical breast examination.
The findings of the study will help nurses to develop suitable nursing intervention of breast cancer screening behaviors in order to early detect or treat breast cancer.
Key words：family history, high risk women, breast cancer screening , health belief model.
