應用健康信念模式探討21-29歲臨床護理人員接受人類乳突病毒疫苗與子宮頸抹片檢查之相關因素:以北部兩所醫院為例

Abstract

Background: Cervical cancer is the fourth common cancer in women and HPV vaccination and Pap smear screening played important roles in primary prevention and secondary prevention of cervical cancer. Health Belief Model has been used extensively to study beliefs and health behaviors of vaccination and Pap smear testing. Many previous studies focused on students in HPV vaccination and females who aged over 30 years in Pap smear testing. Besides, nursing staffs play an important role in promoting health behavior about prevention of disease, but few studies focused on this group in Taiwan. Aim: To assess the predictability of taking HPV vaccine and Pap smear testing by socio-demographic variables, awareness and health belief among young nurses. Methods: We designed the structured questionnaire tested the validity by experts and analyzed the internal consistency (Cronbach’s α) to assess the reliability. Between 2016.09-2017.01 we collected 205 nurses from two hospitals in northern Taiwan. This data was analyzed by exploratory factor analysis, descriptive statistics, stepwise multiple linear regression and stepwise multiple logistic regression. Results: Among the 205 subjects, the vaccination rate was about 42.4%. The significant associated factors included awareness, perceived barriers, action cues and self-efficacy (5.5 vs. 5.0, p-value=0.009; 7.6 vs. 13.5, p-value <.0001; 11.9 vs. 8.3, p<0.0001; 3.1 vs. 2.4, p-value=0.003). Moreover, the significant predictors included perceived barriers, self-efficacy and family history of cervical cancer (β=-0.22, Wald X2=20.24, p-value<.0001; β=0.28, Wald X2=20.5, p-value<.0001; β=1.52, Wald X2=4.56, p-value= 0.03) The rate of Pap smear testing was about 26.4%. The significant associated factors included awareness, perceived barriers, action cues and self-efficacy (5.7 vs. 5.0, p-value= 0.006; 7.6 vs. 13.5, p= 0.0004; 9.9 vs. 8.4, p-value= 0.005; 3.4 vs. 2.8, p-value= 0.006). Moreover, the significant predictors included awareness, perceived barriers, action cues and specialty nurses (β=0.25, Wald X2=4.06, p-value=0.04; β=-0.11, Wald X2=10.64, p-value=0.001; β=0.28, Wald X2=5.44, p-value=0.02; β=0.82, Wald X2=4.84, p-value=0.03). Conclusions: The awareness of cervical cancer, perceived barriers, self-efficacy and action cues influence the subjects taking the prevention of cervical cancer. Therefore, providing on-job education of cervical cancer, and a supportive environment are the key factors to young nurses in the preventions of cervical cancer.