聽見女性的聲音—更年期健康促進與照護需求調查

Abstract

背景：台灣女性平均壽命已超過84歲，約有三分之一的生命歷程處於更年期後階段。然現行醫療體系與公共政策長期以生育與疾病治療為核心，對中高齡女性的健康促進與照護需求著力甚少。更年期常遭過度醫療化，導致女性在面對身心轉變時缺乏支持與資源。過去相關研究多集中於生理症狀與荷爾蒙治療，較少從性別與公共衛生的觀點，系統性探討女性的健康知識、態度及照護需求。為填補此研究缺口，本研究以台灣中高齡女性為對象，透過設計具性別意識與本土文化意涵的問卷進行調查，分析其更年期經驗、知識、態度與照護需求現況，並檢視社會人口學因素之影響，以提供政策及衛教推動之參考依據。

目的：本研究旨在瞭解台灣年滿45歲女性更年期階段的健康經驗、知識、態度與照護需求現況，並分析年齡、婚姻、生育、教育與收入等社會人口學變項對更年期知識與態度之影響，期以建構具性別敏感度與文化脈絡之健康促進政策建議。

方法：本研究採橫斷式設計，研究工具為研究者自編之「更年期認知與照護需求調查問卷」，內容涵蓋五大面向：更年期經驗、更年期知識、更年期態度、照護政策與資訊使用、人口學特性。問卷經倫理審查通過（臺大行為與社會科學研究倫理委員會核准案號：202504HM039），於2025年6月至7月間以SurveyCake線上平台進行便利取樣，共回收332份，扣除無效問卷後有效樣本數為311份。資料分析採用描述性統計、交叉分析及多元線性迴歸，探討各社會人口學變項與更年期知識及態度之關聯性。

結果：研究結果顯示，多數受訪者具有一定程度的更年期知識，特別在基本生理概念與健康促進行動方面表現良好，但對疾病風險與就醫判斷的理解仍顯不足。迴歸分析結果指出，教育程度對更年期知識差異具顯著影響（p<0.001），教育程度愈高者知識得分愈高。在更年期態度部分，年齡及生育經驗為態度之顯著正向因子（p<0.05），年齡愈大及有生育經驗者對更年期抱持較為正向態度；更年期知識與態度則呈顯著負相關（p<0.05），顯示知識若著重疾病敘事、缺乏賦權與支持性內涵，反而可能強化焦慮與自我懷疑。此外，女性主要透過網路與非正式管道（如婦女團體、親友或社群媒體）獲取資訊，官方衛教資源能見度不足。

結論：本研究揭示，教育程度是影響更年期知識的重要因素，而生育經驗則有助於形塑正向態度，顯示社會經驗與性別角色對健康觀具有深刻影響。未來政策應發展分眾與分齡化的衛教策略，針對教育程度較低及未育女性提供友善教材與社區支持；同時，政策設計應跳脫以「婚育女性」為中心的預設框架，回應單身與未育女性在更年期階段的多樣需求。此外，建議建立跨平台的官方資訊整合機制，並推動具正向健康觀與女性賦權導向的衛教內容。政府亦應將婦女團體正式納入健康政策治理架構，建立長期合作與資源支持，方能有效促進中高齡女性的健康權益與照護可近性。

Background: The average life expectancy of women in Taiwan exceeds 84 years, with nearly one-third of their lifespan spent in the postmenopausal stage. However, current medical systems and public health policies in Taiwan have long prioritized fertility and disease treatment, paying insufficient attention to the health promotion and care needs of middle-aged and older women. Menopause is often over-medicalized, leaving women with insufficient support and resources to manage physiological and psychological transitions. Previous studies have primarily focused on physiological symptoms and hormone therapy, with few adopting gender and public health perspectives to systematically examine women’s health knowledge, attitudes, and care needs during menopause. To address this research gap, this study designed a gender-sensitive and culturally contextualized survey to explore Taiwanese women’s menopausal experiences, knowledge, attitudes, and care needs, as well as the sociodemographic factors influencing them, with the goal of providing evidence-based insights for policy and health education initiatives.

Objectives: This study aims to investigate the health experiences, knowledge, attitudes, and care needs of Taiwanese women aged 45 and above during menopause, and to analyze the effects of sociodemographic factors—including age, marital status, parity, education, and income—on menopausal knowledge and attitudes. The ultimate goal is to develop gender-sensitive and culturally relevant health promotion policy recommendations.

Methods: A cross-sectional design was adopted. The main research instrument was the Menopause Cognition and Care Needs Survey Questionnaire, developed by the researcher. The questionnaire covered five major domains: menopausal experiences, menopausal knowledge, menopausal attitudes, care policies and information use, and demographic characteristics. The study was approved by the NTU Behavioral and Social Sciences Research Ethics Committee (Approval No. 202504HM039). Data were collected via the online platform SurveyCake from June to July 2025 using convenience sampling. A total of 332 responses were received, of which 311 were valid. Data analysis included descriptive statistics, cross-tabulation, and multiple linear regression to examine the associations between sociodemographic variables and menopausal knowledge and attitudes.

Results: The findings revealed that most respondents possessed a moderate level of menopausal knowledge, performing well in basic physiological understanding and health-promoting behaviors but showing limited comprehension of disease risks and medical decision-making. Regression analysis indicated that education level was a significant predictor of menopausal knowledge (p<0.001), with higher educational attainment associated with greater knowledge scores. Regarding menopausal attitudes, age and parity were significant positive predictors (p<0.05), suggesting that older women and those with childbirth experience reported more positive views toward menopause. Conversely, menopausal knowledge and attitudes were negatively correlated (p<0.05), suggesting that knowledge centered on disease narratives, lacking an empowering and supportive framework, could potentially heighten anxiety and self-doubt. Additionally, women primarily accessed information through the internet and informal sources (such as women's organizations, friends, or social media), underscoring the low visibility and accessibility of official health education resources.

Conclusions: This study highlights that education level is a key determinant of menopausal knowledge, while childbirth experience contributes to forming positive attitudes, reflecting the profound influence of social experience and gender roles on women’s health perceptions. Future policies should adopt segmented and age-specific health education strategies, providing user-friendly materials and community support for women with lower educational attainment or without childbirth experience. Policy design should also move beyond the assumption of “married or childbearing women” as the norm, ensuring inclusivity of single and nulliparous women. Furthermore, establishing integrated cross-platform official information systems and promoting empowerment-oriented, positive health education are essential. The government should formally incorporate women’s organizations into health policy governance frameworks, ensuring sustainable collaboration and resource support to enhance health equity and access to care among middle-aged and older women.