從計劃行為理論觀點探討女大學生之月亮杯使用行為意圖及不同經期用品使用者之健康相關生活品質比較分析

Abstract

背景：2015年媒體上首次出現『你繳了多少月經稅?』、『台女募款300萬做月亮杯』等，有關「月亮杯 (menstrual cup)」此項新的經期用品之報導，然而台灣女性較普遍使用之經期用品為衛生棉及衛生棉條，故目前文獻中較缺乏關於台灣女性對月亮杯之使用意願與相關因素，及其與健康相關生活品質之關係。 目的：運用計劃行為理論 (Theory of Planned Behavior, TPB) 探討女大學生未來使用月亮杯之使用意圖與相關因素，並檢視不同經期用品使用者之健康相關生活品質是否存有差異。 方法：本研究於2016年12月至2017年1月期間，以TPB為架構編製之網路匿名自填式問卷進行資料收集，有效樣本為1,245位，並運用多變項羅吉斯迴歸分析台灣女大學生未來月亮杯使用意圖之相關因素，及運用多變項線性迴歸分析不同經期用品使用者 (衛生棉與衛生棉條)，影響其四大範疇之健康相關生活品質的相關因素。 結果：本研究發現，具有下列特質之女大學生，未來有較高之月亮杯使用意圖：對於正向行為結果評價之態度為相對中性 (AOR=2.82) 及相對正向(AOR=4.35) 者、對於負向行為結果評價之態度為相對正向者 (AOR=2.32)、主觀規範為中度 (AOR=2.22) 或高度 (AOR=1.88) 支持者，以及在阻礙情境下具有相對高度自我控制者 (AOR=3.40)。本研究亦發現性別氣質與性傾向具有調節作用。此外，不同經期用品使用者之健康相關生活品質存有差異，例如：於生理健康範疇，使用棉條者較使用衛生棉者，具較佳之生活品質 (β=0.054)；於社會健康範疇，使用棉條者 (β=0.059) 與使用月亮杯者 (β=0.071)，相較於使用衛生棉者，均有較佳之生活品質。 結論：本研究以TPB理論為架構探討女大學生使用月亮杯之行為意圖，並發現無論是行為態度、主觀規範或是自覺行為控制，皆為影響使用月亮杯意圖之重要因素，另也發現性傾向與性別氣質對於月亮杯使用意圖具調節作用，此外，本研究亦證實，使用不同經期用品者，其健康相關生活品質存有差異。本研究之結果，可提供未來於經期相關衛教上之實證參考數據，期能幫助女性選擇適合之經期用品，並提升其健康相關生活品質。

Background and Objectives: Menstruation plays an important role in women’s lives as it accompanies about half of their living years, and menstruation-related factors can influence their HRQOL. However, other than the commonly used sanitary pads and tampons in Taiwan, little is known about women’s intention to use the relatively new menstrual product, menstrual cups, even though they have been used in Europe and USA for decades. Therefore, this study aimed to explore the factors associated with menstrual cup use intention among female university students in Taiwan, using the Theory of Planned Behavior (TPB) as a theoretical framework, and to examine the relationships between different menstrual product use and the 4 domains of health-related quality of life (HRQOL). Methods: Data from 1,245 female university students in Taiwan were collected using an anonymous online survey based on the TPB in December, 2016 through January 2017. Multivariate logistic regression was employed to explore the factors associated with menstrual cup use intention, including their interactions with gender characteristic and sexual orientation. Then, multivariate linear regression was used to examine the relationships between different menstrual products use (tampon and pad users) and the 4 domains of HRQOL. Results: This study found that female university students with the following characteristics had higher menstrual cup use intention: those who had relatively neutral (AOR=2.82) or positive (AOR=4.35) attitudes about positive outcomes, relatively positive attitudes about negative outcomes (AOR=2.32), relatively neutral (AOR=2.22) or supportive (AOR=1.88) subjective norms, and relatively higher perceived control under constraining conditions (AOR=3.40). In addition, sexual orientation and gender characteristic were found to have moderating effects. For example, bisexual college girls with relatively masculine characteristic who perceived high control under constraining conditions had higher menstrual cup use intention (AOR=2.45). Further, different menstrual product users had different HRQOL in all 4 domains. For instance, in the physical health domain, tampon users had better HRQOL (β=0.054) than pad users; in the social domain, tampon users (β=0.059) and menstrual cup users (β=0.071) both had better HRQOL than pad users. Conclusions: This study used the TPB as a theoretical framework to systematically examine menstrual cup use intention among female university students. The results showed that those perceiving more positive attitudes, more supportive norms, and higher behavioral control had higher menstrual cup use intention. Also, sexual orientation and gender characteristic were critical moderators for menstrual cup use intention. In addition, the comparison between pad and tampon users revealed significant differences in factors associated with the 4 domains of HRQOL. Therefore, future menstrual health education could focus more on introducing the different features of various menstrual products and help users make informed decisions about which menstrual products could best suit their needs. The findings of this study can provide empirical evidence to inform future menstrual health promotion to improve women’s HRQOL.