B型肝炎帶原者定期肝臟追蹤檢查行為意圖之相關因素探討

Abstract

本研究的目的是以Ajzen提出之計畫行為理論（Theory of Planned Behavior）為基礎，探討B型肝炎帶原者定期肝臟追蹤檢查之行為意圖及其影響因素。研究對象為參與財團法人肝病防治學術基金會肝炎肝癌檢驗活動篩檢出有B型肝炎帶原的民眾。研究工具為自擬之結構式問卷，依據計畫行為理論設計而成，藉由訪談15位B型肝炎帶原者尋找定期肝臟追蹤檢查的顯著信念，再依此編製成正式問卷，並以郵寄方式發放問卷。回收之有效問卷共248份，有效問卷回收率為25.0%，問卷量表之Cronbach’s α值大於0.6。所收集到之資料以描述性統計、皮爾森積差相關、獨立樣本t檢定、單因子變異數分析、事後檢定及複迴歸分析等統計方法進行分析。研究結果如下： 一、82.7%的研究對象認為有可能與非常有可能在未來三年間，至少每半年至一年做一次肝臟追蹤檢查。 二、研究對象對定期肝臟追蹤檢查的行為態度、主觀規範、知覺行為控制分別與其構成信念「行為信念與行為結果評值的乘積總和」、「規範信念與依從動機的乘積總和」、「控制信念與知覺力量的乘積總和」呈正相關。 三、研究對象之行為態度、主觀規範及知覺行為控制皆與其定期肝臟追蹤檢查行為意圖呈正相關，三者共可解釋研究對象定期肝臟追蹤檢查行為意圖39.7%的變異量，其中知覺行為控制為最主要之預測因子。 四、研究對象之「行為信念與行為結果評值的乘積總和」、「規範信念與依從動機的乘積總和」及「控制信念與知覺力量的乘積總和」皆與其定期肝臟追蹤檢查行為意圖呈正相關，三者共可解釋研究對象定期肝臟追蹤檢查行為意圖35.4%的變異量，最主要之預測因子為「控制信念與知覺力量的乘積總和」。 五、外在變項無法在行為態度、主觀規範及知覺行為控制外，顯著增加對定期肝臟追蹤檢查行為意圖的解釋力。 由本研究結果得知，計畫行為理論能夠應用在預測B型肝炎帶原者定期肝臟追蹤檢查之行為意圖，其中最主要之預測變項為知覺行為控制。建議未來可再做縱貫性的研究以觀察研究對象是否持續執行定期肝臟追蹤檢查的行為。

The study was based on the Theory of Planned Behavior (TPB) by Ajzen to know the behavioral intention of receiving regular liver disease surveillance and its relevant factors in hepatitis B virus (HBV) carriers. Research participants were recruited from the HBV carriers who had joined in hepatitis and hepatocellular carcinoma screening programs by Liver Disease Prevention and Treatment Research Foundation. The instrument of the study was the questionnaire designed by the researcher. Before designing the questionnaire, researcher had interviewed 15 HBV carriers to know their salient beliefs of receiving regular liver disease surveillance. The questionnaire was based on the salient beliefs in the interview data and its Cronbach’s α was higher than 0.6. The questionnaires were sent by post. The response rate was 25.0% and 248 valid questionnaires were returned. The data was analyzed by descriptive statistics, Pearson product-moment correlation, independent-samples t test, post-hoc analysis, and multiple regression analysis. The results are: (1)82.7% of the participants thought they will or may receive regular liver disease surveillance once a year or every six months in the next three years. (2)Participants’ attitude toward regular liver disease surveillance (AB) positively related with the sum of the product of the behavioral beliefs multiplied by evaluations of the behavioral outcomes. Participants’ subjective norm (SN) associated with regular liver disease surveillance positively related with the sum of the product of normative beliefs multiplied by motivation to comply. Participants’ perceived behavioral control (PBC) of regular liver disease surveillance positively related with the sum of the product of control beliefs multiplied by perceived power. (3)The AB, SN, and PBC positively related with the behavioral intention of receiving regular liver disease surveillance, and explained 39.7% variance of the behavioral intention. The major predictor of participant’s behavioral intention was his/her PBC. (4)The sum of the product of behavioral beliefs multiplied by evaluations of behavioral outcomes, the sum of the product of normative beliefs multiplied by motivation to comply, and the sum of the product of control beliefs multiplied by perceived power also positively related with the behavioral intention of receiving regular liver disease surveillance, and explained 35.4% variance of the behavioral intention. The major predictor of the behavioral intention was the sum of the product of control beliefs multiplied by perceived power. (5)In addition to the AB, SN, and PBC, the external variables (ex. demographic variables) did not significantly relate with the behavioral intention. The study showed that the TPB could be applied to predict the behavioral intention of utilizing regular liver disease surveillance and the major predictor of the behavioral intention was PBC. Further study should be done longitudinally to follow up whether participants receive regular liver disease surveillance.