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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 簡國龍 | |
dc.contributor.author | Hui-Ping Chen | en |
dc.contributor.author | 陳慧萍 | zh_TW |
dc.date.accessioned | 2021-06-16T23:17:26Z | - |
dc.date.available | 2013-09-17 | |
dc.date.copyright | 2012-09-17 | |
dc.date.issued | 2012 | |
dc.date.submitted | 2012-08-01 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/65039 | - |
dc.description.abstract | 背景及目標:
因國人十大死因以惡性腫瘤為首,癌症防治重點應早期發現、早期治療,癌症篩檢時常被國人忽略,因為健康信念差異產生的障礙,造成目前癌症篩檢率偏低,尤其以大腸直腸癌、口腔癌的篩檢率不到兩成,因此本研究目的在於以因地制宜的執行整合性健康照護網絡計劃,以提升癌症篩檢成效。 方法: 本研究為橫斷式研究,計劃執行期間為100年1月30日至100年12月30日,利用社會行銷的概念,透過行銷4Ps規劃整合性健康照護網絡策略,並評價參與者與計劃成效之相關性。第一部分促進民眾參與癌症篩檢行為,例如集點換贈品、婦女月刮刮卡的活動、民間社團宣傳、鄰里廣播設站等方式,第二部分另促進轄區內基層醫療提供者的在地資源整合,並進行結盟,給予工作人員優勢能力訓練、創造與衛生所的互動機會及輔導合約診所篩檢流程的建置、並提供誘因,增加癌症篩檢成效。樣本以立意取樣,研究測量以結構式自填問卷,問卷利用探索性因素分析建構效度、Cronbach alpha建構問卷內在一致信度。第一部份請接受服務的民眾填寫防癌行為有關的問卷,內容包括:基本人口學資料、自覺疾病威脅性、行動線索、癌症知能、獲得篩檢利益、障礙及自我效能等量表。第二部份以新莊合約基層院所為研究族群,請診所或藥局人員填寫社區健康照護網絡計劃運作的問卷,包括:診所或藥局的基本特性、工作人員基本資料、對健康照護網絡運作之優勢向度、劣勢向度、機會向度及威脅向度。 結果: 實習期間共收集民眾687份問卷,合約診所工作人員223份問卷。從篩檢的民眾問卷萃取出獲得宣傳訊息、行為障礙兩個重要因素,運用邏輯斯迴歸分析,控制其他變項,探討影響民眾參與社會行銷篩檢行為,以獲得宣傳訊息因素達統計相關。基層醫療工作人員問卷調查萃取出機會、優勢、劣勢因素,經廣義估計方程式並調整干擾變項及聚集效應後,子宮頸抹片檢查篩檢成效、免疫法糞便潛血檢查篩檢成效、口腔癌篩檢成效與機會、優勢因素皆有顯著相關。 結論: 本研究發現整合性健康照護網絡計劃提供以下有效的相關因素,包含有效的宣傳訊息會促使民眾前來接受癌症篩檢,而創造機會給子宮頸抹片檢查提供者並強化工作人員的優勢能力給免疫法免疫法糞便潛血檢查、口腔癌篩檢的提供者,必能增加癌症篩檢成效。此研究結果以俾往後在執行以社區導向的癌症篩檢計畫上,能有一定參考的價值,亦幫助基層公共衛生實務推動 | zh_TW |
dc.description.abstract | Background: Cancer has been the leading cause of death in Taiwan. Cancer control is an important early detection and treatment. The differences of health beliefs from the users may ignore the cancer screenings behavior. To bring of low cancer screening rate, especially in colorectal cancer and oral cnacer screening rate often less than 20%. The aim of this study is to investigate the prevalence and possible causal factors of social marketing project related to the user and the provider.
Methods: The study was cross-sectional designed and divided into two parts. The period of the project is from Jan. 2011 to Dec. 2011. We design multifaceted social marketing intervention project including mass media, small media, scratch card, collecTable exchange for gift to user, client incentives, strength of traning capability, opportunity of learning interactive, counseling process to provider, increase cancer screening in primary care settings serving in xinzhuang urban New Taipei city. The participants in the 1st part were invited from user. Each participant completed a structured questionnaire which includes demographic data, perceived threat, cue to action, perceived benefits, perceived barriers, self efficacy and cancer knowledge. The 2nd part would be performed at contract clinics. Each subject completed the questionnaire which includes opportunity, strength, weakness and threat. Result: The period of 687 users and 223 subjects participated in the marketing activities. In the 1st part, we found the information factor from the exploratory factor analysis in the questionnaire. In the multiple logistic regression analysis we considered sex, age, race, belief, occupation, smoking and drinking, exercise and cancer knowledge. The information factor score was significantly and indicated that user with social marketing campaign. In the 2nd part, the provider was considered by controlled cluster effect and practice division, nature of practice and staff age. The opportunity factor score and strength factor score are effective of cancer screenings. Conclusion: We clearly integrated healthcare network program associated with information factor that induced user to receive cancer screening services. The program created opportunities, intensifying strength for provider to increase the amount of cancer screening. Further studies provide social marketing approach for community-based intervention to promote cancer screenings. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T23:17:26Z (GMT). No. of bitstreams: 1 ntu-101-R99847019-1.pdf: 3849330 bytes, checksum: ff72578e47fcaca820eb2d0f2ceb7ffd (MD5) Previous issue date: 2012 | en |
dc.description.tableofcontents | 謝 辭 i
中文摘要 ii 英文摘要 iv 目錄 vi 第一章 實習單位簡介 1 1-1 新莊區歷史沿革 1 1-2 新莊區人口年齡分布 1 1-3 新莊區民健康需求與社區基層醫療資源 1 第二章 研究背景 3 第一節 建構整合性社區健康照護網絡計劃平臺 3 2-1-1健康轉運站形成 3 2-1-2 健康照護網絡之社會行銷的概念 4 第二節 癌症篩檢民眾之健康信念因素 5 2-2-1 健康信念模式的定義及影響因子 5 2-2-2相關民眾癌症篩檢計劃之文獻回顧 6 第三節 社區基層醫療的角色 7 2-3-1 SWOT模式定義及影響因子 7 2-3-2相關基層醫療提供者與癌症篩檢之文獻回顧 8 第四節 過去研究的不足之處 8 第三章 研究動機與目的 10 第一節 研究動機 10 3-1-1四大癌症篩檢現況 10 3-1-2 癌症防治計劃以都市型衛生所轉型為例 10 第二節 研究目的 11 3-2-1研究假說 11 3-2-2研究架構 11 第四章 研究材料與方法 14 第一節 民眾的問卷調查 14 4-1-1研究對象 14 4-1-2問卷資料收集 14 第二節 基層醫療提供者的問卷調查 15 4-2-1 研究對象 15 4-2-2問卷資料收集 15 第三節 資料分析 15 4-3-1樣本數估計 15 4-3-2資料整理 16 4-3-3統計分析 16 第五章 研究結果 23 第一節 民眾的問卷調查 23 5-1-1研究樣本接受癌症篩檢民眾之人口學特性分布 23 5-1-2接受癌症篩檢民眾的問卷建構效度與信度檢測結果 24 5-1-3「是否為社會行銷宣傳而參加癌症篩檢」分成兩組之比較 26 5-1-4探討「接受社會行銷的癌症篩檢服務的行為」之相關性 27 第二節基層醫療提供者的問卷調查 27 5-2-1研究樣本基層醫療提供者工作人員之人口學特性分布 27 5-2-2基層醫療提供者的問卷建構效度與信度檢測結果 30 5-2-3以「癌症篩檢量多寡」分成兩組之比較 31 5-2-4探討「癌症篩檢量多寡」之相關性分析 33 第六章 討論 35 第一節 整合性健康照護網絡計劃之綜合討論 35 第二節 整合性健康照護網絡計劃之民眾影響因素討論 35 6-2-1不同的因素影響接受社會行銷宣傳癌症篩檢服務的民眾 35 6-2-2 研究對象民眾之代表性及外推性 37 6-2-3整合性健康照護網絡計劃之民眾參與社會行銷涵蓋率推估 37 6-2-4實務應用於民眾的宣傳訊息 37 第三節 整合性健康照護網絡計劃之基層合約診所影響因素討論 38 6-3-1不同的因素影響基層合約診所 38 6-3-2 研究對象基層診所之代表性及外推性 39 6-3-3整合性健康照護網絡計劃之基層診所參與社會行銷涵蓋率推估 39 6-3-4社會行銷之健康照護網絡計劃基層醫療者的實務課題 39 第四節 研究建議與限制 41 第七章 結論 43 第八章 參考文獻 44 Appendix 1-臺灣大學公共衛生學院倫理委員會審查書 99 Appendix 2-受試者同意書 100 Appendix 3-Questionnaire for user 101 Appendix 4-Questionnaire for provider 104 表目錄 Table 1臺灣篩檢政策 48 Table 2民眾健康信念行為問卷之歸類與計分 49 Table 3基層醫療院所SWOT問卷之歸類與計分 51 Table 4原始問卷接受癌症篩檢民眾之基本資料分布 (n=693) 53 Table 5原始問卷接受癌症篩檢民眾之癌症知能分布 (n=693) 55 Table 6原始問卷接受癌症篩檢民眾之自覺健康狀態與威脅性分布(n=693) 56 Table 7原始問卷接受篩檢民眾之行動誘因分布(n=693) 57 Table 8原始問卷接受篩檢民眾之自覺行動利益與障礙、自我效能分布(n=693) 58 Table 9原始問卷接受篩檢民眾之服務滿意度 (n=693) 59 Table 10 Exploratory Factor Analysis of health belief for user (total 16) 61 Table 11因素分析結果代表的變項 62 Table 12萃取重要因素變項之問卷信度結果 63 Table 13 Demographic description of user according to social marketing 64 Table 14 Logistic regression analysis of factors associated with user(N=687) 66 Table 15各基層服務單位回收問卷分布 67 Table 16原始問卷基層醫療提供者的基本資料問卷調查分布情況(n=223) 69 Table 17原始問卷健康轉運站優勢問題分布情況(n=223) 72 Table 18原始問卷健康轉運站劣勢問題分布情況(n=223) 74 Table 19原始問卷健康轉運站機會問題分布情況(n=223) 76 Table 20原始問卷健康轉運站威脅問題分布情況(n=223) 78 Table 21 Exploratory Factor Analysis and factor loading of SWOT analysis for provider(total 29) 80 Table 22基層醫療者問卷萃取出重要因素各代表的變項 82 Table 23基層醫療提供者依問卷分析結果進行信度檢測 84 Table 24 Provider Pap smear test amount with baseline data(n=90) 85 Table 25 Provider fecal occult blood test amount with baseline data(n=153) 86 Table 26 Provider oral cancer screening amount with baseline data(n=119) 87 Table 27 Factors associated with providers' Pap smear test amount(Registrations=18,N=90) 88 Table28 Factors associated with providers' fecal occult blood test(Registrations=34,N=153) 89 Table 29 Factors associated with providers' oral cancer screening(Registrations=29,N=119) 90 圖目錄 Figure 1 新莊區四大癌症死因死亡率分布 91 Figure 2 Social marketing to cancer screening interventions in healthcare 92 Figure 3 Assessment the factors of screening behavior using the health belief model for user 93 Figure 4社會行銷參與者之架構 94 Figure 5 Study matter for user (Questionnaire survey) 95 Figure 6 Study matter for provider (Questionnaire survey) 96 Figure 7 Pap smear test amount 97 Figure 8 Fecal occult blood stool test amount 97 Figure 9 Oral cancer screening amount 97 Figure 10 Sample size estimation of user 98 | |
dc.language.iso | zh-TW | |
dc.title | 以社會行銷的觀點探討都市社區
整合性健康照護網絡計劃與癌症篩檢成效 | zh_TW |
dc.title | Social marketing approach and the effectiveness of cancer screenings in an urban community-based integrated healthcare network program | en |
dc.type | Thesis | |
dc.date.schoolyear | 100-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 季瑋珠 | |
dc.contributor.oralexamcommittee | 黃文鴻,葉雅韻 | |
dc.subject.keyword | 社會行銷,整合性社區健康照護網絡計劃,癌症篩檢成效, | zh_TW |
dc.subject.keyword | social marketing,integrated healthcare network program,effectiveness of cancer screening, | en |
dc.relation.page | 106 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2012-08-01 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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ntu-101-1.pdf 目前未授權公開取用 | 3.76 MB | Adobe PDF |
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