基于健康信念模式的上海市社区妇女宫颈癌筛查行为影响因素研究  

Research of factors associated with cervical cancer screening behavior among community women in Shanghai based on health belief model

作　　者：夏嘉蔚 杨永彬[2] 葛正好 刘琦 冉青青 朱静芬[1] XIA Jia-wei;YANG Yong-bin;GE Zheng-hao;LIU Qi;RAN Qing-qing;ZHU Jing-fen(School of Public Health,Shanghai Jiao Tong University,Shanghai 200025,China)

机构地区：[1]上海交通大学公共卫生学院,上海200025 [2]上海交通大学附属第一人民医院妇产科

出　　处：《现代预防医学》2022年第5期819-823,共5页Modern Preventive Medicine

基　　金：上海市浦江人才计划(2018PJC097);上海市公共卫生三年行动计划(GWV-10.1-XK15)。

摘　　要：目的基于健康信念模式,初步探索社区妇女宫颈癌筛查行为的影响因素,以期提出针对筛查需方角度的建议,为优化宫颈癌筛查工作提供参考。方法对上海市2个区自愿参加宫颈癌筛查的社区女性487例进行问卷调查。应用χ^(2)检验与t检验进行不同筛查行为影响因素的比较,采用logistic回归评估各因素对筛查行为的影响。结果41.7%(203例)的调查对象从未参加过宫颈癌筛查,不同年龄(t=2.332,P=0.020)、户籍(χ^(2)=41.120,P<0.001)、文化程度(χ^(2)=11.169,P=0.004)、居住状况(χ^(2)=27.529,P<0.001)及职业(χ^(2)=7.905,P=0.019)的女性筛查率有差异。曾参与筛查者对宫颈癌筛查的益处认知得分高于从未筛查者(t=2.358,P=0.019),障碍认知得分低于从未筛查者(t=-7.443,P<0.001),有行为线索的比例也高于从未筛查者(χ^(2)=80.181,P<0.001)。障碍认知(OR=1.884,95%CI:1.311~2.709)与行为线索(OR=2.606,95%CI:1.245~5.453)是宫颈癌筛查行为的影响因素。结论障碍认知与行为线索对社区女性的宫颈癌筛查行为有影响,帮助改善障碍认知与行为线索是促进个体参与筛查的有效措施,并对不同特征人群开展针对性的宣教。Objective To make a preliminary investigation of factors associated with cervical cancer screening behavior among community women based on health belief model(HBM),to advance proposals from the perspective of the demand side,and to provide references for cervical cancer screening optimization.Methods A questionnaire survey was conducted on 487community women who volunteered for cervical cancer screening in two districts of Shanghai.Different screening behavior groups were measured for the differences byttest andχ^(2)test.And logistic regression was used to evaluate the influence of various factors on screening behavior.Results Of the 487 women,203(41.7%)had not been screened.Overall,significant differences were found to be in the participation rate of women with different ages(t=2.332,P=0.020),census registers(χ^(2)=41.120,P<0.001),educational levels(χ^(2)=11.169,P=0.004),living conditions(χ^(2)=27.529,P<0.001)and occupations(χ^(2)=7.905,P=0.019).The participated group had higher perceived benefits scores(t=2.358,P=0.019)and lower perceived barriers scores(t=-7.443,P<0.001)than never participants,while the proportion of participants with cues to action was also higher than that of never participants(c=80.181,P<0.001).The perceived barriers(OR=1.884,95%CI:1.311-2.709)and cues to action(OR=2.606,95%CI:1.245-5.453)were significant predictors of screening behavior.Conclusion Both Perceived barriers and cues to action have an impact on the cervical cancer screening behavior and improving them can promote community participation in cervical cancer screening effectively.And to carry out targeted education to different characteristic groups.

关 键 词：宫颈癌 筛查 影响因素 健康信念模式 

分 类 号：R173[医药卫生—妇幼卫生保健]