婦女接受荷爾蒙補充療法的遵從行為與其更年期症狀緩解之相關研究

Hormone replacement therapy: the relationship ofwomen's compliance behaviors and effects of menopause symptoms relief

本研究旨在：1.瞭解國內更年期婦女接受荷爾蒙補充療法（HRT）之遵從行為；2.追蹤婦女在收案後第1及3個月，探討其症狀緩解與接受HRT遵從行為之相關性；及3.探討影響更年期婦女遵從HRT之主要因素。研究設計為縱貫式追蹤調查經門診醫師判定為更年期（不包括人工停經）婦女，並初次給予HRT者。依比例以簡單隨機抽樣選出北市區域級及以上醫院共4家，將該院家醫及婦產科之門診婦女，對符合選案條件者，全部收案。研究工具將郵寄至婦女家，由其自行填答後寄回。在回收的76（收案後第1個月，回收率29.09%）與55（第3個月，21.48%）份問卷中，婦女的平均年齡為51.18，46.9%已停經。自覺更年期不適之發生頻率最高的前三項依次為：腰酸背痛、感覺疲憊及性慾降低；而在接受HRT三個月後，更年期發生頻率與嚴重程度，皆未有明顯改善。但有規則服藥者（36.4%），其生活品質顯著優於不遵從者（38.2%）。在探討影響遵從行為的認知因素中發現，規則服藥者其對HRT的瞭解得分較低、覺得更年期不大嚴重，且覺得HRT使用上不太麻煩。預測何為影響婦女遵從HRT因素時發現，社會支持度、對更年期與HRT的瞭解程度、對更年期的嚴重性認知、對HRT的障礙性認知、與生活品質能預測婦女遵從HRT的行為。藉由本研究的發現，將可助醫護人員發展對更年期症狀適切的處置策略，進而保障婦女的健康。There is lack of valid research studies related to menopause and women's compliance in Hormone Replacement Therapy (HRT). This research project examined variables influencing women's compliance in HRT and the relationship to the relief of menopausal symptoms. A longitudinal follow-up research design was utilized to survey changes in women's compliance behaviors and menopausal symptoms 1 and 3 months after sample recruitment. The Health Belief Model was used for questionnaire design. Structural questionnaires were mailed to eligible and interested out-patients randomly selected from 2 medical centers and 2 regional hospitals in Taipei. Criteria for subjects inclusion were: women who 1) attend the ambulatory facilities, 2) are diagnosed by their physicians as menopausal, 3) whose treatment includes HRT. Based on Dillman's Total Design Method, all subjects would receive a follow-up phone call one week later after questionnaires were sent out. Another phone call was made nonrespondents only three and seven week after the questionnaire was sent. A total of 76 and 55 questionnaires were received within 1 and 3 months (response rates=29.09%, 21.48%). 46.9% of respondents had reached menopause stage, and the frequency for their menopausal symptoms was between 2.47-2.03. After 3 months' HRT treatment, women's symptoms and seriousness were not significantly improved. Knowledge toward menopause and HRT did not become better, either. Some concepts of the Health Belief Model were significant predictors for women's compliance behaviors. The compliance behavior (36.4%) was predicted by social support, knowledge, perceived seriousness, perceived barriers and quality of life. By identifying variables that may influence women's compliance with HRT and examining the effect of HRT in relieving menopausal symptoms, programs can be implemented to remove barriers, promote access, and to improve women's quality of life.