臺灣東南亞籍婦女婦幼預防保健服務使用之滿意度及相關因素探討

Satisfaction of Matemal and Child's Preventive Care Use and Associated Factors among South-East Asian Immigrant Women in Taiwan

目的：本研究旨在瞭解新住民婦女婦幼預防保健服務使用滿意度現況，並以Andersen行為模式理論探討傾向、使能、需求及結果因素是否為婦幼預防保健服務使用滿意度的預測因子。方法：採橫斷式調查法，由某北部及中部縣市健康資料系統中分別抽取1076位及500位新住民婦女進行電話邀請後，以郵寄問卷進行資料收集。研究對象為越南（66.9％）、印尼（19.5％）、泰國（5.2％）及菲律賓籍（8.2％）婦女且家中有6歲以下兒童者，共完成133位新住民婦女資料的收集。研究變項包括新住民婦女基本資料、文化融合、健康狀況、就醫障礙、產前檢查時間及總次數、兒童預防保健服務使用時間及總次數、以及婦幼預防保健服務使用滿意度。結果：新住民婦女年齡平均28.68±4.31歲，在台灣時間平均5.72±2.54年，平均有2.2±1.38個就醫障礙、多屬「整合」之文化融合。婦幼預防保健服務滿意度平均23.33分（range＝5-30，SD=2.93），多數婦女的健康狀況為正常、總產檢次數平均10.06±2.93次、且多能全數完成兒童預防保健服務。以階層分析發現國籍、在台時間、原屬國家教育程度、就醫障礙、隔離、總產前檢查次數為婦幼預防保健服務使用滿意度的預測因子，共可解釋婦幼預防保健服務使用滿意度25％的變異量。結論：本研究驗證傾向、使能及結果因素為婦幼預防保健服務使用滿意度的預測因子，且突顯出文化因素在婦幼預防保健服務使用滿意度模式中的重要性，未來醫療人員必須提供具多元文化內涵的服務，以促進新住民婦女之婦幼預防保健服務使用滿意度。This is a report of satisfaction of maternal and child's preventive care use based on Andersen health seeking behavior model. The purpose of this study was to examine the predisposing, enabling, need and outcome factors among immigrant women in Taiwan, and further to explore predictors of satisfaction. The sample included 133 women living in 2 counties of Taiwan who are Vietnamese (66.9%), Indonesians (15.9%), Thailand (5.2%) and Filipinas (8.2%) women. A hierarchical multiple regression analysis was performed with satisfaction as the outcome variable. The results showed that women were with an average of 28.68 years old (SD=4.31), had lived in Taiwan for 5.72 years (SD=2.54) in Taiwan, with junior and high (vocational) school educational preparation in their original countries. There were in average 2.2 access barriers (range 0-8, SD=1.38) perceived by the subjects for seeking medical care; and 'integration' ranked highest in the 4 domains measured by the acculturation scale. Most of women were in normal health status, in average with 10.06 prenatal examinations (SD=2.93), and completed all children's preventive care use. The satisfaction was in average 23.33 (range 5-30, SD=2.93). The result of hierarchical multiple regression analysis indicated that six factors significantly predicted satisfaction of maternal and child's preventive care use: nationality, length of stay in Taiwan, educational preparation in the country of origin, access barrier, separation and prenatal care utilization. The six predictor variables contributed 25% in shared variability. Our findings indicated a significant positive relationship between predisposing, enabling, and outcome factors with satisfaction. In conclusion, this study revealed that acculturation was an important factor to influence the satisfaction of maternal and child's preventive care use. The clinicians could routinely identify immigrant women who might be in different acculturation and need more health support.