探討某醫療機構之門診民眾對B型肝炎的認知及其篩檢行為的影響因素

The Impact of Hepatitis B Knowledge on Screening Behavior Factors in Outpatients

背景：2011年衛生署資料顯示，肝癌位居國人癌症死因第二位，世界衛生組織也指出每年約有60萬人死於B肝病毒感染的相關合併症，由國內外現況可知B肝病毒感染是不容忽視的公共衛生議題。目的：了解民眾對B型肝炎的認知程度與執行篩檢之現況、並探討影響民眾執行B型肝炎篩檢行為的相關因素。方法：以方便取樣方式、選取282位門診民眾為對象，以描述性統計、獨立t檢定、單因子變異數分析、Spearman相關及複迴歸分析等方法分析。結果：55.7%民眾曾接受過篩檢且B型肝炎認知之平均得分為9.38、總平均答對率72.2%；而「親友是否罹患肝炎」、「B型肝炎認知」、「障礙性認知」及「行動線索」等變項對於篩檢行為的解釋力為12.3%，其中「障礙性認知」為最重要的預測因子。結論／實務應用：民眾B型肝炎認知有中上程度，但篩檢率不盡理想，結果發現「障礙性認知」是影響篩檢行為的關鍵因素，故建議未來可設立獨立門診進行有關B型肝炎篩檢的服務，減少民眾候診時間、增加便利性，也建議政策單位將篩檢費用列入考量，以提升民眾篩檢行為的動力。

Background: According to Taiwan Department of Health and World Health Organization statistics, hepatic tumors are the second leading cause of death from malignant disease in Taiwan, with 600,000 deaths from HBV (hepatitis B virus ) infected complication annually. Hepatitis B virus infection is thus an important issue in public health policy. Purpose: The aims of this study were to investigate hepatitis B knowledge and screening behavior and then identify significant prediction factors of hepatitis B screening behavior. Methods: A cross-sectional survey and convenience sampling were used to investigate 282 outpatients at the one target hospital. Descriptive statistics, independent t test, one-way ANOVA, Spearman relation, and multiple regression were used to analyze impact factors. Results: Slightly over half (55.7%) of the participants had received HBV screening. The average hepatitis B knowledge score was 9.38, with an average correct rate of 72.2%. ”Whether friends and relatives suffer from hepatitis B”, ”knowledge of hepatitis B”, ”perceived barriers to action”, and ”cue for action” explained 12.3% of total variance. Of these, ”perceived barriers of action” was the most important predictor of hepatitis B screening behavior. Conclusions: Although participant knowledge of hepatitis B was relatively good, the screening rate was less than ideal. Results point to ”perceived barriers of action” as a key factor affecting screening behavior. We suggest establishing an independent outpatient service to offer screening for hepatitis B in order to reduce waiting time and provide greater convenience. We also suggest the implementation of a policy to unify charges to raise public motivation to undergo screening.