新移民婦女接受子宮頸抹片檢查之障礙因素

Perceived Barriers to Taking a Pap Smear: Predictors in Immigrant Women

背景：新移民婦女認為沒有生病就是健康，或因檢查不舒服、語言障礙及缺乏保險和就醫資源，而影響其做子宮頸抹片檢查的意願，其受檢率與接受檢查的影響因素值得關注，而國內研究極少探討此議題。
目的：本研究旨在瞭解新移民婦女在子宮頸抹片檢查的受檢率，對子宮頸癌易感性及嚴重性的認知、子宮頸抹片檢查的行動線索及障礙程度，並探討新移民婦女接受子宮頸抹片檢查之障礙因素。
方法：採橫斷式描述性相關研究設計，並以方便取樣於高雄某區域教學醫院之病房及門診收案100名新移民婦女進行調查。結構性問卷包括個案基本資料、子宮頸癌易感性及嚴重性認知量表、行動線索量表、以及子宮頸抹片檢查障礙因素量表。
結果：新移民婦女從未接受過子宮頸抹片檢查者佔25%，且對子宮頸癌易感性及嚴重性的認知略微不足。其中教育程度、有無做過抹片檢查及子女數是新移民婦女子宮頸抹片檢查障礙之重要預測因素，共可解釋檢查障礙總變異量之26.1%。
結論：實務應用建議針對就醫環境和婦女之出生國籍發展適當的介入措施，以改善新移民婦女接受子宮頸抹片檢查的參與。

Background: New immigrant women in Taiwan are believed to generally perceive that “no illness” infers good health. Because medical inspection induces feelings of discomfit and due to language barriers, limited / no insurance coverage and more limited access to medical resources, understanding better the motivation of immigrant women to take Pap smears, the actual examination rate and key factors that influence willingness is important. Coverage of this issue, however, is extremely limited in domestic research.
Purpose: This study aimed to investigate: (i) The Pap smear screening rate amongst immigrant women; (ii) Immigrant women’s perception of cervical cancer susceptibility and severity as well as cues to action and perceived barriers to taking a Pap smear; and (iii) Predictors of perceived barriers to taking Pap smears in this target population.
Methods: Using a cross-sectional descriptive correlation study design, 100 immigrant women were recruited from the outpatient clinic and inpatient wards of a regional teaching hospital in Kaohsiung. Structured questionnaires included a demographic survey, scales of susceptibility and cervical cancer severity, scales of cues to action and barriers to receiving a Pap smear.
Results: One-quarter (25%) of the surveyed population had never taken a Pap smear. Immigrant women perceived their knowledge somewhat insufficient with regard to cervical cancer susceptibility and severity. Level of education, previous Pap smear experience, and number of children represented significant predictors of perceived barriers in taking Pap smears, accounting collectively for 26.1% perceived variance.
Conclusions / Implications for Practice: Findings suggest that appropriate interventions should be targeted on the general healthcare population as well as tailored to specific immigrant national populations in order to improve Pap smear screening rates amongst immigrant women.