影響產婦接受無痛分娩意向之實證研究：以中南部三家教學醫院為例

Factors Affecting the Intention of Pregnant Women to Accept Painless Labor---an Empirical Study from 3 Hospitals in Centro-Southern Taiwan

目標：在台灣孕婦對於無痛分娩的接受度與利用率，遠遠低於先進的國家，而孕婦的選擇行為與行為意向受很多因素影響，本研究期能藉由實種研究，分析孕婦各項變數與其接受無痛分娩之關係，進一步尋找可能影響之相關或可預測之變數。方法：採問卷調查方式，以中南部三家醫院孕婦為對象，有效問卷563份，以ANOVA分析孕婦各項特質之差異，並以其接受無痛分娩意向強度為依變數，進行依序羅輯迴歸分析。結果：在孕婦各項自覺數中，年齡、婚齡、產次、無痛分娩經驗、教育程度、服務業、資訊接觸頻率、醫院員工、與公婆同住、月收入等對無痛分娩接受意向有顯著差異；以依序羅輯理歸模型分析結果為：依變數受到經驗、產次、醫院員工、與教育程度的顯著影響，其β值（勝算比）依序為3.0(19.7)、1.5(4.4)、0.6(1.9)與0.6(1.9)。結論：孕婦具有高薪、晚婚、初產婦、高教育程度、有無痛分娩經驗、高收入、服務業、醫護人員、常接觸資訊、未與公婆同住與居住於市區等以上特質者，其接受無痛分娩的意向較高。換言之，欲提高無痛分娩率可加強對其以上特質孕婦加強行銷。

Objectives: Painless labor prevails in developed countries, however, less than 20% of pregnant women had adopts this service in Taiwan. 'Behavior intention' has been proposed to play a major role based on the theory of planned behavior. This study aimed to investigate the characteristics of pregnant women affecting the intention to accept painless labor. Methods: It was conducted at the antenatal examination department of 3 teaching hospitals in centro-southem Taiwan between land 15 Nov, 2005, and a total of 800 self-designed questionnaires were send out to pregnant women who had not undergone Cesarean section and 563 valid subjects were recruited and analyzed. Results: It showed that women associated with characteristics including pervious history of painless labor, primipara , medical employees, higher education level and family incomes ,older age and marriage age, urban residency, living with parents-in-law, more painless labor information contact, and services industry were significantly more likely to receive the service of painless labor by ANOVA. Ordered logit regression analysis was used to explore independent variables contributing to the intention to accept painless labor and results showed that previous history of painless labor, primipara, medical employees, and higher education level were significant covariates and the beta coefficient estimates (odd ratios) were 3.0(19.7) ' 1.5(4.4) ' 0.6(1.9) and 0.6(1.9) respectively in this model. Conclusions: This finding of the current study suggest that the characteristics of pregnant women will influence the intention to accept painless labor. To promote painless labor rate, it may be helpful to focus on these pregnant women with characteristics such as previous history of painless labor, primipara, medical employees, and higher education level.