母親接受子宮頸抹片篩檢及女兒接種HPV疫苗之相關因素分析──以桃園市育有12-17歲青少女之母親為例

Factors associated with mothers’ health behaviors with regard to receiving Pad-smear screening for themselves and human papillomavirus vaccination for their adolescent daughters in Taoyuan City: a health belief model approach

目標：本研究旨在以健康信念模式探討母親讓女兒接種HPV疫苗、自己接受子抹篩檢之相關因素，以及兩項健康行為之間的關係。方法：透過NIIS系統選取桃園市12-17歲女學生之家戶資料，依分層隨機抽樣並以女學生之母親為對象進行電話調查，最後以羅吉斯複迴歸檢視影響其健康行為之相關因素。結果：職業、地區都市化程度、對HPV疫苗有效性認知是影響女兒接種HPV疫苗的顯著因子；母親接受子抹篩檢的顯著影響因子則有年齡、職業、醫療院所之行動線索、以及對子抹篩檢的障礙性認知。女兒接種HPV疫苗與母親接受子抹篩檢這兩項健康行為呈正相關，並且女兒接種HPV疫苗可以顯著影響母親後續接受子抹篩檢的意願與行為。結論：加強母親對HPV疫苗之有效性認知、降低母親對子抹篩檢之障礙性認知，乃是促使母親採取子宮頸癌預防行為之重要關鍵。而推動青少女免費HPV疫苗政策非僅可達一級預防效果，也可促進母親接受子抹篩檢的意願與行為，對於推動子宮頸癌之二級防治亦有實質助益。

Objectives: The purpose of this study was to explore factors influencing mothers’ health behaviors with regard to Pad-smear screening for themselves and human papillomavirus (HPV) vaccination for their adolescent daughters. Methods: Based on data from the National Immunization Information System (NIIS), we selected families with daughters aged 12-17 in Taoyuan City and interviewed the mothers. We adapted the stratified random sampling method, and a computer assisted telephone interview was conducted in October 2016. We used chi-square tests, point-biserial correlations, and multiple regression models to analyze the 1,031 valid samples. Results: After multiple logistic regression analysis, we found that the statistically significant factors influencing HPV vaccination of teenage girls were: mothers’ occupation, living area, and perceived effectiveness of the HPV vaccine. We also found that mothers’ cues to action, perceived barriers to Pad-smear, and particularly, the daughters’ HPV vaccination, could significantly predict mothers’ later use of Pad-smear screening. Conclusions: The policy of HPV vaccination for adolescent girls could not only achieve the primary prevention of HPV, but could also improve the secondary prevention of cervical cancer. Base on this win-win policy, we suggest that health sectors should provide more comprehensive information for the public about the HPV vaccine in order to improve mothers’ perceived benefits, and therefore to increase the rate of HPV vaccine of adolescent girls. Furthermore, the most significant predictor, a convenient and friendly environment for women to receive Pad-smear screening, should be taken into account in order to reduce the perceived barriers to Pad-smear screening.