門診癌症患者參與心理社會介入之意圖評估——計畫行為理論之運用

Utility of the Theory of Planned Behavior (TPB) for Exploring Intentions to Participate in Psychosocial Intervention for Cancer Survivors in an Oncology Outpatient Department

研究目的：為了提升癌症病患能參與心理社會介入，促進其健康，本研究以計畫行為理論為基礎，並採間接測量的方式編製態度、主觀規範及覺知行為操控力之量表，以瞭解這三個因子是否能有效地預測癌症患者參與心理社會介入之意圖。研究方法：本研究採橫斷式研究，選取中部某醫學中心的癌症病患為研究對象，共招募312名已完成治療程序的癌症病患。所有受試者皆需填寫基本的臨床與人口變項、求助心理社會介入的過往行為經驗、求助心理社會介入的自我污名、疾病控制感及計畫行為理論等四份問卷。最終完成問卷者共有245位。研究結果：階層迴歸分析的結果顯示，當控制了基本的臨床與人口變項、求助心理社會介入的過往行為經驗、求助心理社會介入的自我污名、及疾病控制感之後，計畫行為理論中的態度、主觀規範及覺知行為操控力對於癌症患者參與心理社會介入之行為意圖，可再增加12.7%的解釋性。另外，高、低行為意圖者在正向的行為結果信念、支持的規範信念以及促進的控制信念中，具有顯著的差異。研究結論：本研究不僅支持計畫行為理論是評估癌症病患參與心理社會介入的有效架構，且驗證癌症患者對於心理社會介入之態度、主觀規範及覺知行為操控力是預測行為意圖的重要變項。最後，本研究根據此結果提出一些臨床上的建議。

Purpose: To enhance cancer survivors' intention to participate in psychosocial intervention, we used the TPB model with an indirect (belief-based) method to examine whether attitude, subjective norms, and perceived behavior control can significantly predict behavioral intention. Methods: Using a cross-sectional survey, 312 cancer patients in Taiwan were enrolled in this study and 245 participants completed all questionnaires, which assessed medical and demographic characteristics, past behaviors, self-stigma with seeking psychological help, controllability of illness, and the TPB variables (attitude, subjective norms, and perceived behavioral control). All procedures were authorized by the local Institutional Review Board. Results: Using hierarchical regression analysis, we found that the TPB variables explained an additional 12.7% of the variance of intentions after controlling for medical and demographic characteristics, past behaviors, self-stigma with seeking psychological help, and controllability of illness. Each of the TPB variables can significantly predict intention. In addition, we indentified some specific beliefs of the TPB variables that can discriminate low intenders from high intenders. Conclusions: Our study not only supports the validity of the TPB model, but also identifies some intentionrelated determinants. Strategies to improve cancer outpatients' intention to participate in psychosocial intervention are recommended.