乳房X光攝影是台灣政府針對45-69歲婦女及40-44歲具乳癌家族史之女性每2年1次的免費癌症篩檢服務，也是目前國際上認為較有效的乳癌篩檢工具，但國內這項檢查的定期篩檢率卻只有約3分之2。然而，隨著現代乳癌年輕化及癌症時鐘快轉的發展趨勢，落實癌症防治政策，提高女性乳房攝影檢查篩檢率是必需受正視的課題。
本研究為橫斷面線上問卷之調查研究，旨在探討影響台灣高雄市女性定期進行乳房X光攝影檢查之因素。問卷設計主要是基於健康信念模式，其中包括六個構面，分別是1)自覺罹患性；2)自覺嚴重性；3)自覺行動利益；4)自覺行動障礙；5)行動線索；及6)自我效能。研究最終收集了157份有效問卷，其中64位(40.8%)受訪者表示有定期接受乳癌篩檢。
邏輯迴歸分析結果顯示，與因變量(女性是否定期接受乳房X光攝影檢查)具有顯著相關性之變項為1)自覺嚴重性(OR: 0.45; p<0.05)；2)自覺行動障礙(OR: 3.40; p<0.05)；3)自我效能(OR: 0.11; p<0.001)；4)年齡層(OR: 1.53; p<0.01)；迴歸模型的Nagelkerke-R平方值為0.56。
這項研究中發現到的顯著預測因子將有助於制定相關的衛生政策，以提升台灣女性的乳房攝影檢查篩檢率，從而降低乳癌的死亡率及晚期乳癌發生率。

Mammography is a free cancer screening service provided by the Taiwanese government for women aged 45-69 years and women aged 40-44 years with a family history of breast cancer every 2 years. It is also considered to be an effective breast cancer screening tool in the world, but the regular screening rate of this inspection in China is only about 2/3.However, with the trend of rejuvenation in breast cancer and cancer clock fast-forward, implementing cancer prevention policies and improving the screening rate of female mammography examinations are issues that must be taken seriously.
This study is a cross-sectional online questionnaire survey, which aims to explore the factors that affect the regular mammography examination of women in Kaohsiung, Taiwan. The questionnaire design is mainly based on the health belief model, which includes six facets, namely 1) perceived susceptibility; 2) perceived severity; 3) perceived benefits of taking action; 4) perceived barriers of taking action; 5) cues to action; and 6) self-efficacy. The study eventually collected 157 valid questionnaires, of which 64 (40.8%) respondents said they regularly receive breast cancer screening.
Logistic regression analysis showed that the variable that had a significant correlation with the dependent variable (whether women regularly receive mammograms) was 1) perceived severity (OR: 0.45; p<0.05); 2) perceived barriers of taking action (OR : 3.40; p<0.05); 3) self-efficacy (OR: 0.11; p<0.001); 4) age group (OR: 1.53; p<0.01); the Nagelkerke-R square value of the regression model is 0.56.
The significant predictors found in this study will help formulate relevant health policies to increase the mammography screening rate of Taiwan women, thereby reducing the mortality rate of breast cancer and the incidence of advanced breast cancer.

論文審定書....................................................................................................................... i
致謝.................................................................................................................................. ii
中文摘要......................................................................................................................... iii
英文摘要......................................................................................................................... iv
目錄................................................................................................................................. vi
圖次............................................................................................................................... viii
表次................................................................................................................................. ix
第 一 章 緒論.............................................................................................................. 1
第一節 研究背景與動機...................................................................................... 1
第二節 研究目的.................................................................................................. 3
第三節 研究流程.................................................................................................. 4
第四節 名詞解釋與操作型定義.......................................................................... 5
第 二 章 文獻探討...................................................................................................... 7
第一節 國內外女性乳癌疾病問題...................................................................... 7
第二節 乳癌與乳房攝影檢查............................................................................ 10
第三節 健康信念模式的發展與應用................................................................ 13
第四節 影響女性接受乳房攝影篩檢行為之因素............................................ 17
第 三 章 研究方法.................................................................................................... 32
第一節 研究設計................................................................................................ 32
第二節 研究架構................................................................................................ 32
第三節 研究假設................................................................................................ 34
第四節 研究工具................................................................................................ 34
第五節 研究工具之信效度分析........................................................................ 37
第六節 研究倫理審查........................................................................................ 39
第七節 資料處理與分析.................................................................................... 39
第 四 章 研究結果.................................................................................................. 41
第一節 研究樣本特性分析................................................................................ 41
第二節 雙變量分析............................................................................................ 56
第三節 多變項分析............................................................................................ 70
第 五 章 研究討論.................................................................................................. 72
第一節 女性接受乳房攝影檢查行為之概況.................................................... 72
第二節 影響女性接受乳房攝影檢查行為之相關因素.................................... 76
第三節 與其他相關研究結果之討論................................................................ 78
第 六 章 建議.......................................................................................................... 80
第一節 研究建議................................................................................................ 80
第二節 研究限制................................................................................................ 81
第三節 研究貢獻................................................................................................ 82
第四節 未來研究方向........................................................................................ 82
第 七 章 結論.......................................................................................................... 83
參考文獻...................................................................................................................... 84
附 錄............................................................................................................................ 95
附錄一 研究問卷引用同意書..............................................................................95
附錄二 問卷內容效度檢定專家名單..................................................................98
附錄三 40至69歲女性接受乳房攝影篩檢行為正式研究問卷.......................99

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