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系統識別號 U0026-2705201910382500
論文名稱(中文) 男同性間性行為者接種人類乳突病毒疫苗之企圖與行為探討
論文名稱(英文) Human papillomavirus vaccine uptake and factors associated with intention among men who have sex with men
校院名稱 成功大學
系所名稱(中) 公共衛生研究所碩士在職專班
系所名稱(英) Graduate Institute of Public Health(on the job class)
學年度 107
學期 2
出版年 108
研究生(中文) 姚柏伊
研究生(英文) Po-Yi Yao
學號 SB7061073
學位類別 碩士
語文別 中文
論文頁數 53頁
口試委員 指導教授-莊佳蓉
口試委員-林宗瑩
口試委員-柯乃熒
中文關鍵字 男同性間性行為者  人類乳突病毒疫苗之接種企圖  人類乳突病毒疫苗之接種行為 
英文關鍵字 men who have sex with men  Human papillomavirus vaccine uptake intention  Human papillomavirus vaccine vaccinate 
學科別分類
中文摘要 背景:人類乳突病毒(Human papillomavirus, HPV)除導致皮膚病灶外,更可能誘發男同性間性行為者(Men who have sex with men, MSM)肛門癌與陰莖癌,我國尚未針對MSM族群進行HPV疫苗接種企圖與接種行為之探討。
目的:欲透過MSM族群於HPV知識、HPV疫苗態度、HPV感染情形,進行結構方程式分析,來探討影響MSM族群接種HPV疫苗接種企圖與行為之相關因素。
方法:本研究期程從2015年10月至2016年5月,透過社區健康機構與社群來收案,收案條件須年滿20歲以上,曾有過男同性間性行為者(手淫、肛交、口交),完成同意書後將進行首次「HPV知識、HPV疫苗態度、HPV疫苗接種企圖」之自填問卷,並進行肛門與陰莖HPV檢查,半年後再完成疫苗接種狀態之調查。共171位納入研究分析(平均年齡為29.21±6.18歲)。各變項的描述性統計使用百分比、平均值、標準差來分析。並以結構方程式方法(Structural equation modeling, SEM)來分析HPV知識、HPV疫苗態度、HPV感染情形對HPV疫苗接種企圖與行為之影響。本研究使用SPSS 20.0和AMOS統計軟體進行資料分析
結果:本研究共收集253位MSM,排除資料遺漏過多、接種企圖答題不合邏輯、首次問卷已接種過HPV疫苗與未回覆半年後接種狀態之個案,共剩171位個案納入結果分析。SEM結果發現HPV知識會隨疫苗資訊度越不足而降低。且發現HPV知識得分越高時,疫苗價格上升到8000至12000元仍有接種企圖之情形會隨之上升,另外感知疫苗接種障礙越高時,疫苗價格上升到8000至12000元仍有接種企圖之情形似乎有隨之降低之傾向。並發現疫苗價格到8000至12000元仍有接種企圖者及肛門或陰莖檢查結果陽性者在半年後較容易出現HPV疫苗接種行為。
結論:HPV會導致男性生殖器疣和肛門癌與陰莖癌,且會造成醫療花費,過去研究發現HPV疫苗有減少自身感染與預防傳染的效果。故建議未來可開始評估MSM接種該疫苗的療效與成果效益分析,並訂定相關疫苗接種政策以達防疫效果。本研究結果可作為我國未來訂定MSM族群HPV疫苗接種政策之參考。
英文摘要 Human papillomavirus (HPV) not only causes genital warts but also induces penile and anal cancers among mem who have sex with men (MSM). There were no researches about HPV and HPV vaccine among MSM in Taiwan. We used convenience sampling to recruit participants between October 2015 and May 2016. Participants were from community health centers and on social media. The inclusion criteria were (1) aged over 20 years; (2) had ever had sex (including mutual masturbation, oral sex or anal sex) with another man. In this study we used HPV knowledge, HPV vaccine attitude, and HPV screening to explore the factors associated with intention and behavior about HPV vaccine uptake among MSM (n=171, mean ± SD age = 29.21±6.18). Structural equation modeling (SEM) was applied to test the model about HPV vaccine uptake and factors associated with intention among MSM. Our model with good model fit (comparative fit index (CFI) = 0.983; Tucker–Lewis index (TLI) = 0.963; root mean square error of approximation (RMSEA) = 0.037; standardized root mean square residual (SRMR) = 0.058). Capacity to obtain HPV-related information can predict HPV knowledge; HPV knowledge can predict intent to take up HPV vaccine even the price increased to NT$ 8,000-12,000; Intent to take up HPV vaccine even the price increased to NT$8,000-12,000 and the penile and anal’ s HPV test positive can predict HPV vaccine uptake after 6 months. HPV can be transmit and HPV vaccine can prevent the disease and decrease cost about the disease. In the future, The finding of our research can provide the policies formulated of HPV uptake among MSM in Taiwan.
論文目次 摘要.....................................................III
Extended Abstract.........................................IV
誌謝....................................................VIII
目錄......................................................IX
表目錄....................................................XI
圖目錄...................................................XII
第一章 緒論...............................................13
第一節 研究背景與重要性...................................13
第二節 研究目的..........................................14
第二章 文獻探討...........................................15
第一節 人類乳突病毒與人類乳突病毒疫苗之介紹.................15
第二節 男性對人類乳突病毒與人類乳突病毒疫苗的認知及態度之現況.16
第三節 影響人類乳突病毒疫苗接種企圖之因素...................17
第四節 健康行為理論運用於人類乳突病毒疫苗接種之調查..........18
第五節 人類乳突病毒疫苗之接種政策與現況.....................19
第三章 研究方法............................................21
第一節 研究架構...........................................21
第二節 研究假設...........................................21
第三節 資料來源與研究對象................................ 21
第四節 研究工具..........................................22
第五節 統計分析方法......................................25
第四章 研究結果...........................................27
第一節 研究對象之社會人口學特性描述........................27
第二節 MSM對HPV知識、疫苗態度、HPV檢查結果、疫苗接種企圖與行為之現況....................................................27
第三節 HPV知識、疫苗態度、感染情形、接種企圖與行為之相關性探討........................................................28
第四節 HPV知識、疫苗態度及檢查結果對HPV疫苗接種企圖及行為之關係........................................................28
第五章 討論...............................................29
第一節 研究結果概述.......................................29
第二節 HPV篩檢結果對疫苗接種行為之影響......................29
第三節 HPV知識對接種企圖與行為之影響.......................30
第四節 HPV疫苗態度對接種企圖與行為之影響....................31
第五節 HPV疫苗價格對接種企圖與行為之影響....................32
第六節 研究優勢與限制.....................................33
第六章 結論與建議..........................................34
參考文獻..................................................35
附錄......................................................49
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