探討台灣中部地區高齡長者電子健康識能對大腸癌篩檢行為之影響

前言: 根據衛生福利部統計處的資料顯示，大腸癌於2023年在國人癌症發生率位居第二名，癌症死亡原因位居第四名。衛生福利部國民健康署自2025年起擴大五大癌症篩檢服務，其中大腸癌篩檢提供45至74歲民眾以及具大腸癌家族史的40-44歲民眾，每2年1次糞便潛血檢查，希望達到早期發現、早期治療之目的。隨著數位科技快速發展，使用網路的普及性及方便性不斷提升，高齡長者往往可經由網路上獲取與健康相關的資訊，其中不乏包括癌症篩檢相關健康訊息。因此，本研究旨在探討台灣中部地區高齡長者電子健康識能對大腸癌篩檢行為之影響。 方法:本研究為次級資料庫分析研究，資料擷取自111年中山醫學大學-「健康識能對台灣社區長者教育程度和預防性健康行為的中介作用」研究計畫中符合本研究目的之資料加以分析。資料分析以百分比、平均值、標準差、卡方檢定描述基本屬性與電子健康識能對大腸癌篩檢之關聯及大腸癌篩檢率；以二元羅吉斯回歸統計方式預測電子健康識能是否為大腸癌篩檢預測因子。結果:本研究樣本數共有90人，研究結果發現台灣中部地區高齡長者常規執行大腸癌篩檢之比例為64.4%。電子健康識能與教育程度（F = 9.27，p < .001）及年齡（r = -.21，p = .047）具明顯關聯。此外，本研究結果證實電子健康識能（B = 0.05，OR = 1.06，p = .038）為影響大腸癌篩檢的重要預測因子。結論: 建議未來政府或醫療單位可將電子健康識能課程結合篩檢宣導、預防保健活動，納入「正確網路健康資訊識讀」之相關內容，協助民眾辨識並正確使用網路上的健康資訊，進而提升其電子健康識能，強化健康決策能力。

Introduction:According to statistics from the Department of Statistics, Ministry of Health and Welfare, colorectal cancer ranked second in cancer incidence and fourth in cancer-related mortality among Taiwanese citizens in 2023. Starting in 2025, the Health Promotion Administration has expanded the scope of its five primary cancer screening services. For colorectal cancer, fecal occult blood testing (FOBT) is now offered once every two years to individuals aged 45–74 and to those aged 40–44 with a family history of colorectal cancer. The goal is early detection and timely treatment. With the rapid development of digital technology and the increasing accessibility and convenience of the internet, older adults can increasingly obtain health-related information online, including information related to cancer screening. Therefore, this study aims to explore the influence of eHealth literacy on colorectal cancer screening behaviors among older adults in central Taiwan.Methods:This study utilized a secondary data analysis design. Data were derived from the 2022 research project entitled "The Mediating Role of Health Literacy on Educational Level and Preventive Health Behavior among Community-Dwelling Older Adults in Taiwan" at Chung Shan Medical University. Descriptive statistics such as percentage, mean, and standard deviation were used to describe participants’ characteristics, eHealth literacy, and colorectal cancer screening behaviors. Chi-square tests were conducted to examine associations, and binary logistic regression analysis was used to identify whether eHealth literacy predicted participation in colorectal cancer screening.Results:A total of 90 participants were included in this study. The results showed that the proportion of elderly people in central Taiwan who routinely performed colorectal cancer screening was 64.4%. eHealth literacy was significantly associated with education level (F = 9.27, p < .001) and age (r = -.21, p = .047). In addition, the results of this study confirmed that eHealth literacy (B = 0.05, OR = 1.06, p = .038) was an important predictor of colorectal cancer screening in Taiwan.Conclusion:It is recommended that future government or healthcare initiatives integrate eHealth literacy education into screening campaigns and preventive health programs. These programs should include components on "accurate interpretation of online health information", to help the public identify and correctly use health resources found on the internet. Enhancing eHealth literacy may empower individuals to make better health decisions.