影響民眾選擇子宮頸抹片檢查器械之相關因素

公共衛生一直是各國的重要的議題，因為牽扯到的層面不僅僅只是國民健康問題，甚至連經濟都會被涉入其中。近年來全世界各國都面臨到少子化、高齡化社會的困境，此時公衛問題更顯重要。在台灣，癌症一直以來都是全人民健康殺手，以婦女癌症為例，子宮頸癌在所有婦女癌症中一直居於榜首，直到近年來排名略有下降，但仍是不可忽視的疾病。自民國84 年健保開辦起，國家為 30 歲以上婦女補助每年一次免費子宮頸抹片檢查，自施行每年一次免費子宮頸檢查，篩檢率由民國 86 年的 35.3% 提升至 110 年的 46.5%， 篩檢率與未補助前有顯著的提升，但調閱國民健康署資料庫可以發現，超過 10 年篩檢率一直處在 50%左右浮動，對比其他歐美先進國家，台灣對於子宮頸癌的篩檢率仍有一段進步的空間。 對於子宮頸癌，研究顯示，若定期規律性的施作子宮頸抹片檢查，及早發現異常細胞，及時治療，原位癌恢復的幾乎機率高達 100%，因此國內許多專家對於提升篩檢率提出了相當多的研究討論及看法。但正如上述所說，近年來篩檢率一直無法提升，與其他國家相比也有不小的差距，因此，本研究希望以醫療器材的角度切入，藉以探討醫療器材是否會對於女性民眾提升子宮頸抹片篩檢意願有影響，及影響使用器材的因素為何，並探討醫療器材對於整體醫療產業及環境議題。 本研究依據問卷資料數據進行分析，回收共計 202 份有效問卷，將問卷資料利用描述性統計及卡方檢定分析數據，並依照分析結果進行討論。 其結果顯示，曾經施作子宮頸抹片檢查、定期施作子宮頸抹片檢查、當初使用過拋棄式陰道擴張器、知道陰道擴張器有分拋棄式或非拋棄式、被醫師建議使用拋棄式陰道擴張器、有接收到政府提醒施作抹片檢查、有固定婦產科醫療院所、有接受政府其他預防性醫療及有定期自費健檢，上述各種因素對於選擇拋棄式陰道擴張器具有顯著影響。

“Public Health” is always a big issue for all countries in the world, this not only concerns to various levels, like national health, but also the economics problem is involved. And most of the countries in the world now is facing the “population ageing” and “low fertility rate” issue, so “Public Health” issue becomes more important.In Taiwan, Cancer always is a health killer, and the top of the Gynecology Cancer is Cervical Cancer, although Cervical Cancer is not the most serious cancer of all the Gynecology Cancer, but we still can’t ignore it !Since 1995, the government implemented the health care policy for all women at 30 and over 30 could do pap smear test free once a year, and the test rate of pap smear from 35.3% improved to 46.5% spent only 24 years since 1996. According to Health Promotion Administration’s (MOHW) database, we could find out the pap smear test rate is still flooding at 50% over a decade, compare to the other advanced countries test rate, we still have long way to go. Cervical cancer, many studies show, if women could do the pap smear test regularly, could detect the early symptoms of cervical cancer and have some proper treatment, the “Carcinoma in situ” of cervical cancer could be cured almost 100%, so scholars have done many research and studies hoped to improve the test rate. But just like the data shows, even we have so many researches or studies, we still cannot make the test rate improve largely.In this study, we try to use other aspect, to see if the women who need to do pap smear will be affected by using medical device like vaginal speculum or not ; what are the reasons they choose, and at the end we will discuss the whole healthy industry and the global environment issue. The use of questionnaire to collect the data and base on these 202 valid questionnaire is” Descriptive statistics and Chi-Squared Test” to analyze the IVresult. And the result shows, used to do pap smear test、do pap smear test egularly、had experience to use disposable vaginal speculum、aware of choice of disposable and re-usable vaginal speculum、doctor’s suggest using disposable vaginal speculum、got reminding notice for pap smear test from government、usually go to the same hospital or clinic do the test、get other prevention health care examination and do physical Check-up regularly, all these elements above shows significant effect on choosing disposable vaginal speculum.