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    题名: The factors of utilizing the health screening service of community health center for the Elderly in Nantun District of Taichung City --Application of Health Belief Model--
    作者: TSENG,HUI-CHUAN
    贡献者: Department of Healthcare Administration/Healthcare Division
    关键词: Health Belief Model;community health center;health screening
    日期: 2007
    上传时间: 2009-11-06 05:35:56 (UTC+0)
    出版者: Asia University
    摘要: Due to increased number of aging population and population structure changes, people are concerned about aging-related problems that put great burdens and make enormous impacts on the family, society, and nation. The problems include increased medical expense, chronic diseases, and degeneration of the elderly. The prevention of chronic diseases and cancers for the middle-aged and the elderly are taken as an important issue in our nation’s contemporary public health policy of enhancing healthcare for the elderly. Among the measures, "health screening" is a priority in achieving the goal of disease prevention and healthcare.

    Bureau of Health Promotion made a plan to prevent chronic diseases for the middle-aged and the elderly and a five-year national plan to prevent cancers, in 1985 and 2005 respectively. These plans aim at promoting overall disease prevention for the middle-aged and the elderly. Community health center – medical center for healthcare services in towns and townships - provide initiative health screening services for each community. This research uses the Health Belief Model to explore influence on community health screening services for the elderly. Besides, related factors of the influence are also discussed. Suggestions provide reference for future related plans of Bureau of Health Promotion.

    The subjects of the study are the elderly in the Nantun District of Taichung City aged 65 or above, 348 citizens in total. A questionnaire with closed questions is used to investigate the elderly use of community health services provided by community health center and related factors influencing the use. The method of data analysis Logistic Regression Model is used to analyze the elderly use of health screening services, basic demography characteristics, beliefs for health screening (perceived susceptibility and severity of chronic diseases and cancers), cues to health screening actions, and perceived benefits and barriers of health screening. In addition, the independent variable of health screening behavior is used to analyze the factors of the elderly use of health screening services provided by community health center.

    The findings of the study include:
    (1) 26.1 percent of the elderly in community used the health screening services provided by community health center.
    (2) The gender (P<0.05) of basic demography characteristics and the health state (P<0.05) of the elderly compared to that of the relatives and friends of the same age correlate with the elderly use of health screening services by community health center.
    (3) In cues to actions, the knowledge of health screening items (P<0.000), the difference between perceived benefits and barriers (P<0.000) correlate with the use of health screening services provided by community health center.
    (4) The analysis by Logistic Regression Model indicates cues to action have positive correlations with the use of health screening services (β=0.391, P<0.05) provided by community health center. In other words, the clearer the understanding of health screening items, the more the use of health screening services. The difference between perceived benefits and barriers has positive correlation with the use of health screening services (β=43.157, P<0.000). That is, the more perceived benefits of health screening services provided by community health center, the more use of the services. The predictions of these variables attain statistically significant levels.

    According to the findings, the following suggestions are proposed:
    (1) Understanding reasons for the elderly not using health screening services provided by community health center.
    The reasons for many people not using health screening services is “being used to having health screening services in hospitals”, “health screening items in community health center were few”, “no follow-up after health screening”, “no outpatient services after health screening provided by community health center”. The elderly in community hope community health center can enhance healthcare and health screening services for the middle-aged and the elderly. They expect community health center to develop medical care items for chronic diseases.
    (2) Increasing the elderly perceptions of preventive healthcare services provided by community health center.
    The function and role of community health center should be marketed. The package and propaganda of preventive healthcare services provided by community health center will change people’s values and make them seek for health care services.
    (3) Using multiple channels to propagate the purpose, content, and importance of health screening services in community health center.
    The use of health screening services can be promoted by printing flyers, enhancing local leaders’ understanding of health screening content, and establishing propaganda and volunteer groups making phone calls.
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