人類乳突病毒感染已被證實和子宮頸癌發生有關，人類乳突疫苗又稱子宮頸癌疫苗已被產生，用於預防人類乳突病毒感染。本研究目的為探討父母親對於青少女施打子宮頸癌疫苗之意願及其預測因素。本研究為應用計畫行為理論(Theory of Planned Action)為架構之相關性研究設計，採方便取樣(Convenience Sampling)，調查448位來自台南地區國中一、二年級女學生之父母親或監護人，以結構式問卷調查父母親對於青少女施打子宮頸癌疫苗之態度、主觀規範、知覺行為控制、性行為影響之態度及施打疫苗之意願，並以logistic regression分析研究對象之人口學變項、對HPV的認識、HPV傳染知識、疫苗注射態度、主觀規範、知覺行為控制、性行為影響之態度對施打疫苗之預測意願。
研究結果發現，參與此研究以母親最多佔84.4%，有75.4%父母親是有高度意願讓青少女施打疫苗，若政府願意免費提供施打疫苗，88.2%的父母親有意願讓青少女施打疫苗。Simple logistic regression分析結果顯示家族有人罹患婦科腫瘤或婦科感染、曾聽過人類乳突病毒、對疫苗持正向態度、主觀規範受他人影響、自覺有知覺行為控制及性行為影響有限，可用來預測父母親讓青少女施打疫苗之意願。Multivariable logistic regression分析顯示，家族有人罹患婦科腫瘤或感染、主觀規範及知覺行為控制，能預測出父母親對於靑少女施打子宮頸癌疫苗之意願，此三個變項模式能解釋69%預測能力。父母親讓青少女施打子宮頸癌疫苗有高度意願，特別是疫苗能免費提供。家族健康史與他人的建議會影響父母親對疫苗施打意願，所以促進醫護人員對此疫苗的認識有其必要性，以便做適當疫苗施打建議與諮詢。

Human papillomavirus (HPV) has been determined an assocaiton with cervical cancer. Human papillomavirus vaccine has proven efficacious for prevention of the human papillomavirus infection. This study aimed to explore the parental intention towards obtaining human papillomavirus vaccine for their adolescent daughters and the prediciting factors of the intention. The Theory of Planned Action was applied to design for this study. A convenience sampling was used to recruite 448 parents or guardians of Grade1 to 2 female adolescents from junior high schools in Tainan. A constructive questionnaire was applied to assess the parental intention toward obtaining HPV vaccination, the subjective norms, the perception of behavioural control, and the attitudes toward influence of HPV vaccination on sexual behavioural. Simple and multiple logistic regressions were implemented to analyze the data.
The results indicated that 84.4% of the subjects was morther. Of the subjects, 75.4% reported high willingness to obtain the HPV vaccination for their adolescent daughters. While the HPV vaccine was supplied free, 88.2% of the subjects reported high intention toward HPV vaccination. Simple logistic regressions revealed that parental intention toward obtaining HPV vaccination for their adolescent daughters was predicted by these factors; a history of gynecological tumors or infections in parents, knowledge of HPV, positive attitudes toward HPV vaccination, subjective norms, perception of behavioural control, and attitudes toward the influence of HPV vaccination on sexual behavioural. Furthermore, using multiple logistic regression, a three-variable model which included parents who have the history of gynecological tumors or infections, subjective norms, and perception of behavioural control significantly predicted the parental intention toward obtaing HPV vaccination for their daughters. The model explained 69% of variation in the parental intention.
Parents toward HPV vaccination for their adolescent daughters have high willingness, especially if a free vaccination is provied. Parental intention towards HPV vaccination is influenced by recommdation from others and a history of gynecological tumors or infections. To provive better consultation to parents, health care professionals should know HPV vaccine and its application. .

台灣婦癌醫學會（2007年3月7日）•子宮頸癌•2008年2月15日取自
http://www.tago.gov.tw/
行政院衛生署國民健康局（2007）•民國95年子宮頸抹片登記報告•台北：行政院衛生署國民健康局。
行政院衛生署國民健康局（2008）•認識子宮頸癌與人類乳突病毒•2008年12月22日取自http://health99.doh.gov.tw/box2
/HPVvaccine/toknow.aspx
行衛生署衛生統計公佈（2008，10月20日）•96年度死因統計-當年死因統
計•2009年1月15日取自http://www.doh.gov.tw/CHT2006
/DM/DM2_2.aspx?now_fod_list_no=10238&class_no=440&level_no=1
行政院主計處（2008）•97年家庭收支調查報告•2009年12月15日取自
htt://win.dgbas.gov,tw/fies/doc/result/97.pdf
吳明隆、涂金堂（2007）•SPSS與統計應用分析•台中：五南。
邱皓政（2006）•量化研究與統計分析•台北：五南。
香港防癌會（2008）•香港防癌會積極推動「資助弱勢團體婦女注射子宮頸癌疫苗計劃」•2008年11月19日取自http://www.hkacs.org.hk/content
/anti_ cancer_society.php?page=208
倪國炎（2008年10月17日）•金門率先實施免費子宮頸癌疫苗接種•中央社•2008年11月18取自http://www.cna.com.tw/CAN/china/SearchDetail.aspx?strCatL
=HEL&strNewID=20081017
陳清芳（2008，8月12日）•2種子宮頸癌疫苗先後上市公費仍無望•中央社•2008年11月18日取自http://www.cna.com.tw/CAN/china/SearchDetail.aspx?str
CatL=HEL&strNewID=20080812
國立台灣大學婦產部（2007年11月23日）•澳洲子宮頸癌疫苗發明者-Prof. Ian.Franzer訪台記者會•2008年3月17日取自http://ntuh.mc.
ntu.edu.tw
葉樹人、陳慧祺、黃立民（2007）•子宮頸癌疫苗，台灣醫學，11（6），649-654。
溫麗芬、洪麗珍、張彩秀（2008）•靑少女自費接種子宮頸癌疫苗意向之相關因素探討•台灣衛誌，27（2），133-142。
廖靑（2008，5月8日）•預防子宮頸癌女童獲打免費•大紀元溫哥華報導•2008年11月18日取自http://www.bccancer.bc.ca/PPI/
Screening/Cervical/default.htm
盧成皆（1997）•線性複迴歸所需樣本數之討論•護理研究5（4），337-383。
Ajzen, I. & Fishbein, M. (1980). Understanding attitudes and Predicting social behavior: Englewood Cliffs, New Jersey: Prentice-Hall, Inc.
Ajzen, I. (2005). Attitudes, personality and behavior (2nd). Maidenhead, Berkshire, England: Open University Press. Abhyankar, P., O`connor, D. B. & Lawton, R.(2008). The role of message framing in promoting vaccination: Evidence of loss-frame advantage. Psychology, Health & Medicine, 13(1),1-16.
Brabin, L., Roberts, S. A., Farzaneh, F.,& Kitchener, H.C. (2006). Future acceptance of adolescent human papillomavirus vaccination: A survey of parental attitudes.Vaccine,24 (16), 3087-3094.
Bonnez, W. (2007). Human papillomavirus vaccine- recent results and Futuredevelopment. Current Opinion in Pharmacology, 7(5), 470-477.
Brown, D. R., Schroeder, J. M., Bryan, J. T., Stoler, M. H., & Fife, K. H. (1999). Detection of multiple human papillomavirus types in Condylomata acuminata lesions from otherwise healthy and immunosuppressed patients. Journal of Clinical Microbiology, 37(10), 3316-3322.
Bonanni, P., Boccalini, S., & Bechini, A. (2009). Efficacy, duration of immunity and cross protection after HPV vaccination: A review of the evidence. Vaccine, 27
(Supplemen1), A46-A53.
Breitkopf, C. R., Pearson, H. C., Dinh, T. A., Tran, B.C T., Vu, T., Phan, G. A. B., Ngo, Q. V., Tran, V. D., & Rosenthal, S. L., (2009). Human papillomavirus vaccine decision-making in Da Nang, Vietnam: Perceived spousal and adolescent-parent concordance. Vaccine, 27(17), 2367-2371.
Cutts, F.T., Franceschi, S., Goldie, S., Xcastellsague, X., Sangjose, S.D., & Garnett, G., et al. (2007). Human papillomavirus and HPV vaccines: a review. Bulletin of the
World Health Organization, 85(9), 719-726.
Chen, C. J., Viscidi, R. P., Chuang, C. H., Huang, Y. C., Chiu, C. H., & Lin, T. Y. (2007). Seroprevalence of human papillomavirus types 16 and 18 in the general population in
Taiwan: implication for optimal age of human papillomavirus vaccination. Journal of Clinical Virology,38(2), 126-130.
Centers for Disease Control (2004). Use of Pap smears for women 18 years of age and over according to selected characteristics: United States, selected years 1987–2000.
2008年10月30日取自http: //www.cdc.gov/nchs/data/hus/hus04 trend.pdf.
Clifford, G., Franceschi, S., Diaz, M., Muñoz, N., & Villa, L. L. (2006). Chapter 3: HPV type-distribution in women with and without cervical neoplastic diseases. Vaccine,
24(S3), S26-S34.
Carter J. J., Koutsky L. A., Hughes J. P., Lee S. K., Kuypers J., & Kiviat, N., et al. (2000). Comparison of human papillomavirus types 16, 18, and 6 capsid antibody responses following infection. The Journal of Infectious Disease, 181, 1911-1919.
Chan, S.S. C., Cheung, T. H., Lo, W. K., Chung, T. K. H. (2007). Women's Attitudes on Human papillomavirus vaccination to their daughters. Journal of Adolescent Health. 41(2), 204-207.
Dinh, T. A., Rosenthal, S. L., Doan, E. D., Trang, T., Pham, V. H., Tran, B. D., Tran, V.D., Bao Phan, G. A., Chu, H. K. H., Breitkopf, C. R. (2007). Attitudes of mothers in
Da Nang, Vietnam toward a human papillomavirus vaccine. Journal of Adolescent Health. 40(6), 559-563.
Department of Health and Ageing Australian Government (2007). The National HPV Vaccination Program-About the Program. 2008年11月17日取http://www.health.gov.au/
internet/standby/publishing.nsf/Content/about
Department of Health and Human Services Centers for Disease Control and Prevention(n.d). HPV Vaccine Information For Young Women. 2008年11月17日取自http://www.cdc.gov/std/hpv/
STDFact-HPV-vaccine.htm
Dempsey, A. F., Zimet, G .D., Davis, R. L., & Koutsky, l. (2006). Factors that arassociated with parental acceptance of human papillomavirus vaccines: A randomize intervention study of written information about HPV. American Academy of
Pediatrics, 117, 1486-1493.
Dempsey, A. F., Abraham, L. M., Dalton, V., Ruffin, M., Dempsey, A. F., Abraham, L. M., Dalton, V., Ruffin, M. (2009). Understanding the reasons why mothers do or do
not have their adolescent daughters vaccinated against human papillomavirus. Annals of Epidemiology, 19(8), 531-538.
Davis, K., Dickman, E. D., Ferris, D., & Dias, J. K. (2004). Human papillomavirus vaccine acceptability among parents of 10-to15-year-old Adolescents. Jounal of
Gential Tract Disease, 8(3), 118-194.
Doorbar, J. (2005). The papillomavirus life cycle. Journal of Clinical Virology, 32S, S7-S15.Greer, C. E., Wheeler, C. M., Ladner, M. B., Beutner, K., Coyne, M. Y. Liang, H. & et al. (1995). Human papillomavirus (HPV) type distribution and
serological response to HPV type 6 virus-like particles in patients with genital warts. Journal of Clinical Microbiology, 33(8), 2058-2063.
Merckvaccines.com. (2009). Efficacy data and duration of protection. 2009年12月9日取自https://www.merckvaccines.com/
vaccines/gardasil/deeicacy.html.
Godin, G. & Kok, G. (2004). The theory of planned behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 11(2), 87-98.
Glaxosimthkline (2005). Public health & education | GSK HPV vaccine produces stronger immune response in girls ages 10 -14 than in older women. The Henry Journal Kaiser Family Foundation. 2008年12月22日取http://www.kaisernetwork.
org/daily_reports/rep_index.cfm?hint=2&DR_ID=34384
Glaxosimthkline (2008年3月11日). GSK cervical cancer candidate vaccine Cervarix dem0nstrates long-term protection for more than six years. 2009年11月06日取自
http://us. gsk.com/html/media-news/pressreleases/2008/2008_us_ pressreleases_0009.htm.
Hines, J. F., Ghim, S. J., & Jenson, A. B. (1988). Prospects for human papillomavirus vaccine development: emerging HPV vaccines. Current Opinion in Obstetrics &
Gynecology. 10(1), 15-9.
Humiston, S. G., & Rosenthal, S. L. (2005). Challenges to vaccinating adolescents vaccine implementation issues. The Pediatric Infection Disease Jounal, 24(6), S134-S140.
Harper, D. M. (2008). Impact of vaccination with Cervarix(TM) on subsequent HPV-16/18 infection and cervical disease in women 15-25 years of age. Gynecologic Oncology,
110(3), S11-S17.
Ho, Y. F., Bierman, R., Beardsley, L., & Chang, C. J. (1998). Natural history of cervicovaginal papillomavirus infection in young women. The New England Journalof Medicine, 338(7), 423-428.
International Union Against Cancer (2008). Harald zur Hausen awarded Nobel prize. 2008年12月22日取自http://www.uicc.org/index.php?option=com_content&task=view&id =16492&Itemid=406
International Agency for Research on Cancer (2008). World cancer report 2008. 2009年1月15日取自http://www.iarc.fr/en/Media-Centre/IARC-News/World-Cancer-Report-2008
Joura, E. A., Leodolter, S., Hernandez-Avila, M., Wheeler, C. M., Perez,G., & Koutsky, L.A., et al. (2007). Efficacy of a quadrivalent prophylactic human papillomavirus (types
6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials. The Lancet, 369(9574),
1693-1702.
Koutsky, L. A., Ault, K. A., Wheeler, C. M., Brown, D. R., Barr, E., Alvarez, F. B., & et al. (2002). A controlled trial of a human papillomavirus type 16 vaccine. New
England Journal of Medicine, 347(21), 1645-1651.
Koutsky, L. (1997). Epidemiology of Genital Human Papillomavirus Infection. The American Journal of Medicine, 102(5A), 3-8.
Kahn, J. K., Zimet, G. D., Bernstein, D. I., Riedesel, J. M., Lan, D., Huang, B. & Rosenthal, S. L. (2005). Pediatricians' intention to administer human papillomavirus
vaccine: the role of practice characteristics, knowledge, and attitudes. Journal of Adolescent Health, 37(6), 502-510.
Kaiser Family Foundation (2006). Sexual Health Statistics for Teenagers and Young adults in the United States. 2010年1月14日取自http://www.kff.org/womenshealth/upload/3040-03.pdf
Marlow, L. A., Waller, J., & Wardle, J. (2007). Parental attitudes to pre-pubertal HPV vaccination. Vaccine, 25(11), 1945-1952.
Lynn, M. R. (1986). Determination and quantification of content validity. Nursing Research, 35(6), 382-386.
Liddon, N., Pulley, L. V., Cockerham, W. C., Lueschen, G., Vermund, S. H., & Hook, E.W. (2005). Parents'/guardians' willingness to vaccinate their children against genital herpes, Journal of Adolescent Health, 37(3), 187-193.
Lazcano-Ponce, E., Rivera, L., Arillo-Santillan, E., Salmeron, J., Hernandez-Avila, M., & Muñoz, N. (2001). Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico, Archives of Medical Research,32 (3), 243-247.
Mays, R. M., Sturm, L. A., & Zimet, G. D. (2004). Parental perspectives on vaccinating children against sexually transmitted infections. Social Science & Medicine, 58
(7), 1405-1413.
Moscicki, Anna-B., Schiffman, M., Kjaer, S., & Vill, L. L. (2006). Chapter 5: Updating the natural history of HPV and anogenital cancer. Vaccine, 24(S3), S42-S51.
Muñoz, N., Mendez, F., Posso, H., Molano, M., van de Brule, Adrian J. C., & Ronderos,M., et al. (2004). Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of colombian women with normal cytological results. The Journal of Infectious Diseases, 190(12), 2077-2087.
Muñoz, N., Castellsagu, X., de Gonzalez, A. B., & Gissmann, L. (2006). Chapter 1: HPV in the etiology of human cancer. Vaccine, 24(S3), S1-S10.
Muñoz, N., Bosch F. X., Castellsague X., Diaz M., de Sanjose S.,& Hammouda D., et al. (2004). Against which human papillomavirus types shall we vaccinate and
screen? The international perspective. International Journal of Cancer, 111(2), 278-85.
Markowitz, L. E., Dunne, E. F., Saraiya, M., Lawson, H. W., Chesson, H., & Unger, E.
R. (2007). Quadrivalent Human Papillomavirus Vaccine Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 56(RR02), 1-24.
Nobelprize. org (2008). The Nobel Prize in Physiology or Medicine 2008. 2009年12月07日取自http://nobelprize.org/
nobel_prizes/medicine/laureates/2008/press.html
Olshen, E., Woods, E. R., Austin, S. B., Luskin, M., & Bauchner, H. (2005). Parental acceptance of the human papillomavirus vaccine. Journal of Adolescent Health,
37(3), 248-251.
Ogilvie, G. S., Remple, V. P., PharmD, F. M., McNeil, S. A., Naus, M., & Pielak, K. L., et al. (2007). Parental intention to have daughter eceive the human papillomavirus
vaccine. Canadian Medical Association, 177(12), 1506-1512.
Parry, J. (2007). Vaccination against cervical cancer. Bulltin of the World Health Organization. 85(2), 89-90. 2008年11月19日取自http://www.who.int/bulletin/
volumes/85/2/en/index.html
Pagliusi, S. R., & Aguado, M. T. (2004). Efficacy and other milestones for human papillomavirus vaccine introduction. Vaccine, 23(5), 569-578.
Pollack, A.E., Balkin, M., Edouard, L., Cutts, F., Broutet, N., on behalf of the WHO/UNFPA Group on Sexal & Reproductive Health and HPV vaccines. (2007).
Ensuring access to HPV vaccines through Integrated services. Bulletin of the World Organization, 85(1), 57-63.
Paavonen, J., Jenkins, D., Bosch, F. X., Naud, P., Salmeron, J., & Wheeler, C. M., et al.(2007). Efficacy of a prophylactic adjuvanted bivalent LI virus-like-particle
vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet, 369(9580), 2161-2170.
Short, M. B., & Rosenthal, S. L. (2006).Fostering acceptance of human papillomavirus and herpes simplex virus vaccines among adolescents and parents. Current
Opinion in Pediatrics, 18, 53-57.
Shaw, A. R. (2005). Human papillomavirus vaccines in development: if they're successful in clinical trials, how will they be implemented?. Gynecologi Oncology, 99(3Suppl1), S246-248.
Schifter. D. E., & Ajzen. I. (1985). Intention, perceived control, and weight loss: An application of the theory of planned behavior. JournaL of Personality and Social
Psychology, 49(3), 843-851
Sam, I. C., Wong, L. P., Rampal, S., Leong, Y. H., Pang, C.F., Tai, Y. T., Tee, H.C., Kahar-Bador, M. (2009). Maternal acceptance of human papillomavirus vaccine in
Malaysia. Journal of Adolescent Health. 44(6), 610-612.
The future II study group (2007). Prophylactic efficacy of a quadrivalent human papillomavirus (HPV) vaccine in women with virological evidence of HPV infection. The Journal Infectious Diseases, 196(10), 1438-1446.
Villa, L. L., Costa, R. L. R., Petta, C. A., Andrade, R. P., Paavonen, J., Iversen, O. E. & et al. (2006). High sustained efficacy of a prophylactic quadrivalent human
papillomavirus types 6//11//16//18 L1 virus-like particle vaccine through 5 years of follow-up. British Journal of Cancer, 95(11), 1459-1466.
Villa, L. L., Ault, K. A., Giuliano, A. R., Costa, L. R., Petta, C. A., & Andrade, R. P., et al. (2006). Immunologic responses following administration of a vaccine targeting
human papillomavirus Types 6, 11, 16, and 18. Vaccine, 24(27-28), 5571-5583.
Villa, L. L., Costa, Ronaldo L. R., Petta, C. A., Andrade, R. P., Ault, K. A.,& Giuliano,A. R., et al. (2005). Prophylactic quadrivalent human papillomavirus (types 6, 11,16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. The LancetOncology,
6(5), 271-278.
Villa, L. L. (2007). Overview of the clinical development and results of a quadrivalent hPV (types 6, 11, 16, 18) vaccine. International Journal of Infectious Diseases,
11(Supplement 2), S17-S25.
Vandepapeliere, P., Barrasso, R., Meijer, Chris J. L. M., Walboomers, Jan M. M., Wettendorff, M., & Stanberry, L. R., et al. (2005). Randomized controlled trial of an adjuvanted human papillomavirus (HPV) type 6 L2E7 vaccine: infection of external anogenital warts with multiple HPV types and failure of therapeutic vaccination. The Journal of Infectious Diseases, 192(12), 2099-2107.
Waller, J., Laura, A. V., Marlow & Wardle, J. (2006). Mother`s attitudes towards preventing cervical cancer throught human papillomavirus vaccination: a qualitative study. Cancer Epidemioi Biomarkers & prevention. 15(7), 1257-1261.
World Health Organization (2006). Comprehensive cervical cancer control: a guide to essenential practice. 2008年10月14日取自http://www.who.int/repord.uctive-health
/publication/cervical-cancer-gep/text.pdf.
World Health Organization (2007). Cervical cancer, human papillomavirus (HPV), HPV vaccines-key point for policy-makers and health professional. RHR(08), 1-14.
2008年11月14日取自http://www.who.int/reportuctive-health/publication/cervical-keypoint /cerv_hpv_keypts. pdf.
World Health Organization (2007). Human papillomavirus vaccines: WHO position paper. Biologicals, 37(5), 338-344.
Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., & Shah, K. V., et al. (1999). Human papillomavirus is a necessary cause of invasive
cervical cancer worldwide. Journal of Pathology, 189(1), 12-19.
Wong, L. P. (2009). HPV information needs, educational messages and channel of delivery preferences: views from developing country with multiethnic populations. Vaccine,
27(9), 1410-1415.
Zimet, G. D., Perkins, S. M., Sturm, L. A., Bair, R. M., Juliar, B. E., Mays, R. M. (2005). Predictors of STI vaccine acceptability among parents and their adolescent
children. Journal of Adolescent Health, 37(3), 179-186.
Zimet, G.D., Liddon, N., Rosenthal, S. l., Lazcano-Ponce, e., & Allen, B. (2006).Chapter24: Psychosocial aspects of vaccine acceptability. Vaccine 24S3, 201-209.
Zimet, G.D., Mays, R.M., Sturm, L. A., Ravert, A. A., Parkin, S. M., & Juliar, B. E.(2005). Parental attitudes about sexually transmitted infection vaccination for their
adolescent children. American Medical Association, 159, 132-137.