94 12 79 90 Journal of Yuanpei University of Science and Technology No. 12, December 2005 P. 79 P. 90 Effects of the Betel-Nut-Chewing Behavior and Oral Cancer Screen by Multimedia Education Programs among the Betel-Nut-Chewing Group 1 Jia-Ling Sun 2 Yi-Shane Yu 1 Yu-Chieh Lin 1 Suh-Mian Wu 3 Ya-Ling Tu 4 Shu-Yu Yuan 1 Wen-Yen Lo 5 Yi-Chun Lu 1 Department of Nursing, Yuanpei University of Science and Technology, 2 Department of Nursing, Excutive Yuan Department of Health Chutung Hospital, 3 Department of Nursing, Tao-Yuan Armed Forces Gerneral Hospital, 4 Department of Anesthesia, Cathay Gernal Hospital, and 5 Department of Nursing, Taipei Show Chwan Hospital (Received, August 11, 2005; Revised, October 20, 2005; Accepted, November 17, 2005) 1. 2. 3. 54 1. 2. 3. 4. Corresponding author 79
5. Abstract: Oral cancer is ranked as the sixth of cancer causes. It is necessary to teach people with high risk knowing the screen of oral cancer. However, the multimedia is the simplest and vividest teaching method at present. Therefore, the purposes of this study were: 1. to understand the attitude of the betel-nut-chewing (BNC) behavior among the BNC group, 2. to evaluate the effects of knowledge on the oral cancer screen and the will of ceasing the BNC behavior after the multimedia education was applied to the group, and 3. to analyze the factors which affect the attitude of the BNC, the knowledge of the oral cancer screen, and the will of ceasing the BNC. This was a quasi-experimental design which recruited 54 BNC persons as subjects. With pre- and post-teaching programs, we understood the knowledge of oral cancer screen and the will of ceasing the behavior among the BNC group by a structural questionnaire. The data were analyzed by statistics and the results showed that 1. the BNC group inclined no idea to agreement with the BNC behavior, 2. the knowledge of oral cancer screen had statistical difference between pre- and post-teaching programs, 3. the subjects had a lower will for ceasing the BNC behavior after the teaching program, 4. women agreed with the BNC behavior most than men, and 5. the person with service occupation or never ceasing the BNC behavior had a lower will for ceasing it. This research verified that the multimedia education has contributions on the knowledge of the oral cancer screen but has no influence on ceasing the BNC behavior for the BNC group. It is useful for promoting people s health education activities on the knowledge of the oral cancer screen and furthermore strengthening the work of preventing from diseases in the future. Key words: Multimedia, Betel-nut-chewing, Oral Cancer, Knowledge 93 27.2% 73 2.92% 93 15.94% 1 20 80% 2003 52000 8100 2 3 4 80
(1) (2) (3) 5 88 9.45% 17.69% 1.04% 6 5, 6, 7, 8, 9 1. 2. 3. 5, 10, 11 1. (arecoline)(arecaidine) 12 2. Ca(OH)2 11, 13 3. 114. 13 10,13,14,16, 17 80% 5 () 30% 15, 18 15, 80% 19 (arecoline) (betel tree) 81
19, 20 () 89% 21 11, 15, 22 (1) (2) (3) ( ) (4) (5) ( ) (6) 11, 23 21, 24 65-80% 30-50% 5 25 3 8 26,28 29 1960 30 140 (L 31 4 620 4 6, 7, 15, 17 Mignogna 25 25 6 1511 14 1022 10 6 82
6 32 1652 32 9,10,26 80% 18 ( ) 450 126 5, 6, 7, 8, 28% 6 9 12 54 1. 2. 3. 7 14 0-4 0 1 2 3 4 0-56 11 1-6 7-11 1 0 0-11 83
5 0-3 0-15 4 3 2 CVI 0.71 CVI 0.91 CVI 0.72 CVI 3 Cronbach s 0.71 0.72() 0.79() 0.95 94 6 30 7 1 13 5-10 25 SPSS 10.0 t t-test one-way ANOVA ( ) Pearson 1 54 94% 32.94 8.90 / (53.7%) 1-5 (42.6%) 1-10 (50%) (88.9%) 29% (37%) 30.06±7.57 ( 0-56) 84
6.30±2.60 7.96±2.39 ( 0-11) pair-t test (t=-4.47, P<.0 5.50±4.31 ( 0-15) (29.55±7.42) (2) % 3 5.6 51 94.4 27 19 8 32.94 8.90 11 20.4 30 55.6 13 24.1 11 20.4 14 25.9 29 53.7 1~5 23 42.6 6~10 14 25.9 11 17 31.5 1~10 27 50.0 11~20 12 22.2 85
% 21 15 27.8 26 48.1 28 51.9 6 11.1 48 88.9 25 46.3 29 53.7 10 18.5 12 22.2 20 37.0 2 3.7 10 18.5 M(SD) F t M(SD) F t M(SD) F t 2.09-0.87-0.76 38.67(5.03) p=.04-3.00(1.73) p=.45 3.67(3.51) p=.39 29.55(7.42) -1.59(2.78) 5.61(4.36) 0.98 0.12 12.16 29.85(8.33) p=.38-1.59(3.19) p=.89 3.07(3.89) p<.001 28.95(6.33) -1.89(2.21) 7.84(3.69), 33.38(7.58) -1.38(2.50) 8.13(2.03) > 1.49 0.09 2.79 ~ 32.45(7.43) p=.24-1.36(2.77) p=.92 3.36(4.11) p=.07 28.50(8.20) -1.77(3.13) 6.63(4.12) / 31.62(5.55) -1.69(1.75) 4.69(4.35) 0.40 1.26 2.17 31.36(7.23) p=.67-1.82(2.82) p=.29 7.82(3.31) p=.13 30.79(5.31) -2.57(1.95) 5.29(4.10) / 29.21(8.67) -1.17(2.99) 4.72(4.55) 2.25 1.22 0.10 1~5 27.61(7.82) p=.12-1.26(2.94) p=.30 5.57(4.82) p=.91 6~10 31.36(7.30) -2.64(2.13) 5.07(4.02) 11 32.29(6.86) -1.41(2.85) 5.76(4.02) 86
M(SD) F t M(SD) F t M(SD) F t 1.74 0.79 3.27 1~10 28.22(7.47) p=.19-1.85(3.06) p=.46 6.93(4.02) p=.05 11~20 32.67(6.34) -2.17(1.85) 3.75(4.27) 21 31.27(8.23) -0.93(2.73) 4.33(4.40) ( ) 2.29 0.01-7.30 31.65(6.85) p=.14-1.69(3.04) p=.95 2.35(3.17) p<.001 28.57(8.03) -1.64(2.48) 8.43(2.95) 1.70 0.62 0.64 3.83(5.88) p=.20-2.50(1.76) p=.43 6.83(4.17) p=.44 29.58(7.68) -1.56(2.84) 5.33(4.34) 0.02 0.31 1.38 3.20(6.27) p=.90-1.44(2.84) p=.25 4.76(4.02) p=.58 29.93(8.65) -1.86(2.68) 6.14(4.52) 0.36 0.61 1.44 31.20(12.99) p=.84-1.80(3.22) p=.66 6.60(5.46) p=.23 29.25(6.00) -1.92(2.39) 3.00(3.93) 31.05(5.98) -2.10(2.10) 5.85(3.99) 30.00(0.01) -5.50(0.71) 7.50(3.54) 27.90(6.31) -0.60(3.92) 6.30(3.77) 56 30.06±7.57 2.15 3 15 87
3 () 17.69% 1.04% 6 7, 17 () 5 () () (2.35±3.17) 3 32 7 3 88
54 VCD DVD 1. http://www.doh.gov.tw/statistic/data/ /93.xls 94 2. http://bulletin.coa.gov.tw/view.php?catid=7399 94 3. 24 3 94 239-253 4. 14 92 97-104 5. 92 6. 5 4 90 312-323 7. 19 1 89 42-49 8. 18 91 1-16 9. Tsai, Y. F., Wong, T. K. S. and Chen, S. C., Prevalence and Related Risk Factors of Areca Quid Chewing among Junior High Students in Eastern Taiwan, Public Health, No. 116, 2002, pp.190-194. 10. 91 18 167-183 11. 89 12. 16 12 91 1-6 13. Trivedy, C. R., Craig, G. and Warnakulasuriya, S., The Oral Health Consequences of Chewing Areca Nut, Addiction Biology, No. 7, 2002, pp. 115-125. 14. 2 1 87 49-64 15. 17 90 1-14 16. 20 5 93 529-531 17. Ho, C. S., Gee, M. J., Tsai, C. C., Lo, C. I. and Wang, S. C., The Prevalence of Betel Chewing among the 89
Students of the Different Senior High Schools in Southern Taiwan, Kaohsiung Journal Medicine Science, No. 16, 2000, pp. 32-38. 18. Kao, S. Y., Tu, H. F., Yang, J., Lo, W. L. and Chang, C. S., An Overview of the Detection and Screening of Oral Cancer and Precancer, Chinese Journal Oral Maxillofacial Surgical, No. 21, 2001, pp. 91-98. 19. 21 3 93 278-286 20. Wu, M. T., Wu, D. C., Hsu, H. K., Kao, E. L. and Lee, J. M., Relationship Between Site of Esophageal Cancer and Areca Chewing and Smoking in Taiwan, British Journal of Cancer, Vol. 89, No.7, 2003, pp. 1202-1204. 21. 16 89 296-313 22. Wilkie, S., Oral CancerPresumptions of Innocence Can Prove Deadly, Access, Vol. 19, No. 3, 2005, pp. 24-28. 23. Powe, B. D. and Finnie, R., Knowledge of Oral Cancer Risk Factors among African AmericansDo nurses have a role? Oncology Nursing Forum, Vol. 31, No. 4, 2004, pp. 785-791. 24. Ranganathan, K., Devi, M., Joshua, E., Kirankumar, K. and Saraswathi, T., Oral Submucous FibrosisA Case-control Study in Chennai, South India, Journal of Oral Pathology & Medicine, Vol. 33, No. 5, 2004, pp. 274-277. 25. Mignogna, M. D., The World Cancer Report and the Burden of Oral Cancer, European Journal of Cancer Prevention, Vol. 13, No. 2, 2004, pp. 139-143. 26. 30 93 371-380 27. 15 3 93 248-257 28. Liaw, J. J., Use of a Training Program to Enhance NICU Nurses Cognitive Abilities for Assessing Preterm Infant Behaviors and Offering Supportive Interventions, Journal of Nursing Research, Vol. 11, No. 2, 2003, pp. 91-92. 29. 50 1 93 20-24 30. Giacoma, T., Ingersoll, G. L. and Williams, M., Teaching Video Effect on Renal Transplant Patient Outcomes, Americans Nephrology Nurses Association Journal, Vol. 26, No. 1, 1999, pp. 29-33. 31. 52 2 94 27-37 32. 18 5 89 349-362 90