背景：糞便潛血檢查基隆市社區闔家歡健康篩檢中結直腸癌的篩檢工具，糞便潛血檢查陽性者應接受內視鏡檢查才算完成「完整診斷評估」。由於民眾的健康行為與其健康信念有關，而部份研究發現健康識讀與健康行為有關，因此本研究試圖探討民眾的健康信念、健康識讀與進行完整診斷評估的行為之關連性。
目的：針對不同的健康識讀程度之糞便潛血檢查陽性民眾，探討接受完整診斷評估與其健康信念之關係。
方法：以2006年至社區參加基隆市社區闔家歡健康篩檢的所有糞便潛血檢查陽性民眾為研究對象（共610名），以研究者自行發展之結構式問卷進行電話訪問。排除資料不完整者，餘318名進行分析，以健康識讀分層進行邏輯斯回歸，依變項為接受完整診斷評估的行為，重要自變項為健康信念及行動線索。
結果：以健康識讀分層並調整重要變項後，健康識讀足夠者拒絕進行CDE的民眾與醫療環境有關的障礙分數（2.88±0.70）高於有進行CDE者與醫療環境有關的障礙分數（2.43±0.74）；健康識讀不足者對FOBT(+)的嚴重度高1分，有進行CDE的比例多2.07倍，不記得有人協助預約專診的人有進行CDE的比例為記得者的0.08倍。
結論：本研究發現進行CDE的相關因素因健康識讀程度而異，建議應先瞭解FOBT(+)民眾之健康識讀再分別提供不同的CDE衛教資訊。
Background: Fecal occult blood test (FOBT) is one of screening service in the Keelung Community-based Integrated Screening (KCIS). People with positive FOBT result have to receive endoscope as complete diagnostic evalation (CDE). Health behavior is related to people’s health beliefs. Studies find that health behavior is correlated with their health literacy. This study tries to explore the relationship between health beliefs, health literacy, and the behavior of adherence CDE.
Purpose: To analysis the relationships between adherence CDE and health beliefs among different health literacy in people with positive FOBT.
Methods: All of the positive FOBT participants (n=610) from KCIS in 2006 are study subjects. Using structured questionnaire which is developed by researchers to interview subjects by phone. Excluding subjects with incomplete data, 318 persons were included in analysis. Predictors of adherence CED were identified in logistic regression with stratified by health literacy. The dependent variable is the behavior of adhearece CDE, and the independent variables are health beliefs and cues to action.
Results: In the adequate health literacy people, adherence CDE have higher perceived barrier regarding to the environment of hospital. In the inadequate health literacy people, adherence CDE have lower perceived severity regarding to positive FOBT and higher rate of the memory of appointment for CDE.
Conclusion: The factors of adherence CDE are different between adequate and inadequate health literacy people. Understanding people’s health literacy to offer appropriate health education to people with positive FOBT is needed.
