[ 摘要 ]

本研究目的為探討花蓮地區孕婦於懷孕期間吸菸行為之相關因素。研究採橫斷式相關性設計，採方便取樣的方式，選定花蓮縣醫學中心、區域醫院、地區醫院及婦產科診所接受產前檢查之懷孕婦女為研究對象，共計收取395位個案，研究方法是採結構式問卷調查法，研究工具包括：菸害認知量表、菸害態度量表、戒菸自我效能量表、尼古丁成癮量表、愛丁堡周產期憂鬱量表。統計方法包括描述性統計、卡方檢定、單因子變異數分析、線性迴歸分析、邏輯迴歸分析。

研究結果發現：( 1 ) 懷孕婦女吸菸率為11.14%，其懷孕後戒菸率42.86% ( 2 )懷孕吸菸婦女特質以原住民婦女、年紀輕、第一胎、教育程度較低、已婚、收入較低、喝酒習慣等因素 ( 3 ) 菸害認知得分每增加1分，孕婦於懷孕期間會成為已戒菸孕婦之勝算比為1.1倍 ( 95% CI = 1.0 - 1.2 ) ( 4 ) 戒菸自我效能得分每增加1分，孕婦於懷孕期間會成為已戒菸孕婦之勝算比為1.09倍 ( 95% CI = 1.05 - 1.14 )，達統計上之顯著意義 ( 5 ) 相對於尼古丁低成癮孕婦，高成癮孕婦成為已戒菸之勝算比較低為0.17 ( 95% CI = 0.01 - 38.53 ) ( 6 ) 孕期憂鬱得分在10 - 30分之孕婦較得分 ≦ 9分之孕婦有34%容易落於吸菸組而繼續吸菸 ( 7 ) 吸菸孕婦戒菸行為階段之分佈以意圖期 ( 30% ) 及準備期 ( 39% )居多，已戒菸組以行動期 ( 30% ) 及維持期 ( 30% ) 較多，分佈達統計上的顯著差異。

本研究結果提供政府部門、護理實務及護理教育者參考，並提供未來研究方向之建議。

[ 英文摘要 ]

The aim of this study is to research the factors of smoking behavior in pregnant women in Hualian area. Adopting the cross sectional design and convenience sampling, this study targeted the pregnant women receiving prenatal period checks in medical centers, area hospitals, regional hospitals and clinics in Hualian County. There were 395 pregnant womem were recruited in this study. The method was line with structural questionnaire, which includes: the Knowledge of Smoking Damage Scale, the Smoking Attitude Scale, the Self-Efficacy of Quitting Smoking, the measurement list for Fagerstrom Tolerance questionnaire and the Edinburgh Perinatal Depression Scale for the depression in pregnancy. The methods of analysis were as follows: descriptive statistics, Chi-square test, one way ANOVA, linear regression analysis, logistic regression analysis.

The smoking rate of pregnant women was 11.14%, after pregnancy, 42.86% pregnant women would quit smoking. ( 2 ) The features of the women smoking in pregnancy were as follows: aboriginal women, young age, first fetus, poorer education, married, lower income, drinking habit. ( 3 ) With the increase of smoking damage knowledge score, the rate of quitting smoking would increase. When score increases one point, the rate increases by 110% ( 95% CI = 1.0 - 1.2 ). ( 4 ) With the increase of score in Self-Efficacy for quitting smoke, the rate of quitting smoking would increase. When score increases one point, the rate increases by 109% ( 95% CI = 1.05 - 1.14 ). These result all showed significant level in statistics. ( 5 ) Compared with the pregnant women of Nicotine dependence, the rate of quitting smoking of highly smoke obsessed pregnant women was lower 0.17 ( 95% CI = 0.01 - 38.53 ). ( 6 ) Compared with the pregnant women depression scoring under 9 points, 34% of the pregnant women scoring between 10 and 30 in depression during pregnancy were liable to continue their smoking habit. ( 7 ) The stages of quitting smoking of pregnant women could be divided into contemplation stage ( 30% ), preparation stage ( 39% ). In addition, successfully quitting groups could be divided into action stage ( 30% ), and maintenance stage ( 64% ). The statistic distribution had significant differences.

The results of the study can serve references for the governmental sections as well as practitioners of nursing affairs and education, providing suggestion for future research.