[[alternative]]A study of the influencing the using intention of mobile shopping : the TAM model perspective

碩士[[abstract]]全球網際網路流量逐年成長,利用行動裝置上網的比率也是逐年上升,電子商務 的型態也隨之改變,變成行動商務,在國外行動購物市場占交易量的比率呈正向成 長,行動購物已蔚為風潮,因此,本研究以技術接受模型(Technology Acceptance Model) 為基礎,加入信任變數,探討臺灣行動購物市場,消費者的「知覺易用 性」、「知覺有用性」、「信任」及「態度」對於「使用意圖」之影響。 本研究對研究對象進行人員紙本發放以及網路問卷的施測,並使用 LISREL 來進 行 SEM 分析,以驗證本研究模型與相關假說,得知以下結論: ㄧ、對臺灣行動購物市場而言,消費者的態度是影響消費者使用意圖重要的關鍵前因,信任對使用意圖無直接影響效果,但會透過態度間接影響使用意圖。 二、對臺灣行動購物市場而言,知覺易用性對行動購物使用意圖的影響中,知覺有用性、信任及態度確實扮演著中介角色,其中以態度最為關鍵。 根據本研究資料分析的結果,態度是影響行動購物使用意圖的關鍵因素,故如何提升消費者正面的態度,並進一步促動使用意圖,將是購物平台商需追求目標。[[abstract]]The global Internet traffic growth has been increasing year after year and same as to the ration of using mobile devices to access to the Internet. And this has caused E-business pattern transforming into mobile commerce one. Actions’ shopping is a trend and the trading volume in foreign markets also shows a growth rate. Therefore, on the basis of Technology Acceptance Model (TAM), this study is aimed to examine the effect of the four variables: the customers’ “Perceived Ease of Use(PEU)”, “Perceived Usefulness(PU)”, “Trust” and “Attitude” on“Behavioral Intention to Use” and furthermore to propose subjective suggestion to Taiwan actions’ shopping market. In this study, both paper and online questionnaires are collected, and LISREL is adopted for SEM analysis to validate this model and related research hypothesis. The results of this study are as follows: 1. A customer’s attitude is the important key antecedent to affecting his or her intention; trust has no direct but indirect effect through the use of intent attitude.  2. Perceived usefulness, trust and attitude do play a mediation role to the influence of PEU on the shopping action intention, in which attitude is the key. According to the study, a customer’s attitude is a key factor affecting the intended use of the shopping action. To enhance a customer’s perception attitude, it is essential that action shopping development and design should be based on a customer’s point of view. In addition, the formation of the trust is the cornerstone of a customer’s attitude. Therefore, shopping platform providers need to devote into pursuing the goal of enhancing positive customer attitudes, and further promote intended use.[[tableofcontents]]目錄 第一章　緒論 第一節 研究背景 1 第二節 研究動機 4 第三節 研究目的 6 第四節 研究範圍與對象 6 第五節 研究流程 7 第二章 文獻探討 第一節 行動商務發展及特性 8 第二節 技術接受模型與相關模型回顧 15 第三節 信任 25 第三章 研究方法 第一節 研究架構 29 第二節 研究假設 30 第三節 各構面的操作性定義及衡量工具 32 第四節 研究設計 36 第五節 資料分析方法 37 第四章 資料分析與結果 第一節 敘述性統計分析 41 第二節 信度分析 52 第三節 結構方程模式分析 52 第五章 研究結論與發現 第一節 研究結論 63 第二節 研究發現 64 第三節 研究限制與未來研究建議 67 參考文獻 68 附錄-正式問卷 77   表目錄 表2-1 不同角度對電子商務之定義 9 表2-2 行動商務之定義 11 表2-3 技術接受模型相關研究 25 表2-4 各領域對信任的敘述的定義 26 表2-5 各學者對信任的定義 27 表2-6 各學者對電子商務消費者關係中之信任定義 31 表3-1 研究假說整理 32 表 3-2 知覺易用性之操作性定義與衡量問項 33 表 3-3 知覺有有性之操作性定義與衡量問項 33 表 3-4 信任之操作性定義與衡量問項 33 表 3-5 態度之操作性定義與衡量問項 34 表 3-6 使用意圖之操作性定義與衡量問項 35 表 3-7 問卷發放與回收情況統整表 36 表 3-8 Cronbach''α與信度 37 表 3-9 LISREL 參數符號說明 38 表 3-10 整體模式之配適度判斷標準 40 表 4-1 有無行動購物經驗 41 表 4-2 曾經使用過之行動購物平台 43 表 4-3 最常使用之行動購物平台 45 表 4-4 行動購物之平均購買頻率 46 表 4-5 行動購物之平均購買金額 47 表 4-6 性別 48 表4-7 年齡 48 表 4-8 教育程度 49 表4-9 目前居住地區 49 表4-10 職業 50 表 4-11 婚姻狀況 51 表 4-12 平均月收入 51 表 4-13 研究變項之信度分析彙整表 52 表 4-14 結構方程模式之參數說明 54 表 4-15 整體配適度衡量結果 56 表 4-16 整體衡量模式之評估 57 表 4-17 整體樣本假說驗證結果 60 表 4-18 整體路徑效果分析 62 圖目錄 圖1-1上網工具個人電腦與行動裝置使用狀態比較…………………………… 1 圖1-2 研究流程 7 圖 2-1 臺灣「電子商務」市場交易金額 14 圖2-2 技術接受模型發展圖 15 圖2-3理性行為理論模型 (Theory of Reasoned Action,TRA) 16 圖2-4 計劃行為理論模型(Theory of Planned Behavior, TPB) 17 圖2-5 技術接受模型(Technology Acceptance Model, TAM)) 18 圖2-6 技術接受模型擴充理論(ETAM) 22 圖2-7 整合型科技接受模型(UTAUT) 23 圖3-1 研究架構 29 圖 4-1 整體模式之線性結構關係圖 53 圖 4-2 本研究之路徑結構關係圖 62[[note]]學號: 702550178, 學年度: 10

[[alternative]]Exploring the Resilience, Self-Care Behavior and Related Factors among Pre-End Stage Renal Disease Patients

[[abstract]]背景：慢性腎臟病是進行性、永久性和全球性的健康問題，若疾病沒有得到良好的控制，將導致尿毒症需長期透析治療，自我照顧行為是重要因素，復原力會影響疾病適應及衝擊的程度，然而國內鮮少針對此族群的復原力與自我照顧行為相關因素探討。目的：探討末期腎臟病前期病患復原力與自我照顧行為之預測因子方法：採橫斷式、相關性研究設計，方便取樣方式選取北部某醫學中心腎臟內科門診追蹤之末期腎臟病前期病患為研究對象，採結構式問卷，包括：復原力量表、自我照顧行為量表進行資料收集。以描述性、推論性統計之t-test、ANOVA、逐步迴歸進行資料分析。結果：收案182位末期腎臟病前期病患，平均年齡為68.07歲(SD±13.14)，男性居多。結果顯示整體復原力為中等程度，整體復原力及整體自我照顧行為呈現正相關。工作狀況、復原力對自我照顧行為之解釋變異量為26.9％。結論與實務應用：工作狀況和復原力是末期腎臟病前期病患自我照顧行為重要影響因子。護理人員宜重視末期腎臟病前期患者復原力及相關因素，可透過在職教育訓練提升知識及技能、主動關懷工作情形、鼓勵病人學習自我照顧，以增強病人復健動機及信心程度、藉由跨領域醫療團隊合作及支持性關係，促使疾病恢復及生活因應能力。[[abstract]]Abstract: Chronic kidney disease is a progressive, permanent and global health concern. If the disease is not well-controlled which indicates the importance of self-care behaviors , it will lead to dialysis treatment for patients with uremia . Resilience is known to affect the degree of the indiviual adaptation to impact of Pre-End Stage Disease patients. However, few studies have examined resilience and self-care behaviors realated factors among Pre-End Stage Renal Disease patients in Taiwan.Purpose: To explore the resilience and self-care behaviors realated factors among Pre-End Stage Renal Disease. Methods：A cross-sectional study design was adopted. Convenience sampling was employed to recruit participants from of the Central District of a regional teaching hospital in northern Taiwan. A structured questionnaire, including the Chinese version of the resilience scale and the self-care behaviors, was used for data collection. Data were analyzed using descriptive and inferential statistics, and correlational analysis, stepwise regression analysis were done for the result.Results: A total of 182 Pre-End Stage Renal Disease patients who averaged age were 68.07 ± 13.14 years, predominantly male were recruited. The results of this study showed that the global resilience of participants was moderate degree, and a significantly positive correlation existed between global resilience and global self-care behaviors . Job and the global resilience accounted for 26.9% of the total variation in self-care behaviors.Conclusion /Implications for Practice: Job and resilience were identified as the crucial predictive factors of resilience in Pre-End Stage Renal Disease patients. CKD nursing staff should pay attention to the resilience and related factors of Pre-End Stage Renal Disease patients through cross-disciplinary medical team cooperation and supportive relationships. The results support the recommendations that healthcare providers should acquire advanced knowledge and skills through in-service education, proactive caring job situation , and encouraging patients to learn self-care in order to enhance rehabilitation motivation and confidence levels and subsequently promote disease recovery and the ability to adapt to life

醫院品管圈的團隊結構與衝突處理行為

[[abstract]]目標：探討大台北地區區域級以上醫院之品管圈團隊結構(團隊合作規範、團隊任務凝聚力)與團隊衝突處理行為之相關性。方法：採橫斷式問卷調查法，有效樣本為大台北地區16家醫院263個品管圈團隊1914成員，回收率達86.80%。研究工具包括Chatman及Flynn之團隊合作規範量表、Van de Van及Ferry之團隊任務凝聚力量表和Rahim之衝突處理行為量表，量表Cronbach’s alpha值範圍為0.70~0.92，顯示各量表具良好內在一致性。以團體為分析單位，每個團隊內個人層級之資料聚合來代表該團隊分數，以單因子變異數分析(one-way analysis of variance)、內部相關係數(Intraclass correlation coefficients)及eta square檢定個人資料聚合為團體資料之適切性，再以迴歸模式分析團隊合作規範、任務凝聚力與團隊衝突處理行為之關係。結果：控制團隊規模與品管圈組圈次數後，團隊合作規範(b＝0.49，p＜0.01)、團隊任務凝聚力(b＝0.10，p＜0.05)兩者共解釋整合型衝突處理行為58%變異量；團隊合作規範(b＝-0.17，p＜0.05)能解釋支配型衝突處理行為15%變異量；逃避型與順應型團隊衝突處理行為模式皆未達顯著意義。結論：團隊合作規範與團隊任務凝聚力較能預測品管圈整合型與支配型衝突處理行為，研究結果將有助於未來醫療相關機構在教育訓練及實務上應用之參考並作為未來相關研究的依據。 Objectives: This study investigated the relationship between group structures (i.e., cooperation norms and task cohesion) and styles of handling conflict within the quality control circles (QCCs) of Taipei-area hospitals. Method: Utilizing a cross-sectional design with the distribution of questionnaires, a valid sample was collected which included 263 groups comprised of 1914 individuals from 16 hospitals. The instruments with acceptable Cronbach's alpha values, ranging from 0.70~0.92, were included in this study. Because of unit for group level analysis, the aggregated individual level data in a single group were used as representative values of the group. The results of intra-class correlation coefficients, eta-square, and one-way analysis of variance indicated that the aggregated individual level data satisfactorily represented group level data. Four hypotheses were tested by regression analysis. Results: The response rate was 86.8%. After controlling for the variables of group size and times of QCC formation, cooperation norms (b=0.49, p＜0.01) and task cohesion (b=0.10, p＜0.05) together accounted for 58% of the variance in the ”integrating” style of handling conflict, while cooperation norms (b=-0.17, p＜0.05) alone accounted for 15% of the variance in the ”dominating” style of handling conflict. ”Avoiding” and ”obliging” styles of handling conflict were not predicted by cooperation norms and task cohesion. Conclusions: The findings of the current study suggest that cooperation norms and task cohesion are good predictors of the ”integrating” and ”dominating” styles of handling conflict for the QCCs of hospitals. The results may thus be helpful for health care institutions seeking to improve the quality of in-service education, practice, and research

The Relationship between Leadership Style and Group Effectiveness: An Example of Quality Control Circles of Hospitals in Taipei Area

[[abstract]]Objectives: The aim of the study was to examine the association between the leadership styles and group effectiveness of quality control circles (QCCs) of hospitals accredited at the level beyond regional teaching in the Taipei area. Methods: Based on the predictive corelational design, data were collected from target members of QCCs by using structured questionnaires modified from Stogdill's LBDQ-Ⅱ and Hwang's group effectiveness questionnaires from May 2002 to June 2002. At a group response rate of 86.8%, 263 QCC groups including 1994 cases from 16 hospitals in the Taipei area were enrolled for analysis using individual circle members as the study targets. Results: The result of logistic regression analysis revealed significantly positive association between combined task and consideration-oriented leadership and group effectiveness (OR=1.47, p＜.001). Multiple regression analysis also showed considerably positive association between combined task and consideration-oriented leadership and group effectiveness (β=.052, p＜.001). The results were consistent with the leadership of combined product center and people center as the best one to promote the group effectiveness reported by O'Donnell & O'Donnell and the characteristics of democratic leadership style in the managing grid theory proposed by Blake and Mouton. Conclusions: This study discovers the leadership style of combined task and consideration-orientation is a basic aspect in the training course of enhancing hospital QCC effectiveness, can promote human relations and group interactions, and, moreover, achieves persistently high group effectiveness

Group Perspective: Group Structure and Effectiveness of Quality Control Circles in Hospitals

[[abstract]]目標：探討台北地區區域級以上醫院之品管圈團體結構（團體規模、團體合作規範、團體任務規範及團體任務凝聚力）與團體效能之相關性。方法：採橫斷式問卷調查法，台北地區已推行品管圈之醫院共19家，有16家醫院品管圈圈員同意接受調查，共收集263個有效品管圈樣本，包括1,914位品管圈圈員，團體回收率達86.80%。以團體為分析單位，每個團體內的個人層級之資料將聚合代表該團體的分數，以內部相關係數(Intraclass correlation coefficients, ICCs), eta squared (η^2)，及單因子變異數分析(one-way analysis of variance)檢定，確定個人層級資料可聚合後代表團體層級之資料，再以迴歸模式進行四個與團體相關之研究假說檢定。結果：團體合作規範、團體任務規範、團體任務凝聚力與團體效能呈正相關之三個假說獲得支持，共解釋51%團體效能的變異量，但團體規模與團體效能則無顯著的正相關，該假說未獲支持。結論：品管圈具有較高的團體合作規範、團體任務規範及團體任務凝聚力的特質時，會有較好的績效表現，因此建議未來可積極建立團體合作規範、團體任務規範及團體任務凝聚力來促進良好的團體互動，以提昇團體效能。 Objectives: This study aimed to investigate the relationship between group structures (group size, cooperation norms, task norms, and task cohesion) and group effectiveness of the quality circles of hospitals in Taipei area. Methods: A cross-sectional research design was adopted for data collection. Two hundred and sixty-three quality circle groups with 1,914 individuals from the 16 of the 19 hospitals in the Taipei area were enrolled for analysis. The groups' response rate was 86.8%. Because the unit for analysis was the quality circle group, the aggregated individual-level data in a single group were used as the representative values for the group. Results of intraclass correlation coefficients (ICCs), Eta-squared (η^2), and one-way analysis of variance showed that aggregated individual-level data were capable of representing the group level data. Multiple regression analysis was adopted to test four hypotheses. Results: Groups with higher levels of cooperation norms, task norms, and task cohesion had greater feeling of group effectiveness as perceived by the members. In spite of this group size was not considerably associated with group effectiveness. The cooperation norms, task norms, and task cohesion accounted for 51% of the variance in group effectiveness. Conclusions: It was concluded that the group members having better feeling of cooperation norms, task norms, and task cohesion demonstrated highe

Organizational Change and Reshaping the Nursing Profession

[[abstract]]世界快速變化，由工業社會變成e化的資訊社會，醫療產業也遭受空前的壓力，醫院紛紛以策略聯盟、民營化、外包等方式進行改革以順應時代之巨變，如果變革已是唯一的選擇，那麼如何做好變革管理就顯得特別重要。本文旨在提供讀者有關組織變革與組織再造相關的概念及研究，其能有助讀者對這些概念有更明確的認識，並能以積極創新的心態勇於面對護理的再造。 Recently the economic and technological environment has undergone enormous changes. In response to rapid external forces, healthcare organizations have sought to increase efficiency and effectiveness through strategic alliances, privatization, and outsourcing. Since change is inevitable, it is important to manage it well. An attempt is made to provide knowledge of organizational change and restructuring that will help the nursing professional face the reshaping of nursing with creativity and courage

The Truth about Quality: An Introduction of Quality Function Deployment

[[abstract]]由於財務限制，醫療健康產業面臨競爭壓力，藉由改善健康照護品質以提升組織面臨之挑戰，但若無法對品質的內涵理解透徹，即無法有效改善健康照護品質。本文旨在幫助醫療成員了解品質機能展開法的技能，以便了解顧客的聲音及有效改善品質。 Health care industries have faced competitive pressure due to cost constraint. Improving health care quality is an approach to increasing the competitive challenges an organization faces. However, the effort of improvement would be ineffectual without clearly understanding the meaning of quality. This paper assists health care providers in understanding quality function deployment (QFD) techniques which can find out the voice of the customer and enhances the quality effectively

加速失敗時間模式分析新發乳癌病患併發血栓栓塞對其存活的影響

[[abstract]]目標：血栓栓塞併發症（TEEs）為乳癌併發症主要之一且增加死亡風險，本研究擬探討台灣新發乳癌病患併發血栓栓塞之相關因素及對其兩年存活的影響。方法：本回溯性世代研究使用1997至2010年全民健康保險研究資料庫。以Poisson分佈探討2000到2008年新發乳癌世代觀察兩年其併發TEEs的發生情形。透過propensity socre匹配後再以Accelerated Failure Time Model檢視有無併發症病患對其兩年存活之影響。結果：2000-2008年新發乳癌世代共80,598人，罹癌確診後兩年內併發TEEs之累積發生率1.78%（95% CI = 1.74-1.82），且第一個半年併發症發生密度為1.38發生事件數／每100個人年。併發TEEs危險因子有年齡（≧65歲比＜45歲adjusted incidence rate ratio [adj. IRR] = 3.87，95% CI = 3.80-3.93），共病指數（≧3分比0分adj. IRR = 1.96，95% CI = 1.93-2.00），有高血壓病史（adj. IRR = 1.43，95% CI = 1.41-1.45），有乳房手術者（adj. IRR = 1.47，95% CI = 1.45-1.49），接受放射線治療者（adj. IRR = 1.29，95% CI = 1.28-1.31），接受化學藥物治療者（adj. IRR = 1.40，95% CI = 1.38-1.42），醫院層級（地區醫院比醫學中心adj. IRR = 1.13，95% CI = 1.11-1.15）。AFT model分析顯示在控制其他變項後，有併發TEEs者比無者有較高比例的兩年死亡風險（adjusted Rate Ratio = 2.55, 95% CI = 2.24-2.91），且風險隨時間增加而增加。結論：新發乳癌病患併發TEEs會增加其死亡風險。醫療專業人員者可針對易併發TEE之危險群（如年長、共病指數高、有高血壓、接受乳癌手術、接受化療放療），即早警覺並提供適當的預防措施以利降低併發症的發生及提升癌症照護品質