[[alternative]]The study of enters senior hotel behavior intention in rotary club member

碩士[[abstract]]論文提要內容： 本研究旨在探討扶輪社會員其退休後選擇入住養生村的態度及行為意向。本研究從相關的文獻探討開始著手，再根據計劃行為理論為基礎建立本研究之架構與假設，並選用適當的量表為研究工具，本研究採用滾雪球抽樣法進行抽樣，並且透過紙本方式寄發調查問卷。本研究共發放240份問卷，有效回收樣本203份，有效回收率為84.6%。針對回收的有效樣本203份，進行敘述性統計、信度分析、效度分析、因素分析、t 檢定及變異數分析、相關分析及SEM結構方程模型檢定。經實證分析和討論後，有以下重要發現： (1) 個人選擇入住養生村時受他人影響性，直接正向影響扶輪社會 員入住養生村的態度。 (2) 扶輪社會員對入住養生村的態度、個人選擇入住養生村時受他 人影響性、個人選擇入住養生村的行為可支配性三者均會直接 正向影響扶輪社會員入住養生村的行為意向。 (3) 實證研究結果發現，主觀規範對入住養生村的行為意向倾向的 影響是顯著的，同時主觀規範對入住養生村的行為態度的影響 也是顯著，顯示主觀規範是透過態度作為中介變數來間接影響 行為意向，此顯示了計劃行為理論可用於解釋扶輪社會員入住 養生村行為上。 關鍵字：態度、主觀規範、知覺行為控制、行為意向[[abstract]]Abstract: The main purpose of this research is to determine how a northern Taiwan Rotary Club member chooses to move into a particular retirement facility upon his or her retirement. This research employs Ajzen’s Theory of Planned Behavior model (TPB) to study the behavioral intention of the Rotary Club member. TPB model, constructed by attitude, subjective norm, perceived behavioral control and behavioral intention, is widely adopted to predict and explain individual’s behavior. This research is begun to set about from relevant references, then set up structure and hypotheses of this research according to its theoretical foundation, select proper scale for study tool, adopt snowball sampling, implement questionnaire investigation for total 240 Rotary Club member in northern Taiwan. To effective 203 materials of sample retrieving which account for effective rate of 84.6%, analyze the descriptive statistics, reliability, validity analysis, factor analysis, t-test, one way ANOVA, correlation analysis and structural equation model (SEM). After the empirical research, the major findings as follows: （1）Subjective norm has positive effects on attitude to the particular retirement facility. （2）Consistent with the theory, the results of a structural equation analysis revealed that attitude, subjective norm, and perceived behavioral control positively affected intention to move into a particular retirement facility of the Rotary Club member. （3）The relationship between subjective norm and behavior intention is mediated by attitude. It can be concluded that the study also revealed that Planned Behavioral Theory can be used to explain Rotary Club member’s choice of retirement facility.[[tableofcontents]]目錄 I 表目錄 II 圖目錄 III 第一章 緒 論 1 第一節 研究背景與動機 1 第二節 研究目的 4 第三節 研究範圍與對象 5 第四節 研究流程 6 第二章 文獻探討 8 第一節 養生村經營模式 8 第二節 扶輪社 12 第三節 計劃行為理論 15 第三章 研究方法 21 第一節 研究架構 21 第二節 研究假說 22 第三節 研究變數之操作性定義 23 第四節 抽樣設計 25 第五節 問卷設計 25 第六節 資料分析方法 30 第四章 資料分析 32 第一節 樣本結構分析 32 第二節 信度分析 35 第三節 相關分析 36 第四節 效度分析 36 第五節 結構方程模型SEM檢定 39 第六節 人口統計變項對入住養生村行為意向之探討 45 第五章 結論與建議 47 第一節 研究結論 47 第二節 管理意涵、研究建議與研究限制 49 參考文獻 52 一、中文部份 52 二、英文部份 54 三、網站 57 問 卷 調 查 58 表目錄 表2-1 潤福押租金 9 表3-1 態度評價之衡量題項 26 表3-2 主觀規範評價之衡量題項 27 表3-3 知覺行為控制評價之衡量題項 28 表3-4 行為意向評價之衡量題項 28 表4-1 人口統計變數次數分配表 34 表4-2 各研究構面之信度分析表 35 表4-3 各研究構面之相關係數 36 表4-4 各研究構面之區別效度表 39 表4-5 態度、主觀規範、知覺行為控制與行為意向構面之收斂效度表 38 表4-6 整體模式配適度 42 表4-7 研究模型路徑結果 44 表4-8 各研究構面之效果分析 44 表4-9 人口統計變項對入住養生村行為意向之差異性分析表 46 圖目錄 圖1-1 研究流程圖 7 圖2-1 計劃行為理論模式 16 圖3-1 研究架構圖 21 圖4-1 本研究模式之線性結構關係路徑分析圖 43[[note]]學號: 797610093, 學年度: 9

Application and Construction of Physical Examination in Health Center of Elementary School

[[abstract]]學童主要的死因包括：事故傷害、惡性腫瘤、心臟疾病、肺炎、腦血管疾病及自殺等，校園中這些疾病需要學校護理人員運用身體評估技巧與批判性思考(critical thinking)進行疾病初步篩檢，以提供更有效率的健康照顧或轉介醫療院所。緊急狀況下護理人員能熟練的評估學生的意識狀況、昏迷指數(GCS)、生命徵象、呼吸型態及皮膚濕冷等休克症狀，在第一時間內將學生送醫並維持生命，可以挽救學童幼小的生命，避免殘疾的發生。其次，疾病盛行率的評估，緊急處理集體食物中毒，避免傳染病擴大，在公共衛生有重要的功能。一般狀態下，學校護理人員經由視力健康篩檢，注意學生潛在的健康主訴，評估學生身體外觀、行走步態、心音、呼吸音、腸音及腹部柔軟度，即能簡易篩檢其健康問題，所花費的時間僅2-5分鐘，卻能守護學生的健康。緊急狀態下，則需熟悉快速的腦神經、心肺功能評估，確立疾病的嚴重度而有所根據才能依緊急傷病救護的原則送醫。本文介紹身體評估各系統簡易評估重點，緊急與一般狀況下評估內容，以提供學校護理人員辨別學童疾病之參考。 The main causes of childhood death were accidents, malignant cancer, heart diseases, pneumonia, cerebral vascular diseases and suicides. School nurses need to apply physical assessments and make a critical thinking to detect pre-existing and extending problems. Sometimes, it would also be necessary to transfer the patients to a hospital for better and more efficient cares. In an emergency situation, school nurses are proficient in performing physical examinations that detect symptoms of shock including conscience level, GCS coma scale, vital signs such as blood pressure, body temperature, heart rate, and breath. The school nurses have to make a critical decision about whether to take care of the ill students or transfer them to a better medical attention. On the other hand, it is also important to detect highly contagious diseases, cases of food poisoning, and prevention of illness from contamination. Physical assessment protocol in school health centers should not only allow the nurses to be skilled in physical assessment skills but also to prepare the equipments for emergency situations. Physical assessment skills are the foundation of medical care, and also the responsibility for school nurses. This document will introduce a more efficient way about simple physical examinations and the content of the evaluations between general and emergency situations. Over all, it will provide valuable suggestions about how to verify different symptoms with children under critical thinking for nursing school

[[alternative]]The Relationships among Family Condition, Illness, and School Achievement of Primary School Students to School Illness and Injury Rates-A Primary School in Southern Taiwan as an Example Running Title: Predicting Factors of School Illness and Injury Rates

[[abstract]]學校衛生護理人員為達事半功倍的護理成效，確認需要高關懷的學童給予合適的介入措施，是學童健康管理重要的楔子。本文為縱貫性研究設計，研究群體以南部某國民小學91學年入學的104學童為對象，資料來源為學生健康系統資料庫，研究目的旨在探討學童的傷病頻率與學童個人特質、學業成就及其家庭型態間的關係。研究假設有三，包括：單親及新移民家庭學童的傷病頻率顯著高於雙親家庭的學童；有特殊疾病學童的傷病頻率顯著高於沒有特殊疾病的學童；學業成就得分較低學童的傷病頻率顯著高於學業成就得分較高的學童。以百分比、平均數及標準差描述受試者的基本資料，利用t檢定及複迴歸驗證研究假設。結果發現，學童傷病的總次數為15.0±13.2次／人，其中學生在六年級時不論受傷（2.9±2.5次／人／年）或疾病（0.8±1.4次／人／年）發生的頻率均最高，在一年級時次高；自二年級開始受傷頻率隨著年級增加而增加，除六年級外疾病頻率則隨著年齡增加而減少。組間差異比較發現單親家庭、國語或數學學業成就表現不佳學童的受傷頻率均較高，並達到統計上的顯著水準。綜合而言，學童傷病頻率的預測因子包括：單親家庭、新移民家庭、國語學業成就的表現，這些變項解釋總變異量介於32.5%-63.0%。本研究結果有助於學校實務工作者了解不同年級學童、家庭型態、宿疾與傷病間的關係，並作為加強管理學童健康需要或提供健康照護服務策略的參考，達到促進學童健康的目標。[[abstract]]There is no doubt that an active intervention by school nurses for the ones who are in possible high risk of health issues in elementary school is the most effective way of school health promotion. With the design of longitudinal studies, this study is based on a collective data from the school health data system of the 104 elementary school students who entered school in the year of 91 in southern Taiwan. The purpose of this study is to discuss about school injury and illness rates and their relationships between family conditions, individual characteristics, and school achievements. There are three study hypotheses which include, first, single parent families and new immigrants have a higher school injury and illness rate compare to the families with parents. Second, the students with particular illnesses will perform a noticeable rate on injury and illness than general students. Last, the ones with lower school achievements will be resulted negatively compare to the ones with better school achievements. By using percentage rate, average rate, standard deviation to describe the basic data of the participants, then the t-test and the multiple linear regression were used to examine the hypothesis. The total result of school injury and illness rate for six-year period is 15.0±13.2 (time/person). On the other hand, grade six students has the highest injury rate of 2.9±2.5(time/person/year; t/p/y) and illness rate of 0.8±1.4(t/p/y) with first grade ended the second highest on injury and illness rates among all other grades. The injury rate increases along with the grades, but the illness rate resulted on the contrary. In the comparison of the variables, Single family or the ones with bad performance on Chinese language or math have a significantly higher injury and illness rate. The predictors of student injury and illness rates include single parent, new immigrants, and bad performance on Chinese language or math achievements with an explaining variation of 32.5% to 63.0%. The value of this study will help school nurse to provide a better school health management strategy for different grades, family conditions, diseases, injuries, and illnesses in order to promote elementary school students' health issues at school

[[alternative]]The Effects of Perimenopausal Health Education Intervention on Perimenopausal Symptoms, Uncertainty and Health Behavior among Midlife Women in Rural Communities in Southern Taiwan

[[abstract]]This study evaluated the effects, at 3 months and 6 months out, of a perimenopausal health education intervention program administered to mid-life women in rural communities of southern Taiwan. Data was collected between August 2005 and July 2006. The study was a quasi-experimental design, controlled trial for middle aged women. Four neighborhood communities were requested to participate in this study. A randomized method was used to assign two to an experimental group and two to a control group. Three instruments were used to collect data, including the (1) Perceived Perimenopausal Disturbances Scale, (2) Perceived Uncertainty Scale and (3) Practice of Health Behaviors Scale. The intervention effects from the study baseline to a 6 months follow-up were estimated using a mixed effect model (SAS-MIXED procedure) for repeated measures of health behaviors, perceived uncertainty and perceived perimenopausal disturbances. A total of 102 women were included in this study, with 53 women in the experimental group and 49 women in the control group. After 3 months follow-up, health education intervention had significantly decreased perceived uncertainty (β=-7.44, p<.05). After 6 months, health education intervention had significantly improved perimenopausal disturbances and increased positive health behavior practices (β=-6.47, 13.05, p<.05). Health providers should continue delivering perimenopausal health counseling and health education to women living in rural communities. Hopefully, such will empower rural women to practice self care of their perimenopausal health

僵直性脊椎炎病人身體心像之相關因素 Factors Associated with Body Image in Patients with Ankylosing Spondylitis

[[abstract]]背景：僵直性脊椎炎病人較一般人遭遇更多生理及功能的損壞，為身體心像紊亂的高危險群，但在臺灣這群病人身體心像的相關因素卻很少被充分探究。目的：探討僵直性脊椎炎病人身體心像的情形及其預測因子。方法：採橫斷性相關性研究及方便取樣，收案時間為2017年1月至12月，由北臺灣某一醫學中心免疫風濕科門診招募120位僵直性脊椎炎病人。以結構性問卷及病例審查進行資料收集，研究工具包括人口學資料、跌倒史、巴斯僵直性脊椎炎疾病活動指數、脊椎炎功能指數、疼痛及身體心像等量表。結果：整體身體心像平均分數為68.16±16.14分，14.2%一年內曾跌倒，九成以上有不同程度的疼痛。多元迴歸檢測顯示脊椎炎疾病活動度分數越高（β=-.31,p= .005）；脊椎炎功能指數越高（β=-.24,p= .026）；有跌倒史者（β=-.16,p= .023），身體心像得分越低，多元迴歸模式整體解釋變異量為47.9%（F=10.95,p＜ .001）。結論／實務應用：疾病活動度、失能狀況和跌倒史與僵直性脊椎炎病人的身體心像感受有顯著相關，臨床人員應定期評估病人疾病活動狀態及身體心像變化，提升病人自我管理能力，並將預防跌倒及疼痛控制整合於照護計畫，以提升病人的身體心像及生活品質。 Background: Patients with ankylosing spondylitis typically exhibit a greater number of physical and functional impairments than do members of the general population and are a group at high risk of body-image disturbance. However, the factors associated with body image among this population have not been adequately explored in Taiwan. Purpose: To explore the status of body image and its predictors in patients with ankylosing spondylitis. Methods: A convenience sampling-based cross-sectional and correlational study was conducted between January and December 2017. In total, 120 patients who had been diagnosed with ankylosing spondylitis were recruited from the immunology and rheumatology department of a medical center in northern Taiwan. A structured questionnaire and chart review were employed to collect research data. Instruments included demographic data, fall history, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Numeric Pain Rating Scale (NRS), and the Rheumatic Arthritis Body Image Scale. Results: The mean score for body image was 68.16 ± 16.14. Overall, 14.2% of patients had experienced a fall in the previous year, and more than 90% of participants experienced various degrees of pain. The multiple regression result revealed that patients with a higher BASDAI (β = - .31, p = .005) score, a BASFI higher (β = - .24, p = .026) score, and had a fall history (β = - .16, p = .023) had higher negative body image scores. The total variance explained in the multiple regression model was 47.9% (F = 10.95, p ＜ .001). Conclusions/Implications for Practice: Disease activity, disability, and fall history were associated with body image in patients with ankylosing spondylitis. Clinical professionals should regularly assess the disease activity and body image of patients and promote their self-management abilities. Furthermore, fall prevention and pain control should be integrated into care plans to improve patients' body image

Living Donor Liver Transplantation: The Decision Experience

[[abstract]]活體肝臟移植手術是因應器官捐贈短缺，而需要解救末期肝病病人生命的一個選擇，而決定採用活體移植的方式可能是整個家庭成員之間互動的結果，從本文的案例發現，由於是自己的親人需要新的器官，捐贈者是義無反顧，有捨我其誰的情操，會經歷掙扎、不捨、害怕與猶豫等天人交戰的時刻，透過對醫護人員的信任、評價自己的情況與風險使決心更加確定。另外，此手術將同時影響捐贈者、受贈者及主要家屬的健康，因此醫護人員必須深入了解他們的經驗與感受，以作為臨床照護的實證基礎。 Living donor liver transplantation is a treatment choice for end-stage liver disease patients who face a shortage of currently available donated livers. The decision process involved in living donor organ donation has been described as a complicate process within the family of the patient. Donors have expressed willingness to donate a part of their own living liver in order to ensure the health of a loved one or relative when such a proposition was raised by the attending physician. Such decisions were taken even in the face of certain struggle, fear and ambiguous feelings. Donation decisions may be reinforced through feelings of confidence and trust in the physician and positive evaluations of the risk to donor health of making a 'living' donation. Necessary surgery will impact not only the recipient and donor but also family members. Staff on the transplantation team should make greater efforts to explore perceptions and concerns within families of living donors in order to deliver effective evidence-based care

專線遠端遙控障礙監測架構

[[abstract]]一種專線遠端遙控障礙監測架構，係採用手機作為遠端測試平台，並利用目前所有行動電話都具備之簡訊傳送功能作為操作介面，障礙查修人員可利用個人所配備之手機傳送障礙查測功能至本系統，系統依照使用者所要求之查測項目，取出專線資料進行自動測試流程，最後並以簡訊回傳查測結果至查修人員手機。提供障礙查修人員迅速找出障礙點以排除障礙

加護病房病人主要照顧者的焦慮、 憂鬱、社會支持與其生活品質之關聯

[[abstract]]目的：本研究探討加護病房主要照顧者的焦慮、憂鬱、社會支持與其生活品質之關聯。方法：本研究採橫斷式研究設計，採用便利取樣方式，於北部某區域教學醫院內科加護病房共蒐集161位主要照顧者的問卷。問卷內容包含焦慮、憂鬱、社會支持及生活品質。統計方法以描述性統計、獨立樣本t檢定（independent samples t-test）、單因子變異數分析（one-way ANOVA）、皮爾森相關分析（Pearson's correlation analysis）及逐步複迴歸分析（stepwise multiple regression analysis）等。結果：焦慮（p＜.05）、憂鬱（p＜.01）與社會支持皆顯著負相關。焦慮（p＜.01）、憂鬱（p＜.01）與生活品質皆顯著負相關。社會支持與生活品質呈顯著正相關（p＜.01）。焦慮、憂鬱及社會支持可預測生活品質解釋力達45.7%。結論：加護病房病患主要照顧者之社會支持程度越低，其焦慮、憂鬱的心理反應程度就越高，生活品質就越低；重症單位病患主要照顧者的焦慮、憂鬱及社會支持可預測生活品質