臺灣博碩士論文加值系統

現今醫療科技的高度發展與電子病歷的推動下，醫療資訊整合已成為世界朝流，
也是開發中國家的主要醫療政策之一，因此醫療資訊化是目前重要議題，中醫未來勢
必也需要朝向資訊化與資訊整合邁進，因此本研究主要目的在探討中醫師對於中醫資
訊系統的知覺效益及觀感的外在因素。本研究試者延伸科技接受模型理論研究中醫資
訊化領域，本研究延伸現有的科技接受模型探討影響中醫師對中醫資訊化的態度之外
在因素：科技成熟度、政策、醫院因素、社會因素，本研究的觀點在於外部變數在科
技接受模型的結構裡用於解釋中醫資訊化接受程度的研究，提供的證明來確定中醫師
對於中醫資訊化之意圖與使用，在中醫資訊化之前，期望中醫未來發展能朝醫療資訊
整合規範( Integrating the Healthcare Enterprise, IHE )的方向邁進並提出建議。
本研究以分析 111 份回收樣本，驗證結果發現，結果顯示科技成熟度與政策對於
系統操作性有正向影響，社會因素對於系統功能性有正向影響，系統操作性對於醫療
品質有正向影響，個人資訊素養會對系統功能性與醫療品質產生干擾效果。最後根據
研究結果提出未來研究方向。

Today, global changes have great influences on healthcare industry. The integration of
medical information has become a global trend and a main policy in many developing
countries. This study explores the opinions based on a quantitative study of investigating
the impacts and attitude of TCM physicians perceived effectiveness toward TCM
technology. This article extends existing technology acceptance models to external factor.
The purpose of this study is the viewpoint of external factor in Technology Acceptance
Model which explains the acceptance of TCM Technology and provides the Actual System
Use of TCM physicians. In the end, we would like to provide suggestions for future
researchers and expect TCM to have a further development toward IHE.
The data were analyzed from questionnaires of 111 TCM physicians, the analysis
shows that the technology maturity and government policy positively influence system of
maneuverable, society factors positively influence system of functionality, system of
maneuverable positively influence quality of healthcare, system of functionality positively
influence quality of healthcare and personal information literacy factor have mediating
effects between system of functionality and quality of care. Finally, we hope to provide
directions to future researches.

第壹章 緒論 ................................................................................................................... 1
第一節 研究背景 ................................................................................................... 1
第二節 研究動機 ................................................................................................... 2
第三節 研究目的 ................................................................................................... 4
第四節 研究範圍 ................................................................................................... 4
第五節 研究流程 ................................................................................................... 5
第貳章 文獻探討 ........................................................................................................... 6
第一節 IHE ( Integrating the Healthcare Enterprise ) ........................................... 6
第二節 電子健康紀錄（Electronic Health Record, EHR ） .............................. 8
第三節 傳統中國醫學( Traditional Chinese Medicine , TCM ) .......................... 11
第四節 中醫資訊系統發展概況 ......................................................................... 16
第五節 中醫診斷決策資訊化 ............................................................................. 17
第六節 中醫專家系統 ......................................................................................... 25
第七節 中草藥資料庫 ......................................................................................... 26
第八節 其他中醫資訊化 ..................................................................................... 28
第九節 科技接受模型( Technology Acceptance Model, TAM ) ........................ 30
第十節 科技接受模型之醫療相關研究與改良 ................................................. 32
第十一節 醫院因素 ............................................................................................. 34
第十二節 社會因素 ............................................................................................. 35
第十三節 科技成熟度 ......................................................................................... 36
第十四節 政策 ..................................................................................................... 36
第十五節 功能性 ................................................................................................. 37
第十六節 操作性 ................................................................................................. 37
第十七節 個人資訊素養 ..................................................................................... 38
第十八節 醫療品質 ............................................................................................. 38
第參章 研究方法 ......................................................................................................... 40
第一節 研究架構 ................................................................................................. 40
第二節 研究假說 ................................................................................................. 41
第三節 研究設計 ................................................................................................. 47
第四節 問卷設計 ................................................................................................. 48
第五節 研究變數與操作化定義 ......................................................................... 49
第六節 研究對象與抽樣方法 ............................................................................. 56
第七節 資料蒐集 ................................................................................................. 57
第肆章 資料分析 ......................................................................................................... 58
第一節 基本資料分析 ......................................................................................... 58
第二節 對未來中醫資訊化態度之敘述性統計 ................................................. 60
第三節 量表之信度與效度分析 ......................................................................... 63
第伍章 研究結論與未來發展 ..................................................................................... 74
第一節 研究發現與研究結論 ............................................................................. 74
第二節 研究限制與建議 ..................................................................................... 77
第三節 未來發展方向 ......................................................................................... 78
參考文獻 ............................................................................................................................. 80
附錄一 ................................................................................................................................. 92
圖 1 研究步驟 ..................................................................................................................... 5
圖 2 IHE 整合規範(Integration Profiles ) ........................................................................... 7
圖 3 中醫整體觀與陰陽五行 ........................................................................................... 15
圖 4 中醫診斷八原則 ....................................................................................................... 15
圖 5 中醫資訊化整合概觀 ............................................................................................... 17
圖 6 科技接受模型 ........................................................................................................... 30
圖 7 本研究架構 ............................................................................................................... 40
圖 8 本研究構面關係圖 ................................................................................................... 42
圖 9 中醫看診能夠被資訊化程度 ................................................................................... 61
圖 10 中醫師未來中醫資訊化期望 ................................................................................. 62
圖 11 研究架構路徑分析與結果 ...................................................................................... 72
表 1 美國病歷協會電子病歷發展5 大階段 .................................................................... 11
表 2 中醫四診「望、聞、問、切」 ............................................................................... 14
表 3 中醫資料探勘工具與相關應用 ............................................................................... 18
表 4 望診資訊化相關研究 ............................................................................................... 20
表 5 聞診資訊化相關研究 ............................................................................................... 23
表 6 中醫問診資訊化相關研究 ....................................................................................... 24
表 7 脈診資訊化相關研究 ............................................................................................... 24
表 8 脈波測量點 ............................................................................................................... 25
表 9 中醫專家系統相關研究 ........................................................................................... 26
表 10 中草藥資料庫 ......................................................................................................... 27
表 11 中醫相關資訊化應用 ............................................................................................. 29
表 12 科技接受模型在醫療照護之相關研究 ................................................................. 33
表 13 本研究假說彙整 ..................................................................................................... 47
表 14 醫院因素之研究變數與操作化定義 ..................................................................... 49
表 15 社會因素之研究變數與操作化定義 ..................................................................... 50
表 16 科技成熟度之研究變數與操作化定義 ................................................................. 51
表 17 政策之研究變數與操作化定義 ............................................................................. 52
表 18 功能性之研究變數與操作化定義 ......................................................................... 53
表 19 操作性之研究變數與操作化定義 ......................................................................... 54
表 20 個人資訊素養之研究變數與操作化定義 ............................................................. 55
表 21 醫療品質之研究變數與操作化定義 ..................................................................... 56
表 22 回收樣本之基本資料(n = 111 ) ............................................................................. 58
表 23 中醫看診能夠被資訊化程度 .................................................................................. 61
表 24 影響看診品質的重要性 ......................................................................................... 62
表 25 中醫未來發展的重要性 ......................................................................................... 63
表 26 信度分析Cronbach α係數值與組合信度(CR) .................................................. 64
表 27 各問項之因素負荷量 ............................................................................................. 66
表 28 相關係數矩陣與AVE 平方根 ............................................................................... 69
表 29 研究假說檢定 ......................................................................................................... 73

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