臺灣博碩士論文加值系統

國民營養狀況象徵著一國之力，也是衡量國家發展狀況的重要指標，育齡女士的特殊生理營養需求，其營養識能狀態影響著個人或家人每日六大類食物攝取、健康飲食行為及罹病風險。本研究旨在探討應用跨理論模式教育介入提升女士營養識能的成效，研究方法採準實驗設計，針對新竹市某醫事科技大學日二技及日四技學生各2班，分實驗及對照組共128位女學生，實驗組進行跨理論模式營養教育介入，對照組進行傳統教學。研究工具進行預試、信效度考驗，資料以SPSS 20.0版進行共變數分析。研究結果歸納如下：營養認知前測答對率為七成五，飲食改變行為階段處於無意圖期佔22.7%、意圖期佔15.5%、準備期20.5%、行動期24.5%、維持期16.9%。研究對象99%每週有外食、未規律吃早餐及吃零食習慣，84.4%每週都有喝含糖飲料、61.7%每週有吃炸物、85.2%未規律運動。飲食行為改變、飲食自我效能與營養認知呈現正相關；飲食共享決策與飲食決策權衡呈現正相關；飲食行為改變與飲食自我效能呈現正相關。有運動習慣、飲食行為改變、飲食自我效能對營養認知的聯合解釋力為39.7%。飲食自我效能、吃健康食品習慣、營養認知及喝含糖飲料頻率對飲食行為改變的聯合解釋力達97.8%，吃健康食品習慣、喝含糖飲料習慣與飲食行為改變呈現負相關，其中飲食自我效能最能影響營養認知及飲食改變行為。以跨理論模式之營養教育策略介入措施後，在營養認知、共享決策、決策權衡、行為改變階段及自我效能上均有顯著提升。本研究結果可供未來提升營養識能相關研究與實務工作參考。

The national nutritional status reflects the status of national development and social condition. The special physiological and nutritional needs of women of childbearing age, their nutritional status affects the daily intake of six major types of food, healthy eating behavior and risk of rickets for individuals or family members. This study aims to apply the Transtheoretical model of education intervention strategy on women's nutritional literacy. The research method adopts the quasi-experimental design among 128 female students divided into experimental and control groups of a medical science and technology university in Hsinchu City. The experimental group conducted Transtheoretical model nutrition education intervention, and the control group conducted traditional teaching method. This research tool was pre-tested, the reliability and validity were examined, and the covariate analysis was performed with SPSS 20.0. The results of which are summarized as follows: The pre-test and answer rate of nutrition cognition is 75%. The stage of dietary uptake behavior was 22.7% in the absence of intention period, 15.5% in the intention period, 20.5% in the preparation period, 24.5% in the action period, and 16.9% in the maintenance period. Study subjects 99% have weekly food, irregular breakfast and snack habits. 84.4% drink sugary drinks every week, 61.7% eat fried food every week, and 85.2% irregular exercise. The results showed that nutritional knowledge was positively correlated with dietary behavior change and dietary self-efficacy; dietary sharing decision-making was positively correlated with dietary decision-making balance; dietary behavior change was positively correlated with dietary self-efficacy. The joint explanatory power of exercise habits, dietary behavior changes, and dietary self-efficacy on nutrition knowledge is 39.7%. Dietary self-efficacy, eating healthy food habits, nutritional knowledge, and the frequency of drinking sugary drinks on dietary behavior change were 97.8%. Eating habits of eating healthy foods and drinking sugary drinks have a negative correlation with changes in eating behaviors. Dietary self-efficacy can affect nutritional knowledge and dietary change behavior. After interventions in the nutritional education strategy across the theoretical model, there has been a significant increase in nutritional knowledge, shared decision making(SDM), decisional balance, stage of behavior change, and self-efficacy. The results of this study can be used as a reference for future research and practical work related to nutritional literacy.

目 錄
頁次
口試委員審定書 I
誌 謝 II
中文摘要 III
英文摘要 IV
目 錄 VI
圖 目 錄 X
表 目 錄 XI
第一章 緒 論 13
1.1 研究背景與動機 13
1.2 研究目的 16
1.3 名詞解釋 16
1.3.1 女士 16
1.3.2 營養識能 16
1.3.3 跨理論模式 16
1.4 研究限制 16
第二章 文獻探討 17
2.1 女士營養與健康議題 17
2.1.1 女士身體質量指數與慢性病 17
2.1.2 女士與鐵質缺乏 18
2.1.3 女士與骨質疏鬆症 19
2.1.4 女性飲食營養攝取量與攝取行為 20
2.1.5 女士與健康食品補充 22
2.1.6 女士與身體活動狀態 23
2.2 女士營養識能 24
2.3 跨理論模式 28
2.4 跨理論模式教育與營養識能相關研究 31
2.5 共享決策 35
第三章 研究方法與設計 37
3.1 研究設計 37
3.2 研究架構 39
3.3 研究假設 40
3.4 研究對象 40
3.4.1 實驗處理 40
3.4.2 介入方法 40
3.5 研究工具 41
3.5.1 女士營養識能量表工具 41
3.5.2 女士營養識能教案工具 44
3.6 研究工具信度及效度檢定 49
3.6.1 專家問卷、片及課程內容效度 49
3.6.2 問卷預試、信效度考驗及修正 51
3.6.3 過程評量 53
3.6.4 正式結構式問卷 54
3.6.5 問卷回收及整理 54
3.7 資料分析 54
3.7.1 質性資料分析 54
3.7.2 量性資料分析 55
3.8 倫理考量 57
第四章 結果與討論 58
4.1女士基本人口學分析 58
4.2女士營養識能現況 62
4.2.1 營養教育介入前，營養認知現況分布及同質性檢定 62
4.2.2 營養教育介入前，共享決策現況分布及同質性檢定 64
4.2.3 營養教育介入前，決策權衡前測現況及同質性檢定 67
4.2.4 營養教育介入前，飲食行為改變階段現況分布及同質性檢定 72
4.2.5 營養教育介入前，飲食自我效能現況及同質性檢定 74
4.3 營養教育介入後之營養識能比較分析 76
4.3.1 營養教育前後對營養認知、共享決策、決策權衡、行為改變階段及飲食自我效能之平均數、標準差 76
4.3.2 實驗教學前對營養認知、共享決策、決策權衡、行為改變階段及飲食自我效能之同質性分析 77
4.3.3 實驗教學前對營養認知、共享決策、決策權衡、行為改變階段及飲食自我效能之共變數分析 78
4.3.4 女士營養教育介入實驗組各題認知前後測的差異分析 79
4.3.5 兩組營養認知、共享決策、決策權衡、行為改變及自我效能前後測的差異分析 80
4.3.6 營養認知、共享決策、決策權衡、行為改變、飲食自我效能的相關分析 80
4.3.7 人口背景特性、行為改變、飲食自我效能對營養認知的預測分析 82
4.3.8 人口背景特性、飲食自我效能、營養認知對飲食行為改變的預測分析 83
4.3.9 營養教育介入課程滿意程度分析 84
4.3.10 營養教育介入後的質性回饋分析 84
4.3.11 教育介入實驗組六大類食物一週飲食紀錄單回饋結果分析 98
第五章 結論與建議 100
5.1 結論 100
5.1.1 研究對象基本人口學之分析 100
5.1.2 女士營養識能現況 101
5.1.3 應用跨理論模式營養教育介入成效 101
5.2 建議 102
5.3 未來研究建議 103
參考文獻 105
附錄一 營養識能量表 121
附錄二 女士營養識能教育課程 125
附錄三 專家效度審查委員名單 180
圖 目 錄
頁次
圖3-1 實驗設計流程圖 38
圖3-2 研究架構 39
表 目 錄
頁次
表2-1 營養識能的層次 24
表2-2 運用跨理論模式營養教育及營養識能之相關文獻探討 31
表3-1 女士營養識能介入研究設計 39
表3-2 窈窕女士飲食營養工作坊教學改變階段及課程活動設計 44
表3-3 女士營養窈窕工作坊營養教育課程教案 46
表3-4 女士營養窈窕工作坊營養教育課程教學流程 47
表3-5 女士期營養識能量表效度分析結果 50
表3-6 女士窈窕工作坊教案效度分析結果 50
表3-7 女士營養識能量表認知題難度及鑑別度分析結果 52
表3-8 女士營養識能量表信度分析結果 53
表3-9 營養教育課程回饋、學習單、網路問卷回應資料編碼 55
表3-10 資料分析方法表 57
表4-1 人口學資料前測分佈與兩組同質性分析 59
表4-2 營養認知前測分布與同質性分析結果 62
表4-3 共享決策前測分布與同質性分析結果 64
表4-4 共享決策前測各題平均值、標準差、t檢定分析 67
表4-5 飲食決策權衡-自覺利益前測分布與同質性分析結果 68
表4-6 飲食決策權衡-自覺障礙前測分布與同質性分析結果 69
表4-7 飲食決策權衡前測各題平均值、標準差、t檢定分析 71
表4-8 飲食行為改變階段前測分布與同質性分析結果 72
表4-9 飲食行為改變階段前測各題平均值、標準差、t檢定分析 73
表4-10 飲食自我效能前測分佈與同質性分析結果 74
表4-11 飲食自我效能前測各題平均值、標準差、t檢定 76
表4-12 營養教育介入前後測平均數、標準差 77
表4-13 兩組組內迴歸係數同質性檢定表 77
表4-14 營養教育介入共變數分析結果 78
表4-15 營養教育介入前後之營養認知Games-Howell檢定結果 78
表4-16 營養教育實驗組介入前後測差異分析表 79
表4-17 實驗組與對照組營養認知、共享決策、決策權衡、行為改變及自我效能前後測比較 80
表4-18 營養認知、共享決策、決策權衡、行為改變、飲食自我效能之相關矩陣表 81
表4-19 研究對象人口背景特性、行為改變、飲食自我效能對營養認知之預測分析 82
表4-20 人口背景特性、飲食自我效能、營養認知對飲食行為改變之預測表 83
表4-21 女士營養窈窕工作坊課程單元滿意度 84
表4-22 實驗組六大類食物一週自行飲食紀錄表 99

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