臺灣博碩士論文加值系統

隨著科技的日新月異，癌症病患對於癌症放射治療的要求也就越來越高，因此癌症放射治療的發展也朝向高科技醫療邁進。雖然目前很多醫療院所在癌症的放射治療上投入相當多的設備資源，然而目前癌症病患對於高科技醫療的使用率仍然偏低，因此有必要進一歩研究癌症病患採用高科技醫療的行為意願為何。本研究引用Ajzen (1985)所提出的計畫行為理論加上創新擴散理論為基礎，試圖建構一個癌症病患採用高科技醫療的行為意願模式，以放射治療之癌症病患為研究樣本，採問卷調查法做實證研究，來探討影響採用高科技醫療的因素，預測及解釋高科技醫療採用模式，以期做為未來醫療院所投入癌症放射治療的參考。
本研究以瞭解高科技醫療之癌症病患為實證對象，問卷共發放160份，有效問卷98份，無效與拒絕填寫共62份。並針對癌症病患研究情境，採取相關研究情境控制，以提高測量效度。在資料分析部份，本研究以PLS路徑分析法進行模型驗證，由測量模型與路徑係數檢定結果顯示，影響癌症病患採用高科技醫療行為意願中，『態度』、『主觀規範』與『知覺行為控制』對行為意圖皆有顯著影響。研究結果顯示：
1.影響癌症病患採用高科技醫療行為意願，最重要因素為「知覺行為控制」，其次是「態度」，最後是「主觀規範」。
2.在癌症病患採用高科技醫療「態度」上，最重要的影響因素為「相對優勢」，其次是「大眾口碑」，最後是「知覺風險」。
3.在癌症病患採用高科技醫療「主觀規範」上，「社會壓力」為主要的影響因素。
4.在癌症病患採用高科技醫療「知覺行為控制」上，「經濟因素」為主要的影響因素。
5.「權威意見」對癌症病患採用高科技醫療「態度」，受「醫療形象」調節。

Purpose：With the progress of technique, the demand of radiation therapy in cancer patient is expanded. Therefore, the development of radiation therapy to cancer tends to become “high-tech”. Although lots of facilities are thrown in radiation therapy to cancer in many hospitals, the utilization rate of high-tech medical technique to treat cancer patient is still low. It is necessary to investigate the behavioral intensions of cancer patients to adopt high-tech medical technique. In this study, we introduced the theory of planned behavior (TPB) by Ajzen (1985) and diffusion of innovations theory to construct the behavioral intension model of cancer patients to adopt the high-tech medical technique. We included the cancer patients to radiation therapy for study and the questionnaire method for evidence, in order to explore the factors, predictors and reasons to accept high-tech medical technique.
Methods：This study invited the cancer patients who accepted high-tech medical technique and 160 questionnaires were distributed. Ninety-eight questionnaires were valid, and 62 questionnaires were in vain or rejected. The study circumstances according to individual cancer patients were controlled for improved study effectiveness. In data analysis, we took PLS pathway analysis to verify the model. By the measurement model and pathway coefficient, in the affections of cancer patients to adopt high-tech medical technique, attitude toward the behavior, subjective norm and perceived behavioral control were significant to behavioral intension.
Results and Conclusion:
1.The most significant factor to cancer patient to adopt the high-tech medical technique was perceived behavioral control, following with attitude toward the behavior, and subjective norm in the last.
2.The most significant factor of the attitude toward the behavior in cancer patients to adopt the high-tech medical technique was relative advantage, following with word-of-mouth, and perceived risk in the last.
3.The social pressure was the most significant factor for cancer patients to adopt the high-tech medical technique in subjective norm.
4.The economy was the most significant factor for cancer patient to accept high-tech medical technique in perceived behavioral control.
5.The opinion from authority to the attitude toward the behavior of cancer patients to adopt the high-tech medical technique was modulated by medical image.

1、 緒 論.............................................1
1.1 研究背景與動機........................................1
1.2 研究目的.............................................6
2、 文獻探討.............................................7
2.1 放射治療相關文獻......................................7
2.2 高科技醫療...........................................9
2.3 慎思行為理論(THEORY OF REASONED ACTION, TRA)........11
2.3.1 行為意願(BEHAVIORAL INTENTION, BI) ...............12
2.3.2 態度(ATTITUDE TOWARD BEHAVIOR, AB) ...............13
2.3.3 主觀規範(SUBJECTIVE NORMS) .......................14
2.4 計畫行為理論（THEORY OF PLANNED BHAVIOR,TPB） .......15
2.4.1 行為意願(INTENTION)...............................16
2.4.2 態度（ATTITUDE TOWARD THE BEHAVIOR）..............17
2.4.3 主觀規範（SUBJECTIVE NORM）.......................18
2.4.4 知覺行為控制（PERCEIVED BEHAVIORAL CONTROL）.......19
2.4.5 影響態度之外生變數.................................20
2.4.6 醫療形象..........................................25
3、 假說推論.............................................26
3.1 假說與定義..........................................26
3.1.1 相對優勢對癌症病患採用高科技醫療的影響 ..............26
3.1.2 大眾口碑對癌症病患採用高科技醫療的影響 ..............27
3.1.3 知覺風險對癌症病患採用高科技醫療的影響 ..............28
3.1.4 權威意見對癌症病患採用高科技醫療的影響 ..............29
3.1.5 態度對癌症病患採用高科技醫療的影響 ..............30
3.1.6 主觀規範對癌症病患採用高科技醫療的影響 ..............31
3.1.7 知覺行為控制對癌症病患採用高科技醫療的影響...........33
3.1.8 醫療形象對癌症病患採用高科技醫療的影響 ..............34
3.1.9 研究假說總結.....................................35
4、 研究方法...........................................36
4.1 研究變數定義與衡量問項 ..............................36
4.1.1 行為意願 ......................................37
4.1.2 態度............................................38
4.1.3 主觀規範（親朋好友的社會壓力）......................39
4.1.4 主觀規範（醫師的權威意見）.........................40
4.1.5 知覺行為控制（經濟因素）...........................41
4.1.6 態度外生變數（相對優勢）...........................42
4.1.7 態度外生變數（大眾口碑）...........................43
4.1.8 態度外生變數（知覺風險）...........................44
4.1.9 醫療形象.........................................45
4.2 問卷設計...........................................46
4.3 前測 ..............................................46
4.4 研究對象...........................................47
4.5 分析工具...........................................48
5、 資料分析...........................................50
5.1 問卷發放...........................................50
5.2 病患基本資料分析....................................51
5.3 測量模型之效度與信度檢定.............................54
5.4 研究模型檢定.......................................58
5.4.1 檢定結果.........................................59
5.4.2 衡量調節變數的影響................................61
5.5 研究結果分析.......................................62
6、 結論與建議.........................................64
6.1 研究結論..........................................65
6.2 研究貢獻..........................................68
6.2.1 學術貢獻........................................68
6.2.2 管理意涵........................................69
6.3 研究限制與未來研究建議..............................71
7、 參考文獻..........................................75

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