臺灣博碩士論文加值系統

醫學是科學及藝術，也是解決病人健康問題的良心事業。醫師專責治療疾病外，更是病人用藥的把關者。因此本研究藉由「計劃行為理論模型」並增加二個變數「習慣」、「藥廠行銷活動」來探討非小細胞肺癌化學治療藥物的醫師處方決策影響因素，來進一步探討(1)醫師「處方決策」與「處方行為」之關係；(2)「態度」、「主觀規範」、「知覺行為控制」與「處方決策」之關係；(3)「藥廠行銷活動」，對醫師「處方決策」之影響及(4)「習慣」對「處方決策」之影響。期能在高度商業化的競爭環境中作為藥廠行銷策略之依據。經研究結果，發現此修正模式更能對醫師處方行為擁有更佳的解釋力。
本研究採問卷調查法，以國內使用化學藥物治療晚期肺癌之醫師為研究對象，並於95年5月6日至7月8日共發放問卷250份，回收130份，有效問卷107份，回收率為52%。並以描述性統計、因素分析、相關分析及廻歸分析等方式進行資料分析。結果顯示：醫師處方行為的「態度」、「習慣」及藥廠行銷活動中的「業務代表」對醫師處方決策有顯著影響。另外還發現主觀規範中的「病人」、「意見領袖」也會影響醫師處方決策。再深入探討發現醫師的年齡、年資、所處醫院機構屬性(公立或私立)及所在地的區別(北、中、南)對醫師處方偏好有顯著差異。本研究結果將促使藥廠省思其行銷策略對醫師處方偏好的影響，藉以調整現有之行銷模式，並擬訂符合IRPMA的行銷規範之行銷活動；另一方面也期能讓醫界了解影響醫師處方行為之藥廠行銷關鍵因子，藉此來督促醫師遵守醫療倫理規範，並確保病患用藥之安全。

誌 謝 ii
摘 要 iii
目 錄 iv
表目錄 v
圖目錄 vi
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 研究流程 5
第二章 文獻探討 7
第一節 計畫行為理論 7
第二節 計劃行為理論的應用 12
第三節 藥廠行銷活動對醫師處方行為研究 17
第三章 理論與假設 19
第一節 研究架構 19
第二節 研究假設 20
第四章 研究方法 24
第一節 非小細胞肺癌化學治療藥物 24
第二節 問卷量表設計步驟與過程 26
第三節 操作性定義與衡量 30
第四節 抽樣設計 36
第五章 研究結果 38
第一節 樣本結構分析 38
第二節 非小細胞肺癌第一線化學治療藥物用藥偏好分析 40
第三節 問卷之信度檢測 42
第四節 藥廠行銷活動的因素分析 42
第五節 研究假設檢測 45
第六章 結論與建議 50
第一節 研究結論 50
第二節 研究建議 52
第三節 研究限制與未來研究方向 53
參考文獻 55

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三、醫藥相關單位網站
1.中華民國行政院衛生署，網址為www.doh.gov.tw
2.中華民國開發性製藥研究協會（International Research-Based
Pharmaceutical Manufacturers Association, IRPMA），網址為
http://www.irpma.org.tw/
3.中央健康保險局（http://www.nhi.gov.tw）。
4.台灣區製藥工業同業工會（http://www.industry.net.tw）。
5.IT IS產業資料庫（http://itisweb.itri.org.tw）。