臺灣博碩士論文加值系統

醫護人員以實證健康照護為基礎的臨床應用來提升病人照護品質是重要的議題，尤其曾參加實證臨床應用比賽的醫護人員已經具備有「注意到」實證應用的能力，目前將實證健康照護主題應用於臨床照護是否處於「養成習慣」的階段，更是進一步需要探討的重要議題。本研究除先瞭解參加實證臨床應用比賽之醫護人員在臨床應用的七階段的分布情形之外，再以解構式計畫行為理論來探討影響實證臨床應用比賽的醫護人員對實證健康照護應用行為的因素，並找出可以預測「養成習慣」階段的因子。方法：本研究採橫斷式研究設計。母群體總人數631人，採普查方式以結構式問卷，針對312位受試者收集資料，回收率49.45%，以線性結構方程式分析整體模式。研究結果：在實證健康照護應用行為的七個階段中，有33.3%已達到「養成習慣」的階段。解構式計畫行為理論模型檢測方面則發現除自覺易用性與態度、科技便利與認知行為控制的關係未獲支持外，其餘研究假設均得到支持，且整體適配度佳；而行為意圖及認知行為控制兩變項均正向影響實證健康照護應用行為，此解釋力為37%。至於可用於預測臨床應用行為是否進入「養成習慣」階段的因子，包括「擔任主管職」的勝算比非主管職者增加2.03倍(OR=2.03, CI=1.10-3.77)、「資源便利」每增加1分，勝算比原來增加1.06倍(OR=1.06, CI=1.01-1.11)、「認知行為控制」每增加1分，勝算比原來增加2.21倍(OR=2.21, CI=1.47-3.32)以及「行為意圖」每增加1分，勝算比原來增加1.96倍(OR=1.96, CI=1.40-2.73)。結論與建議：自覺有用性、相容性、同儕影響、上級影響、自我效能、資源便利、態度、主觀規範、認知行為控制、行為意圖皆會影響醫護人員在實證健康照護應用行為。主管職、資源便利、認知行為控制及行為意圖是可以預測實證健康照護應用行為「養成習慣」階段的因子。因此我們提出以下建議：提升非主管職之醫護人員在實證健康照護應用技能及相關知識的在職教育，設置實證健康照護應用相關之資料庫及設備，及鼓勵參與臨床應用比賽。本研究驗證結果解構式計畫行為理論建構的模型適配度佳，問卷工具信效度亦均良好，將可以做為實證健康照護評量的依據，且有利於未來研究進行複驗並探究相關影響因子。

Physicians and nurses performing clinical application based on the evidence-based healthcare (EBHC) to improve quality of patient care is an important issue. In particular, the physicians and nurses of EBHC competitions are already competent with specific EBHC practices and aware of EBHC clinical application. Whether the clinical application of these EBHC practices reaches the ‘adhered to’ stage is a critical issue requires further investigation. This study was first to understand the distribution of the EBHC clinical application in seven action stages, then to explore factors influencing the behavior of EBHC clinical application by adopting the Decomposed Theory of Planned Behavior (DTPB), and finally to identify factors predicting the ‘adhered to’ stage of EBHC clinical application. Methods: The study employed a cross-sectional study design. The total population of physicians and nurses of EBHC competitions was 631. A survey was conducted using a structural questionnaire. Data was collected from 312 of the population; the returning rate 49.45%. The overall model of the study was analyzed using the structural equation modeling. Results: In the distribution of seven action stages (7As), 33.3% of the survey reported the ‘adhered to’ stage. In DTPB model testing revealed that all hypotheses, except for the association between ease of use and attitude and the association between technology facilitating condition and perceived behavioral control, were supported by the data with good overall model fit. The influences of behavioral intention and perceived behavioral control on the behavior of EBHC clinical application was positive with 37% variance of the behavior explained. As for predicting the ‘adhered to’ stage of EBHC clinical application, the odds for supervisory vs. nonsupervisory was 2.03 (OR=2.03, CI=1.10-3.77) resource facilitating condition, perceived behavioral control, and behavioral intention each incremental point the odds increased by 1.06 (OR=1.06, CI=1.01-1.11), 2.21 (OR=2.21, CI=1.47-3.32) and 1.96 (OR=1.96, CI=1.40-2.73) times respectively. Conclusion and recommendation: The study found that: perceived usefulness, compatibility, peer and superior influences, self-effcacy, resource facilitating condition, attitude, subjective norm, perceived behavioral control, and behavioral intention influencing EBHC clinical application; supervisory duties, resource facilitating condition, perceived behavioral control, and behavioral intention predicting the ‘adhered to’ stage of EBHC clinical application. Therefore, we recommend as follows: promoting continuing education for nonsupervisory physicians and nurses to improve knowledge and skill related to EBHC clinical application; installing databases and equipments necessary for EBHC clinical application as well as encouraging involvement of EBHC competitions. The study model based on the DTPB model revealed a good fit and the questionnaire was valid and reliable hence suitable for measuring the behavior of EBHC clinical application and exploring other relevant factors facilitating the behavior of EBHC clinical application in future studies.

誌謝 I
摘要 II
Abstract III
目錄 IV
圖目錄 VI
表目錄 VII
第一章 緒 論 1
第一節 研究背景、動機及重要性 1
第二節 研究問題 3
第二章 文獻查證 4
第一節 實證健康照護的概念 4
第二節 實證健康照護步驟與應用 6
第三節 探討醫護人員實證健康照護應用行為之理論 18
第四節 本研究概念架構 44
第五節 研究目的與假設 47
第三章 研究方法 49
第一節 研究設計 49
第二節 研究對象 49
第三節 研究工具及效度與信度檢定 52
第四節 研究步驟 76
第五節 研究倫理考量 77
第六節 資料統計與分析 77
第四章 研究結果 79
第一節 參加實證臨床應用比賽後之醫護人員在實證健康照護應用行為七個階段的分布情形 79
第二節 以解構式計畫行為理論確認研究模型中的因子及影響力及其模型適配 82
第三節 探討預測參加實證臨床應用比賽後之醫護人員能夠進入「養成習慣」階段行為的因素 91
第五章 討論 93
第一節 探討實證臨床應用比賽醫護人員在實證健康照護應用行為七個階段之分布 94
第二節 以解構式計畫行為理論確認研究模型中的因子及影響力及其模型適配 94
第三節 探討預測參加實證臨床應用比賽後之醫護人員能夠進入「養成習慣」階段行為的因素 101
第六章 結論、限制與建議 102
第一節 結論 102
第二節 研究限制 102
第三節 研究建議 103
參考資料 105
中文部份 105
英文部份 109
附錄一 問卷專家名單 118
附錄二 問卷 119
附錄三 人體研究同意證明書 129
附錄四 DTPB同意函(Taylor & Todd) 131
附錄五TAM同意函(Davis, F. D.) 133

【圖目錄】
圖2-2-1醫療研究的六種證據階層 10
圖2-2-2 6S模式實證資料庫 11
圖2-2-3 6S模式實證資料庫(本研究整理繪圖) 12
圖2-3-1理性行為理論 19
圖2-3-2計劃行為理論 21
圖2-3-3科技接受模式 23
圖2-4-1本研究解構式計畫行為研究概念架構 44
圖3-2-1研究問卷回收數 50
圖4-2-2本研究結構模型路徑分析 88

【表目錄】
表2-3-1解構式計劃行為理論文獻各變項意涵整理 26
表2-3-2國內外應用解構式計劃行為理論相關研究之文獻整理 42
表3-2-1催收樣本與回收樣本檢定 51
表3-3-1本研究自變項操作定義與計分方式 63
表3-3-2本研究人口學屬性操作定義與計分方式 64
表3-3-3醫護人員在實證健康照護應用行為研究工具效度 66
表3-3-4醫護人員在實證健康照護應用行為工具量表信、效度檢測 67
表3-3-5量表項目分析及內在一致性信度(預試) 68
表3-3-6量表項目分析及內在一致性信度(正式研究) 72
表4-1-1 研究對象基本資料及實證臨床應用行為分布 80
表4-1-2 研究對象在實證健康照護應用行為七個階段之分佈狀況 81
表4-2-1適配度衡量標準表暨本研究模型之配適度 83
表4-2-2精簡適配度衡量標準表暨本研究模型之配適度 83
表4-2-3本研究模型之直接效果與間接效果分析表 89
表4-3-1研究對象在實證健康照護「養成習慣」階段應用行為分析 92
表4-3-2研究對象之實證健康照護「養成習慣」階段應用行為複邏輯對數迴歸 93

中文部份：
王嵩竑、游小美、林永樑（2008）．以結構方程式模式探討護理人員對無線射頻辨識系統接受度—科技接受模型觀點．醫院，41（1），54-64。[Wang, S. H., Yu, H. M., & Lin, Y. L. (2008). The Liner Structure Equation Model of Nurse Acceptance in Using RFID: Technology Acceptance Model (TAM) View. Hosptial, 41(1), 54-64.]
李佳諭、王維芳、張瑩如（2011）．實證護理培訓課程對護理人員實證護理知識、態度及行為之成效探討．新臺北護理期刊，13（1），19-31。[Lee, C. Y., Wang, W. F., & Chang, Y. J. (2011). The effects of evidence-based nursing program on nurse’s knowledge, attitude, and behavior. New Taipei Journal of Nursing, 13(1), 19-31.]
李崇維、侯勝茂（2000）．實證醫學．當代醫學，（317），214-220。[Lee, C. W., & Hou, S. M. (2010). Evidence-Based Medicine. Medicine Today, (317), 214-220.]
李雅惠（2003）‧醫院推行實證醫學現況、醫師認知與推行態度及其影響因素探討-以台北市區域級以上醫院為例‧未發表碩士論文，臺北市：臺北醫學大學醫務管理學研究所。[Lee, Y. H. (2003). The Implementation EBM in Hospitals in Taipei City and Factors Influencing Physicians’ Attitude toward Applying EBM. (Unpublished master’s thesis). Taipei Medical University, Taipei, Taiwan.]
邱文達、林曉蕾（2001）．醫療品質的新發展．新臺北護理期刊，3（2），1-7。[Chiu, W. T., & Lin, H. L. (2001). The New Development of Quality in Healthcare. New Taipei of Journal of Nursing, 3(2), 1-7.]
林重志（2008）‧實習醫學生在醫學網路資源的資訊尋求及資料庫使用行為之研究‧未發表碩士論文，雲林市：國立雲林科技大學研究所。[Lin,C.C. (2008). A study of information seeking behavior of Intern on Medical Science Network Resources and Database. (Unpublished master’s thesis). National YunTech University, Yunlin City, Taiwan.]
徐圭璋（2008）．實證醫學(EBM)與醫療品質．醫療品質雜誌，2（1），16-20。[Hsu, K. J. (2008). Evidence-Based Medicine and Healthcare Quality. Journal of Healthcare Quality,2(1), 16-20.]
高益凱（2008）‧急診醫師對實證醫學認知及應用之差異性分析‧未發表碩士論文，高雄市：國立中山大學醫務管理研究所。[Kao, Y.K. (2008). Analysis of Emergency Physicians’ Perception and Application of Evidence-Based Medicine. (Unpublished master’s thesis). National Sun Yat-sen University, Kaohsiung, Taiwan.]
曾旭民、詹碧端、姜靜穎（2009）‧應用科技接受模型探討護理人員對行動護理站接受度的影響因素‧醫療資訊雜誌，18（1），23-38。[Tseng, H. M., Chan, P. T., & Chiang, C. Y. (2009). Applying technology acceptance model to examine factors related to nurses’acceptance for the use of mobile nursing station in hospitals. The Journal of Taiwan Association for Medical Informatics, 18(1), 2338.]
葉美春（2007）‧使用者採用知識管理系統之影響因素研究─理論模型的比較取向‧未發表碩士論文，臺北市：世新大學資訊傳播學研究所。 [Yeh, M. C. (2007). A Study on Influencing Factors of Knowledge Management Systems Adoption: Models Comparison Approach. (Unpublished master’s thesis). Shih Hsin University, Taipei, Taiwan.]
陳杰峰、邱文達（2008）．實證醫學之知識轉譯地圖．台灣醫學，12（4），455-460。[Chen, C. F., & Chiu, W. T. (2008). The knowledge translation map of EBM. Formosan Journal of Medicine, 12(4), 455-460.]
陳杰峰、曾珮娟、邱文達（2007）．IOM五大核心能力～基於實證醫學的專業執行．醫療品質雜誌，1（4），32-40。 [Chen, C. F., Luo, H L., & Chiu, W. T. (2007). IOM五大核心能力～基於實證醫學的專業執行. Journal of Healthcare Quality, 1(4), 32-40.]
陳杰峰、 羅恒亷、郭耿南、譚家偉（2011）．實證醫學於臨床之發展與應用．醫療品質雜誌，5（6），P24 - 29。[Chen, C. F., Kuo, K. N., Kuo, K. N., & Tam, K. W. (2007). 實證醫學於臨床之發展與應用. Journal of Healthcare Quality, 5(6), 32-40.]
陳玉枝（2014）．實證護理概念與臨床應用．領導護理，15（2），2-12。[Chen, Y. C. (2014). The concept and clinical application of evidence-based nursing. Leadership Nursing, 15(2), 2-12.]
張國祥（2016）‧精神衛生護理人員的實證護理能力與實證護理自我效能之相關探討‧未發表碩士論文，臺北市：國立臺北護理健康大學護理研究所。[Chang, K. H. (2016). Correlation between Evidence based Nursing Competence and Evidence-Based Practice Self-Efficacy for Psychiatric Nurses. (Unpublished master’s thesis). National Taipei University of Nursing and Health Science, Taipei, Taiwan.]
梁實秋(1993)．遠東實用英漢辭典．台北市：遠東。[Loung, S. C. (1993). Far East Preatical English-Chinese Dictionary. Taipei City, Taiwan, ROC: Fareast.]
侯文萱（2015）．以病人為中心的實證健康照護--共同決定模式．醫療品質雜誌，9（5），4-9。[Hou1, W. H. (2015). Patient Centered Evidence-based Healthcare: Shared Decision Making. Journal of Healthcare Quality, 9(5), 4-49.]
黃靜宜、黃素猜、李雅文、廖以誠、張淑真（2006）．中部某醫學中心推動實證護理經驗．護理雜誌，53（5），52-57。[Huang, C. Y., Huang, S. T., Lee, Y. W., Liao, Y. C., & Chang, S. C. (2006). An experience promoting evidence-based nursing at a medical center in central Taiwan. The Journal of Nursing, 53(5), 52-57.] doi:10.6224/JN.53.5.52
黃秀芬（2014）‧基層護理人員實證能力訓練成果之相關因素探討‧未發表碩士論文，臺北市：國立臺北護理健康大學醫護教育研究所。[Huang, H. F. (2014). Factors Related to the Training Result of Evidence-Based Nursing for Clinical Nurse. (Unpublished master’s thesis). National Taipei University of Nursing and Health Science, Taipei, Taiwan.]
郭雪敏、林貞秀、李秀現、張美珍、范聖心、張瑩如（2011）．營造實證實務組織文化—實證護理與能力進階制度結合之經驗．護理雜誌，58（2），68-74。[Kuo, H. M., Lin, C. H., Lee, H. H., Chang, M. J., Fan, S. H., & Chang, Y. J. (2011). Building an evidence-based practice culture: Incorporating evidence-based nursing in the clinical ladder system. The Journal of Nursing, 58(2), 68-74.] doi:10.6224/JN.58.2.68
盧美秀（2001）．實證醫學、實證護理與實證管理．新臺北護理期刊，3（1），1-6。[Lu, M. S. (2001). Evidence-Based Medicine, Nursing and Management. New Taipei of Journal of Nursing,3(1), 1-6.]
穆佩芬（2009）．Joanna Briggs Institute 之簡介．全聯護訊，68，13-14。[Mu, P. F. (2009). An introduction of Joanna Briggs Institute. Journal of Taiwan Union of Nurses Association, 68, 13-14.]
蔡榮美（2014）．實證健康照護在臨床護理發展歷史與現況簡介．護理雜誌，61（6），17–22。[Tsai, J. M. (2014). The historical background and present development of evidence-based healthcare and clinical nursing. The Journal of Nursing, 61(6), 17–22.] doi:10.6224/JN.61.6.17
蔡榮美、吳育弘（2012）．馬偕醫院實證競賽參賽及推動經驗分享．台灣實證醫學學會會刊，3(3)，19-21。[Tsai, J. M., & Wu, Y. H. (2012). Contest for evidence-based medicine promotion, the experience in Mackay Memorial Hospital. Evidence Counts, 3(3), 19-21.]
蔡榮美、吳育弘、于漱、李君儀、聶梅珍、范毓佩（2012）．中文版夫勒斯諾量表(Fresno Test)在實證照護訓練評估應用簡介．馬偕護理雜誌，6（1），16-23。[Tsai, J. M., Wu, Y. H., Yu, S., Li, J. Y., Buttrey, M. J., & Fan, Y. P. (2009). Evaluating the evidence-based health care training programs: An introduction to Chinese version of the Fresno test. Journal of Mackay Nursing, 6(1), 16-23.]
蔡順發（2010）‧消費者實際行為前置因素之研究—以選購智慧型手機作業系統為例‧未發表碩士論文，花蓮縣：國立東華大學企業管理學系暨運籌管理研究所。[Tsai, S. F. (2011). The Study of Antecedents of Consumer’s Actual Behavior: An Empirical Study of Purchase Smartphone Operating System. (Unpublished master’s thesis). National Dong University, Shou-Feng, Hualien, Taiwan.]
蘇惠文（2010）‧某醫學中心護理人員實證護理信念、技能、執行頻率及自覺障礙‧未發表碩士論文，臺北市：國立陽明大學研究所。[Su, H. W. (2010). Beliefs, Skills, Practice Frequencies and Perceived Barriers toward Evidence-based Nursing among Nurses in a Medical Center. (Unpublished master’s thesis). National Yang-Ming University, Taipei, Taiwan.]
英文部份：
Ajzen, I. & Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behavior. Prentice-Hall, Englewood Cliffs, NJ.
Ajzen, I. (1985). From intentions to actions: a theory of planned behavior, in Kuhl, J. & Beckman, J. (Eds), Action-Control: From Cognition to Behaviour. Springer-Verlag, Berlin, NY.
Ajzen, I. & Madden, T.J. (1986). Predication of goal-directed behavior: attitude, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453-474.
Ajzen, I. (1989). Attitude Structure and Behavior. In Breckler, S.J. & Greenwald, A.G., Eds., Attitude Structure and Function, Lawrence Erlbaum, Hillsdale, 241-274.
Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human Decision Process, 50(2), 179-211.
Ajzen, I. & Driver, B. L. (1992). Application of the Theory of Planned Behavior to Leisure Choice. Journal of Leisure Research, 24(3), 207-224.
Ajzen, I. (2002). Perceived Behavioral Control, Self-Efficacy, Locus of Control, and the Theory of Planned Behavior. Journal of Applied Social Psychology, 32(4), 665-683.
Ajzen, I. & Klobas, J. (2013). Fertility intentions: An approach based on the theory of planned behavior. Demographic Research, 29(8), 203-232. doi: 10.4054/DemRes.2013.29.8
Allan, H. T., & Smith, P. (2010). Are pedagogies used in nurse education research evident in practice? Nurse Education Today, 30(5), 476-479. doi: 10.1016/j.nedt.2009.10.011
Agency for Healthcare Research Quality.Translating Research Into Practice (TRIP)-II: fact sheet. (1992). Agency for Healthcare Research and Quality Rockville.
ACGME (Accreditation Council for Graduate Medical Education). (2008).Common Program Requirements: General Competencies. Retrieved August 24, 2008 from http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdf.
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411-423.
Armstrong, R., Waters, E., Dobbins, M., Anderson, L., Moore, L., Petticrew, M., . . . Swinburn, B. (2013). Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan. Implement Sci, 8, 121. doi: 10.1186/1748-5908-8-121
Atchan, M., Davis, D., & Foureur, M. (2014). Applying a knowledge translation model to the uptake of the Baby Friendly Health Initiative in the Australian health care system. Women Birth, 27(2), 79-85. doi: 10.1016/j.wombi.2014.03.001
Bagozzi, R. P. & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74-94.
Baker, P. R., Shipp, J. J., Wellings, S. H., Priest, N., & Francis, D. P. (2012). Assessment of applicability and transferability of evidence-based antenatal interventions to the Australian indigenous setting. Health Promot Int, 27(2), 208-219. doi: 10.1093/heapro/dar032
Baker, R., Chang, C., Bunting, J., & Betit, E. (2015). Triage for action: Systematic assessment and dissemination of construction health and safety research. American Journal of Industrial Medicine, 58(8), 838-848. doi: 10.1002/ajim.22477
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122-147
Bentler, P.M. & Chou, C. (1987). Practical issues in structural modeling. Sociological Methods and Research, 16, 78–117.
Bigham, B., & Welsford, M. (2015). Applying hospital evidence to paramedicine: issues of indirectness, validity and knowledge translation. Cjem, 17(3), 281-285. doi: 10.1017/cem.2015.65
Bosch, M., Tavender, E., Bragge, P., Gruen, R., & Green, S. (2013). How to define 'best practice' for use in Knowledge Translation research: a practical, stepped and interactive process. Journal of Evaluation in Clinical Practice, 19(5), 763-768. doi: 10.1111/j.1365-2753.2012.01835.x
Brownson, R. C., & Jones, E. (2009). Bridging the gap: translating research into policy and practice. Preventive Medicine, 49(4), 313-315. doi: 10.1016/j.ypmed.2009.06.008
Burns, N. & Grove, S.K. (2001). The practice of nursing research: Conduct, critique & utilization (4th ed.). Philadelphia: WB Saunders.
Charles C., Gafni A., & Whelan T. (1997). Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social science & medicine, 44(5), 681-692.
Cochrane A. L. (1979). 1931-1971: a critical review, with particular reference to the medical profession. In: Teeling-Smith G, Wells N, editor(s). Medicines for the year 2000. London (UK): Office of Health Economics, 2-12.
Cochrane, A. (1999). Effectiveness and efficiency: Random reflections on health services. London, England: Royal Society of Medicine Press.
Compeau, D. R. & Higgins, C. A. (1991). A social cognitive theory perspective on individual reactions to computing technology. ICIS Proceedings. 55.
Cook, D. J., Jaeschke, R., & Guyatt, G. H. (1992). Critical appraisal of therapeutic interventions in the intensive care unit: human monoclonal antibody treatment in sepsis. Journal Club of the Hamilton Regional Critical Care Group. Journal of Intensive Care Medicine, 7(6), 275-282.
Davis, F. D. (1986). A technology acceptance model for empirically testing new end-user information systems: theory and results. Doctoral dissertation, Cambridge, MA: MIT Sloan School of Management.
Davis, F. D. (1989). Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Quarterly, 13(3), 319-340. doi: 10.2307/249008
Davis, F. D., Bagozzi, R. P. and Warshaw, P. R. (1989). User acceptance of computer technology: a comparison of two theoretical models. Management Science, 35(8), 985.
DiCenso, A., Bayley, L., & Haynes, R.B. (2009). Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evidence Based Nursing, 12, 99-101.
Etezadi-Amoli, J. & Farhoomand, A.F. (1996). A structural model of end user computing satisfaction and user performance. Information & Management, 30(2), 65-73. doi:10.1016/0378-7206(95)00052-6
Evidence-Based Medicine Working Group. (1992). Evidence-based medicine: A new approach to teaching the practice of medicine. Journal of the American Medical Association, 268, 2420-2421.
Fischer, T., Brothers, K.B., Erdmann, P., & Langanke, M. (2016). Clinical decision-making and secondary findings in systems medicine. BMC Med Ethics, 17(1), 32. doi: 10.1186/s12910-016-0113-5.
Fishbein, M. & Ajzen, I.(1975). Belief, Attitude, Intention and Behavior: An Introduction to theory and Research. Addison-Wesley, Reading, MA.
Fitzsimons, E., & Cooper, J. (2012). Embedding a culture of evidenced-based practice. Nursing Management, 19(7), 14-19. doi:10.1016/j.nepr.2010.10.008.
Fischer,T, Brothers,K.B, Erdmann,P,& Langanke,M. (2016) .Clinical decision- making and secondary findings in systems medicine. BMC Med Ethics. 2016 May 21;17(1):32. doi: 10.1186/s12910-016-0113-5.
Flemming, K. (1998). Asking answerable questions. Evidence-Based Nursing, 1(2), 36-37. doi:10.1136/ebn.1.2.36
Flores-Mateo, G., & Argimon, J. M. (2007). Evidence based practice education in postgraduate health care: A systematic review. BMC Health Services Research, 7, 119. doi:10.1186/1472-6963-7-119
Glasziou P. & Haynes B. (2005). The paths from research to improved health outcomes. ACP Journal Club, 142(2), A8-10.
Guyatt, G., Cook, D., & Haynes, B. (2004). Evidence based medicine has come a long way. British medical journal, 329, 990-991. doi:10.1136/bmj.329.7473.990
Goyet, S., Barennes, H., Libourel, T., van Griensven, J., Frutos, R., & Tarantola, A. (2014). Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country. Implement Sci, 9, 82. doi: 10.1186/1748-5908-9-82
Gregory, D. M., & Twells, L. K. (2015). Evidence-based decision-making 5: Translational research. Methods in Molecular Biology, 1281, 455-468. doi: 10.1007/978-1-4939-2428-8_27
Grinspun D1, Virani T, Bajnok I.(2001)Nursing best practice guidelines: the RNAO (Registered Nurses Association of Ontario) project. Healthcare Quarterly, 5(2), 56 – 60. doi: 10.12927/hcq..16690
Hair, J. F. Jr., Black, W. C., Babin, B. J., & Anderson, R. E. (2010), Multivariate Data Analysis (7th Ed.), Prentice-Hall, Englewood Cliffs, NJ.
Hatala, R., & Guyatt, G. (2002). Evaluating the teaching of evidence-based medicine. Journal of the American Medical Association, 288, 1110-1112.
Harbour, R. & Miller, J. (2001) “A new system for grading recommendations in evidence based guidelines”. BMJ, 323(7308), 334-336. doi: 10.1136/bmj.323.7308.334
Haynes, R. B. (2006). Of studies, syntheses, synopses, summaries, and systems: the "5S" evolution of information services for evidence-based healthcare decisions. Evidence Based Medicine, 11(6), 162-164. doi: 10.1136/ebm.11.6.162-a
Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural Equation Modelling: Guidelines for Determining Model Fit. The Electronic Journal of Business Research Methods, 6, 53-60.
Hsieh, P. J. (2015). Physicians' acceptance of electronic medical records exchange: An extension of the decomposed TPB model with institutional trust and perceived risk. International Journal of Medical Informatics, 84(1), 1-14. doi: 10.1016/j.ijmedinf.2014.08.008
Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1 - 55.
Hung, S. Y., Ku, Y. C., & Chien, J. C. (2012). Understanding Physicians' Acceptance of the Medline System for Practicing Evidence-Based Medicine: A Decomposed TPB Model. International Journal of Medical Informatics, 81(2), 130-142.
Institute of Medicine. (2007). The learning healthcare system: Workshop summary. Washington, DC: The National Academies.
Johansson, B., Fogelberg-Dahm, M., & Wadensten, B. (2010). Evidence-based practice: the importance of education and leadership. Journal of Nursing Management, 18(1), 70-77. doi: 10.1111/j.1365-2834.2009.01060.x
Lederer, A.L., Maupin, D.J., Sena, M.P., & Zhuang, Y. (2000). The technology acceptance model and the World Wide Web. Decision Support Systems, 29,269-282
Lockwood, C., Aromataris, E., & Munn, Z. (2014). Translating evidence into policy and practice. Nursing Clinics of North America, 49(4), 555-566. doi: 10.1016/j.cnur.2014.08.010
Ma, C., Kuo, K. & Alexander, J.W. (2015). A survey-based study of factors that motivate nurses to protect the privacy of electronic medical records. BMC Medical Informatics and Decision Making, 16:13. doi: 10.1186/s12911-016-0254-y
Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2012). Policy & politics in nursing and health care. St. Louis, MO: Elsevier Saunders.
Mathieson, K. (1991). Predicting User Intentions: Comparing the Technology Acceptance Model with the Theory of Planned Behavior. Information Systems Research, 2(3), 173-191.
McGlynn, E. A., Asch, S. M., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., & Kerr, E. A. (2003). The quality of health care deliveredto adults in the United States. New England Journal of Medicine, 348(26), 2635-2645. doi: 10.1056/NEJMsa022615
Mohide, E. A., & King, B. (2003). Building a foundation for evidence- based practice: Experiences in a tertiary hospital. Evidence-Based Nursing, 6(4), 100-103.
Moore, G.C. & Benbasat, I. (1991). Development of an Instrument to Measure the Perceptions of Adopting an Information Technology Innovation. Information Systems Research, 2(3), 192-222.
Morris, Z. S., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104(12), 510-520. doi: 10.1258/jrsm.2011.110180
Nasca, T.J. (2008). The CEO's first column: the next step in the outcomes-based accreditation project. ACGME Bull. 2-4.
Oxford Centre for Evidence-based Medicine. (2011). Levels of evidence and grades of recommendation. [Web document]. Oxford, UK.
Oxford Centre for EBM Levels of Evidence http://www.cebm.net/index.aspx?o=1047
Paik, S.-K. (2014). A portfolio approach to purchasing development in small and medium sized enterprises (SMEs). Journal of Supply Chain and Operations Management, 12(1), 1.
Pearson, A., Field, J., & Jordan, Z. (2007). Evidence-based clinical practice in nursing and health care: Assimilating research, experience and expertise. Taiwan: lsevier.
PubMed (2016). U.S. National Library of Medicine. Detailed Indexing Statistics: 1965-2016. Retrieved from https://www.nlm.nih.gov/bsd/index_stats_comp.html
Rogers, E. M. (1983). Diffusion of Innovations (3rd ed.). New York: The Free Press.
Rogers, E. M. (1995). Diffusion of Innovations (4th ed.), New York: The Free Press.
Rogers, E. M. (2003). Diffusion of Innovations (5th ed.), New York: The Free Press.
Rycroft-Malone, J., Harvey, G., Kitson, A., Seers, K., Titchen, A., & McCormack, B. (2003). Getting evidence into practice: The experience of practitioners. RCN Publishing, London.
Straus, S. E. (2004). What’s the E for EBM? British Medical Journal. 328, 535-536.
Streiner, D., & Norman, G. R. (2008). Health measurement scales. A practical guide to their development and use (4th ed.). Oxford Medical Publications.
Sackett, D. L., Rosenberg, W. M. C., Gray, J. S. M., Haynes, R. B., Richardson,W.S. (1996). Evidence based medicine: what it is and what it isn’t. British Medical Journal,312:71-2.
Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence¬based medicine: How to practice and teach EBM (2nd ed.). London, England: Churchill Livingstone.
Sackett, D. L.(2005). Inference and decision at the bedside. Journal of Clinical Epidemiology , 42(4), 309-316. doi: 10.1016/0895-4356(89)90035-8
Shepard, B. H., Hartwick, J., & Warshaw, P. R. (1988). The Theory of Reasoned Action: A Meta-Analysis of Past Research with Recommendations for Modifications and Future Research. Journal of Consumer Research, 15, 325-343.
Straus, S. E. (2004). What’s the E for EBM? British Medical Journal. 328, 535-536.
Straus, S., Richardson, W.S., Glasziou, P. & Haynes, R.B. (2005). Evidence-based medicine: How to practice and teach EBM (3rd ed.). Edinburgh: Churchill Livingstone.
Streiner, D., & Norman, G. R. (2008). Health measurement scales. A practical guide to their development and use (4th ed.). Oxford Medical Publications.
Sigma Theta Tau International 2005-2007 Research and Scholarship Advisory Committee. (2008). Sigma theta tau international position statement on evidence-based practice February 2007 summary. Worldviews on Evidence-Based Nursing, 5(2), 57-59. doi:10.1111/j.1741-6787.2008.00118.x
Szajna, B. (1996). Empirical evaluation of the revised technology acceptance model. Management Science, 42(1), 85-92.
Taylor, S., & Todd, P.A. (1995). Understanding Information Technology Usage: A Test of Competing Models. Information Systems Research, 6(2), 144-176. doi: 10.1287/isre.6.2.144
Taylor, S. & Todd, P. A. (1995b) “Decomposition and crossover effects in the theory of planned behavior: A study of consumer adoption intentions, International Journal of Research in Marketing, 12,.137-155. doi: 10.1016/0167-8116(94)00019-K
Tsai, J. M., Wu, Y. H., Yu, S., Li, J. Y., & Buttrey, M. J. (2014). Validated Chinese translation of the Fresno test for evidence-based health care training. International Journal of Gerontology, 8, 209-212. doi: http://dx.doi.org/10.1016/j.ijge.2013.10.008
Waltz, C. F., Strickland, O. L., & Lenz, E. R. (1991). Measurement in nursing research (2nd ed.). Philadelphia: A. Davis.
Wu, Y. H., Tsai, J. M., & Li, J.Y. (2014, November). Competition-based Model for Knowledge Transfer in Establishing and Promoting Evidence-Based Nursing Care . In 3rd International Society of Evidence-Based Health Care, ISEHC, Taipei, Taiwan.