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研究生:莊曉雯
論文名稱:應用遊戲化聊天機器人於老人營養教育活動之成效
論文名稱(外文):The Effectiveness of Applying Gamification Chatbot for Nutrition Education in Elderly Population
指導教授:陳秋瑩陳秋瑩引用關係黃瀚諄黃瀚諄引用關係
口試委員:黃瀚諄廖麗娜
口試日期:2023-05-30
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:公共衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:中文
論文頁數:117
中文關鍵詞:遊戲化聊天機器人營養教育TAM科技接受理論營養KAP
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研究背景及目的
隨著人口老化的趨勢,長者健康議題受到越來越多的關注。長者常常 因缺乏正確的營養知識而面臨著非傳染性疾病的危害。然而,營養師的人力不足,導致長者無法得到足夠的營養衛教。此外,健康假消息對長者的公共衛生造成了嚴重的危害。因此,提供長者易於接受和有效的健康教育, 成為當前的迫切需求。本研究旨在開發一個專為長者而設計的 line 營養 聊天機器人,並運用遊戲化元素提高使用者學習動機,以持續性的個人化互動形式提供營養衛教課程。透過對不同社區長者的營養知識態度和行為的評估,本聊天機器人有望提高長者對營養的關注和瞭解,並進而促進健康老化。本研究旨在解決現有公共衛生初段預防營養衛教不足的問題, 並為長者提供一個可靠和有效的學習平台。 
研究方法
本研究進行聊天機器人系統規劃及完成開發建置,並採用實驗介入設計,共邀請 272 位長者參與營養衛教課程,包括實體衛教及線上衛教, 場域涵蓋城市與原民部落。為評估介入成效,研究採用營養知識(K)、態 度(A)、行為(P)及科技接受度(TAM)問卷進行前後測評估,同時以聊天機器人日常互動模式問卷蒐集每日心情指數、營養知識、態度、膳食多樣 性(DDS)與飲食日記等資料,以掌握參與者在活動期間的營養知識、態度、 行為的改變情況。 
研究結果 
共 99 位參與者完成了前後測。營養知識、態度與行為及 TAM 科技接受度結果均為顯著,且後測表現皆優於前測。其中營養知識提升最多, 由前測平均 2.86 分提升至後測平均 3.36 分,提升比例為 17.5%;營養態 VI 度由前測平均 2.25 分提升至後測平均 2.46 分,提升比 例為 9.3%;營養 行為由前測平均 3.4 分提升至後測平均 3.82 分,提升比例為 12.3%。聊 天機器人日常互動模式問卷的每日營養 K、A 及 DDS(膳食多樣性)答對率 均有提升。
結論 
本系統的設計考慮了長輩的需求,並成功提高了他們對科技的接受度和對營養知識的了解。研究發現,本系統的使用者,其營養知識、態度、 行為及 TAM 後測均有顯著提升。聊天機器人日常互動問卷推播的每日營養 KAP 也有不同程度的提升。此外,本系統結合遊戲化的設計,讓長輩更願意參與學習,提高自主學習動機,並在遊戲中學習營養知識。總體而言,本系統的設計有助於提高長輩的營養知識與健康素養,並且顯著提高了他們對科技的接受度,讓長輩更能夠享受健康老化的生活。
With the trend of aging population, the health issues of the elderly have received increasing attention. The elderly often face non- communicable diseases due to a lack of correct nutrition knowledge. However, the shortage of nutritionists has resulted in a lack of sufficient nutrition education for the elderly. In addition, health misinformation poses serious risks to public health among the elderly. Therefore, providing easy-to-accept and effective health education for the elderly has become an urgent need. This study aims to develop a line nutrition chatbot designed specifically for the elderly and use gamification elements to enhance users' learning motivation. It provides personalized interactive nutrition education courses in a sustainable manner. Through evaluating the nutrition knowledge, attitudes, and behaviors of different community elders, this chatbot is expected to increase their attention and understanding of nutrition and promote healthy aging. This study aims to solve the problem of insufficient primary prevention nutrition education in public health and provide a reliable and effective learning platform for the elderly.
This study carried out chatbot system planning and completed development construction, using experimental intervention design to invite 272 elders to participate in nutrition education courses including physical education and online education, covering urban areas and aboriginal tribes. To evaluate intervention effectiveness, pre- and
post-tests were conducted using questionnaires on nutritionknowledge (K), attitudes (A), and behaviors (P). Daily mood index, nutrition knowledge, attitudes, dietary diversity score (DDS), and food diary data were also collected to understand changes in participants' nutrition knowledge, attitudes, and behaviors during the activity.
A total of 99 participants completed pre- and post-tests. The results showed significant improvements in participants' nutrition knowledge, attitudes, behaviors as well as TAM technology acceptance.
The design of this system considers the needs of the elderly and successfully improves their acceptance of technology and understanding of nutrition. The study found that the users of this system had significantly improved nutrition knowledge, attitudes, behaviors, and TAM post-tests. The daily broadcast of nutrition KAP and DDS also improved to varying degrees. In addition, the system combines gamification design to make the elderly more willing to participate in learning, improve their autonomous learning motivation, and learn nutrition knowledge in games. Overall, the design of this system helps improve the elderly's nutrition knowledge and health literacy, significantly improves their acceptance of technology, and enables them to enjoy healthy aging.

第一章 緒論 1
第一節 研究背景與研究動機 1
第二節 研究的重要性 1
第三節 研究目的 10
第四節 研究問題 11
第五節 名詞界定 12
第二章 文獻探討 13
第一節 長者營養知識與健康促進 13
第二節 營養講座的型態與發展 13
第三節 科技接受理論(TAM) 16
第四節 科技化系統設計重要元素概念 20
第五節 虛假健康信息危害 28
第三章 研究方法 36
第一節 研究架構與設計 36
第二節 研究對象 43
第三節 研究工具的擬定 45
第四節 資料收集過程 55
第五節 資料統計與分析 57
第四章 研究結果 59
第一節 系統開發與建置 59
第二節 實證結果 61
第五章 討論 84
第一節 對營養知識、態度與行為的提升作用 84
第二節 科技接受度提升的實證分析 85
第三節 聊天機器人日常互動問卷與營養知識、態度、行為的關聯 86
第四節 DDS與飲食紀錄對於改善長者飲食結構的影響 87
第五節 加強社會連結並優化心理健康 89
第六章 結論與建議 91
第一節 結論 91
第二節 研究限制 95
第三節 應用與建議 96
參考文獻 98




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