臺灣博碩士論文加值系統

隨著全球人口老化和醫療進步，65歲以上人口的增長使慢性病的盛行率上升，壓力性損傷（壓傷）成為普遍現象。壓傷的發生被視為醫療品質管理的重要指標之一。在2015年，台灣醫療品質策進會將壓傷列為臨床照護的重要品質指標，顯示壓傷在醫療照護中的重要性。學校對壓力性損傷的教育不足，且傳統護理教育多以講授與靜態圖片教學為主，學習者參與度有限，導致護理實習生在臨床實務中，常難以正確辨識傷口特徵、判斷分級，並將判斷結果有效連結至實際照護決策，臨床護理人員亦普遍反映學校教學內容缺乏實用性。
近年來，教育機器人具備互動性、多媒體呈現與即時回饋等優勢，結合 5E 探究式教學策略，有助於引導學習者透過情境觀察、探究與反思歷程，促進知識建構與臨床思考能力。
本研究採準實驗研究設計，方便取樣自台灣新北市某醫學中心實習之護理實習生為研究對象共 82 人，依教學介入方式分為實驗組（結合 5E 探究策略之機器人輔助學習模式）與對照組（機器人輔助學習模式），比較兩種教學模式對壓力性損傷照護學習成效之影響；研究工具包括壓力性損傷照護知識測驗、預防態度量表、預防行為量表、問題解決傾向量表、群體自我效能量表及認知負荷量表，於教學介入前、後及延宕測進行測量，並以共變數分析與廣義估計方程式進行資料分析。
研究結果顯示，兩組護理實習生在壓力性損傷照護知識、預防態度、預防行為、問題解決傾向及群體自我效能等構面於教學介入後皆呈現提升，結合 5E 探究策略之教學模式在上述學習成效上未達顯著差異，此外，兩組在認知負荷、心智負荷與心智努力表現上皆無顯著差異，顯示將 5E 探究策略融入機器人輔助學習中，不會增加學習者之認知負擔。
整體而言，本研究證實機器人輔助學習能有效促進護理實習生於壓力性損傷照護相關學習構面之正向發展，而結合 5E 探究策略之教學模式在不增加認知負荷的前提下具備良好可行性，建議未來研究可延長介入時間並結合更多臨床實作情境，以進一步探討其對高層次與長期學習成效之影響。

關鍵詞：壓力性損傷、機器人輔助教學、5E探究策略、護理實習生

With global population aging and advances in medical care, the rapid growth of the population aged 65 years and older has led to an increased prevalence of chronic diseases, making pressure injuries (pressure ulcers) a common clinical issue. The occurrence of pressure injuries is regarded as an important indicator of healthcare quality management. In 2015, the Taiwan Joint Commission on Hospital Accreditation identified pressure injuries as a key quality indicator in clinical care, underscoring their significance in healthcare practice. However, pressure injury education in nursing schools remains insufficient. Traditional nursing education relies primarily on lectures and static images, resulting in limited learner engagement. Consequently, nursing students often experience difficulty accurately identifying wound characteristics, determining pressure injury stages, and effectively translating their assessments into appropriate care decisions in clinical practice. Clinical nurses have also commonly reported that school-based education lacks practical applicability.
In recent years, educational robots characterized by interactivity, multimedia presentation, and real-time feedback have emerged as innovative teaching tools. When combined with the 5E inquiry-based instructional strategy, these technologies can guide learners through processes of situational observation, exploration, and reflection, thereby facilitating knowledge construction and the development of clinical reasoning skills.
This study adopted a quasi-experimental research design. A total of 82 nursing students undertaking clinical training at a medical center in New Taipei City, Taiwan, were recruited through convenience sampling. Participants were divided into an experimental group (robot-assisted learning combined with the 5E inquiry-based strategy) and a control group (robot-assisted learning only), to compare the effects of the two instructional approaches on learning outcomes related to pressure injury care. Research instruments included a pressure injury care knowledge test, a prevention attitude scale, a prevention behavior scale, a problem-solving tendency scale, a collective self-efficacy scale, and a cognitive load scale. Measurements were conducted before the intervention, immediately after the intervention, and at a delayed post-test. Data were analyzed using analysis of covariance (ANCOVA) and generalized estimating equations (GEE).
The results showed that both groups of nursing students demonstrated improvements in pressure injury care knowledge, prevention attitudes, prevention behaviors, problem-solving tendency, and collective self-efficacy after the instructional intervention. However, the teaching model integrating the 5E inquiry-based strategy did not demonstrate statistically significant differences from the control group in these learning outcomes. In addition, no significant differences were observed between the two groups in terms of overall cognitive load, mental load, or mental effort, indicating that integrating the 5E inquiry-based strategy into robot-assisted learning did not increase learners’ cognitive burden.
Overall, this study confirms that robot-assisted learning effectively promotes positive development across multiple learning dimensions related to pressure injury care among nursing students. Furthermore, integrating the 5E inquiry-based strategy demonstrates good feasibility without increasing cognitive load. Future research is recommended to extend the duration of instructional interventions and incorporate more clinical practice scenarios to further examine the effects on higher-order and long-term learning outcomes.

Keywords: pressure injury, robot-assisted instruction, 5E inquiry-based strategy, nursing students

摘　　要 ⅰ
ABSTRACT ⅱ
目　　次 ⅳ
表　　次 ⅵ
圖　　次 ⅶ
第一章　緒論 1
第一節　研究背景與動機 1
第二節　研究目的及研究問題 6
第三節　研究假設 6
第四節　名詞解釋 7
第二章　文獻探討 10
第一節　壓力性損傷簡介 10
第二節　機器人輔助教學 17
第三節　5E探究式教學 22
第三章　研究方法 26
第一節　研究設計 26
第二節　研究架構 27
第三節　研究對象與場所 28
第四節　實驗設計 29
第五節　研究工具 31
第六節　資料處理與分析 34
第七節　研究倫理 38
第四章　結合5E探究策略之機器人輔助學習模式設計 39
第一節　結合5E探究策略之機器人設計 39
第二節　教學內容與活動設計 41
第五章　研究結果 48
第一節　護理實習生人口學特性之分佈與差異 48
第二節　壓力性損傷學習成就測驗 51
第三節　壓力性損傷預防態度 54
第四節　壓力性損傷預防行為 56
第五節　問題解決傾向 57
第六節　群體自我效能 58
第七節　認知負荷 60
第八節　訪談結果 60
第六章　討論 66
第一節　兩組的學習成就測驗得分之分析 66
第二節　兩組的壓力性損傷預防態度得分之分析 68
第三節　兩組的壓力性損傷預防行為得分之分析 69
第四節　兩組的問題解決傾向得分之分析 70
第五節　兩組的群體自我效能得分之分析 71
第六節　兩組的認知負荷得分之分析 72
第七章　結論與建議 74
第一節　結論 74
第二節　研究限制 76
第三節　建議 77
參考文獻 80
中文部分 80
英文部分 81
附　　錄 92
附錄一 護理實習生基本屬性問卷 92
附錄二 訪談大綱 103
附錄三 專家背景資料表 104
附錄四 德菲法研究法專家評分表_壓力性損傷學習成就測驗 105
附錄五 量表授權使用同意書 107
附錄六 人體試驗委員會審核通過證明 108
附錄七 學位論文原創性比對檢核表 109

中文部分
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