臺灣博碩士論文加值系統

臺灣人口高齡化衍生出醫療資源需求增加、成本龐大的問題，遠距照護科技被認為是一個有效解決的方法。許多研究利用科技接受模型探討老人使用遠距照護科技的動機與障礙，卻忽略老人重視人際關係及利用情感做決策的特性。這方面的學術討論仍嫌薄弱，本研究的目的即是探討人際因素對老人科技使用的關鍵性。
初步研究已在2014年初執行，訪談南投縣竹山秀傳醫院遠距照護計劃中，2010年至今定期使用遠距照護系統的老人。分析發現，社會支持是長輩進行遠距照護的重要因素。有受到來自健康管理師以及社區成員社會支持的長輩，接受遠距照護科技的程度也較高。讓人思考老人得到社會支持與遠距照護之間是否具社會交換關係。
現階段研究中，作者試圖瞭解中華文化特有社會法則(面子與人情)和老人使用遠距照護科技的關聯。本研究方法採用質性研究，訪談定期使用竹山秀傳遠距照護的老人。訪談方式依循現象學訪談法，讓受訪者描述過去的相關經歷，同時會有一位不參與訪談的觀察員從旁記錄資料。訪談資料則利用案例分析法進行分析。
本研究結果對未來臺灣地區遠距照護科技產業的發展，以及相關政府部門例如經濟部、衛福部在政策制定能提供幫助與參考，同時也能貢獻予老人學與中華文化之間結合的研究。

In recent years, the life expectancy in Taiwan increases to nearly 80 years and senior citizens account for 11% of the country’s population. Facing these structural changes in population, telehealth technology is identified as one of the utmost solutions to provide medical services with reduced overall costs. A vast amount of studies address the motivations and barriers for elder adults to adopt telehealth technology. Technology Acceptance Model is often adopted as the framework, which, nevertheless, neglects important age-related characteristics such as memory impairments. Recent calls are made for research to include more age-specific variables into the application of TAM, especially for telehealth technology. This study aims to address this gap.
The Chu-Shan Show-Chwan Hospital (CSSC) Telehealth Project has proven popular since 2010 over 2,200 local senior residents developed a habit of using the telehealth device at least once every week. Nevertheless over 16% of the residents are over 65 and among them over 11% are illiterate. Our preliminary project conducted between February to June 2014 identifies the role of social support, that the elderly became more receptive to use telehealth services once they formed personal relationships and felt supported by the health promotion professionals and/or the other community members. As a follow up study, this project intends to investigate further in terms of the impact of rules such as renquing and mien-tzu on the motivations and decisions to use telehealth technology for these elderly. In the Chinese culture, the rule of renquing is a derivative of the norm of reciprocity and mien-tzu acts as prestige given by practicing self-regulation in the society. The interviewers will follow the phenomenological interview method and try to engage the interviewees with conversations describing their past experiences. Data analysis will utilize the extended case method and use prior theories as guide.

Chinese abstract I
English Abstract II
Figure lists IV
Table lists V
Chapter 1 Introduction 1
Chapter 2 Literature Review and Preliminary Findings 5
2.1. The Age Factor: The Role of Emotion in Decision Making 5
2.2 Social Support and Reciprocity 7
2.3 Mien-tzu / Face 10
2.4 Bao (reciprocate) and Renquing (owe) 11
Chapter 3 Methodology and Analysis 15
Chapter 4 Results 19
4.1 Why these elderly use the telehealth system service of CSSC hospital? Is it free? 19
4.2 Why the elderly who have bad impression about CSSC still use the telehealth system service of CSSC hospital? Is it free? 22
4.3 How does the social support affect the elderly to use the telehealth system service of CSSC hospital? 24
Chapter 5 Conclusions 27
5.1 Conclusions 27
5.2 Implications 28
5.3 Future Research 30
References 31
著作權聲明 37

English References
Abaluck, J., & Gruber, J. (2011). Heterogeneity in choice inconsistencies among the elderly: Evidence from prescription drug plan choice. The American Economic Review, 101, 377-381.
Adler, P. A. (1987). Membership roles in field research (6nd ed.). Newbury Park, CA: Sage.
Antonucci, T. C., & Akiyama, H. (1987). An examination of sex differences in social support among older men and women. Sex roles, 17(11-12), 737-749.
Argyris, C. (1982). Reasoning, learning, and action: Individual and organizational. San Francisco, CA: Jossey-Bass.
Befu, H. (1986). The social and cultural background of child development in Japan and the United States. Mainland, KY: Everbest Printing Co.
Brown, P., & Levinson, S. (1987). Politeness: Some universals in language. Cambridge, UK: Cambridge University.
Bunn, F., Byrne, G., & Kendall, S. (2005). The effects of telephone consultation and triage on healthcare use and patient satisfaction: A systematic review. British Journal of General Practice, 55, 956-961.
Burawoy, M. (1998). The extended case method. Sociological theory, 16(1), 4-33.
Burawoy, M. (Ed.). (1991). Ethnography unbound: Power and resistance in the modern metropolis. Oakland, CA: Univ of California Press.
Burton-jones, A., & Hubona, G. S. (2005). Individual differences and usage behavior: revisiting a technology acceptance model assumption. SIGMIS Database, 36, 58-77.
Carpenter, S. M., & Yoon, C. (2011). Aging and consumer decision making. Annals of the New York Academy of Sciences, 1235, 1-12.
Carstensen, L. L., & Mikels, J. A. (2005). At the intersection of emotion and cognition aging and the positivity effect. Current Directions in Psychological Science, 14, 117-121.
Carstensen, L. L., Isaacowitz, D. M., & Charles, S. T. (1999). Taking time seriously: A theory of socioemotional selectivity. American Psychologist, 54(3), 165-181.
Chang, H. C., & Holt, G. R. (1994). A Chinese perspective on face as inter-relational concern. In S. TingToomey (Ed.), The Challenge of facework. New York, NY: State University of New York Press.
Chen, K., & Chan, A. H. S. (2011). A review of technology acceptance by older adults. Gerontechnology, 10(1), 1-12.
Czaja, S., Beach, S., Charness, N., & Schulz, R. (2013). Older Adults and the Adoption of Healthcare Technology: Opportunities and Challenges. Technologies for Active Aging. New York, NY: Springer New York.
Drolet, A., Schwarz, N., & Yoon, C. (2010). The aging consumer: Perspectives from psychology and economics. Oxford, UK: Routledge.
East, R., Uncles, M. D., & Lomax, W. (2013). Hear nothing, do nothing: The role of word of mouth in the decision-making of older consumers. Journal of Marketing Management, 30(7), 1-16.
Ellis, R. D. , & Allaire, J. C. (1999). Modeling computer interest in older adults: The role of age, education, computer knowledge, and computer anxiety. Human Factors: The Journal of the Human Factors and Ergonomics Society, 41, 345-355.
Fukada, A., & Asato, N. (2004). Universal politeness theory: Application to the use of Japanese honorifics. Journal of pragmatics, 36(11), 1991-2002.
Goffman, E. (2005). Interaction ritual: Essays in face to face behavior. Piscataway, NJ: Aldine Transaction.
Goffman, E. (1959). The presentation of self in everyday life. New York, NY: Anchor Books.
Gouldner, A. W. (1960). The norm of reciprocity: A preliminary statement. American sociological review, 25(2), 161-178.
Gregoire, Y. (2003). The impact of aging on consumer responses: What do we know? Advances in Consumer Research, 30, 19-26.
Heinz, M., Martin, P., Margrett, J. A., Yearns, M., Franke, W., Yang, H.-I., Wong, J., & Chang, C. K. (2013). Perceptions of technology among older adults. J Gerontol Nurs, 39(1), 42-51.
Hess, T. M., Rosenberg, D. C., & Waters, S. J. (2001). Motivation and representational processes in adulthood: The effects of social accountability and information relevance. Psychology and aging, 16(4), 629-642.
Hibbard, J. H. , & Peters, E. (2003). Supporting informed consumer health care decisions: Data presentation approaches that facilitate the use of information in choice. Annual Review of Public Health, 24, 413-433.
Hu, H. C. (1944). The Chinese concepts of “face”. American anthropologist, 46(1), 45-64.
Ho, D. Y. F. (1976). On the concept of face. American journal of sociology, 81(4), 867-884.
Hong, S.-J., Lui, C. S. M., Hahn, J., Moon, J. Y., & Kim, T. G. (2013). How old are you really? Cognitive age in technology acceptance. Decision Support Systems, 56, 122-130.
Hwang, K. K. (1987). Face and favor: The Chinese power game. American journal of Sociology, 92(4), 944-974.
Jahn, S., Gaus, H. , & Kiessling, T. (2012). Trust, commitment, and older women: exploring brand attachment differences in the elderly segment. Psychology & Marketing, 29, 445-457.
Kim, S., Goldstein, D., Hasher, L., & Zacks, R. T. (2005). Framing effects in younger and older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, 215-218.
Kim, S. S., & Malhotra, N. K. (2005). A longitudinal model of continued IS use: An integrative view of four mechanisms underlying postadoption phenomena. Management science, 51, 741-755.
King, A. Y. C. (1988). Renquing Analysis in Interpersonal Relationship. Yang, KS Chinese Psychology. Taipei, Taiwan: Guiguan Book Stocks Ltd.
Kraskowsky, L. H., & Finlayson, M. (2001). Factors affecting older adults’ use of adaptive equipment: Review of the literature. The American Journal of Occupational Therapy, 55, 303-310.
Krause, N. (1987). Satisfaction with social support and self-rated health in older adults. The Gerontologist, 27(3), 301-308.
Lambert-pandraud, R., & Laurent, G. (2010). Why do older consumers buy older brands? The role of attachment and declining innovativeness. Journal of Marketing,74, 104-121.
Lambert-pandraud, R., Laurent, G., & Lapersonne, E. (2005). Repeat purchasing of new automobiles by older consumers: empirical evidence and interpretations. Journal of Marketing, 69(2), 97-113.
Leary, M. R., , & Kowalski, R. M. (1990). Impression management: A literature review and two-component model. Psychological bulletin, 107(1), 34-47.
Lebra, T., & Lebra, W. P. (EDS.). (1986). Japanese culture and behavior: Selected readings. Hawaii, HI: University of Hawaii Press.
Lee, G. R. (1985). Kinship and social support of the elderly: The case of the United States. Ageing and Society, 5(1), 19-38.
Melenhorst, A.-S., Rogers, W. A., & Bouwhuis, D. G. (2006). Older adults' motivated choice for technological innovation: Evidence for benefit-driven selectivity. Psychology and aging, 21, 190-195.
Mikels, J. A., Löckenhoff, C. E., Maglio, S. J., Carstensen, L. L., Goldstein, M. K., & Garber, A. (2010). Following your heart or your head: Focusing on emotions versus information differentially influences the decisions of younger and older adults. Journal of Experimental Psychology: Applied, 16(1), 87-95.
Moisio, R., & Beruchashvili, M. (2010). Questing for Well‐Being at Weight Watchers: The Role of the Spiritual‐Therapeutic Model in a Support Group. Journal of Consumer Research, 36(5), 857-875.
Paré, G., Jaana, M., & Sicotte, C. (2007). Systematic review of home telemonitoring for chronic diseases: The evidence base. Journal of the American Medical Informatics Association, 14, 269-277.
Porter, C. E., & Donthu, N. (2006). Using the technology acceptance model to explain how attitudes determine Internet usage: The role of perceived access barriers and demographics. Journal of Business Research, 59, 999-1007.
Riggle, E. D., & Johnson, M. M. (1996). Age difference in political decision making: Strategies for evaluating political candidates. Political Behavior, 18, 99-118.
Roedder, J. D., & Cole, C. A. (1986). Age differences in information processing: Understanding deficits in young and elderly consumers. Journal of Consumer Research, 13(3), 297-315.
Schau, H. J., Gilly, M. C., & Wolfinbarger, M. (2009). Consumer Identity Renaissance: The Resurgence of Identity‐Inspired Consumption in Retirement. Journal of Consumer Research, 36, 255-276.
Schmitter-edgecombe, M., Seelye, A., & Cook, D. (2013). Technologies for Health Assessment, Promotion, and Assistance: Focus on Gerontechnology. In: RANDOLPH, J. J. (ed.) Positive Neuropsychology. New York, NY: Springer New York.
Schofield, R. S., Kline, S. E., Schmalfuss, C. M., Carver, H. M., Aranda JR, J. M., Pauly, D. F., Hill, J. A., Neugaard, B. I., & Chumbler, N. R. (2005). Early outcomes of a care coordination-enhanced telehome care program for elderly veterans with chronic heart failure. Telemedicine Journal , & e-Health, 11, 20-27.
Scott, J. (2000). Understanding contemporary society: Theories of the present. London, UK: SAGE Publications Ltd.
Solomon, M. (2010). Consumer behaviour: A European perspective. Boston, MA: Pearson Education.
Spiggle, S. (1994). Analysis and interpretation of qualitative data in consumer research. Journal of consumer research, 21(3), 491-503.
Thompson, C. J., Locander, W. B., & Pollio, H. R. (1989). “Putting consumer experience back into consumer research: The philosophy and method of existential-phenomenology”. Journal of consumer research, 16(2), 133-146.
Vasunilashorn, S., Steinman, B. A., Liebig, P. S., & Pynoos, J. (2011). Aging in place: Evolution of a research topic whose time has come. Journal of aging research, Article ID 120952, DOI:10.1155/2012/120952.
Venkatesh, V., & Davis, F. D. (2000). A theoretical extension of the technology acceptance model: four longitudinal field studies. Management science, 46, 186-204.
Wade, R., Shaw, K., & Cartwright, C. (2012). Factors affecting provision of successful monitoring in home telehealth. Gerontology, 58, 371-377.
Williams, P., & Drolet, A. (2005). Age‐Related Differences in Responses to Emotional Advertisements. Journal of consumer research, 32, 343-354.
Yoon, C., COLE, C. A. , & LEE, M. P. (2009). Consumer decision making and aging: Current knowledge and future directions. Journal of Consumer Psychology, 19, 2-16.
Online References
Nantou Country Government. (2014). Household Registration Service of Nantou Country : statistics [Online]. Nantou Country Government. Available: household.nantou.gov.tw/CustomerSet/064_NantouEPNum/u_Mpgae_v.asp?id=%7BD8656AD8-9C89-4635-8C47-3386F017C519%7D [Accessed 1st December 2014].
Taipei Times. (2013). Taiwan’s population moves from ‘aging’ to ‘aged’: statistics [Online]. Taipei Times. Available: http://www.taipeitimes.com/News/taiwan/archives/2013/10/23/2003575197 [Accessed 1st December 2013].