簡易檢索 / 詳目顯示

研究生: 蕭文
Hsiao, Wen
論文名稱: 運用設計思考改善高齡者乳品攝取
Using Design Thinking to Improve Dairy Products Intake in the Elderly
指導教授: 連盈如
Lien, Yin-Ju
張鳳琴
Chang, Fong- Ching
口試委員: 劉貴雲
Liu, Guey-Yun
張鳳琴
Chang, Fong-Ching
連盈如
Lien, Yin-Ju
口試日期: 2022/08/25
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系健康促進與衛生教育碩士在職專班
Department of Health Promotion and Health Education_Continuing Education Master's Program of Health Promotion and Health Education
論文出版年: 2022
畢業學年度: 110
語文別: 中文
論文頁數: 126
中文關鍵詞: 高齡者設計思考乳品攝取
英文關鍵詞: elderly people, design thinking, dairy products intake
DOI URL: http://doi.org/10.6345/NTNU202201604
論文種類: 學術論文
相關次數: 點閱:241下載:0
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 本研究運用設計思考 (Design Thinking) 發展改善社區高齡者乳品類攝取的策略,並測試介入後的成效。研究方法以史丹佛設計研究院所提出的設計思考五步驟實施,在「同理」階段找出7個據點15位社區高齡者進行訪談,於「測試」的階段找2個據點41位社區高齡者進行介入測試。研究結果於「同理」階段發現多數高齡者有攝取乳品類,但沒有攝取足量的原因是因為沒想到或沒想過要攝取乳品類食物或認為營養已足夠,而部分是因經濟或個人生理因素導致攝取不足;「定義」階段將受訪者收斂為經濟壓力型、生理因素型、認知不足型、缺乏觸發點型及依靠他人型,5個典型的人物誌;在「發想」階段透過腦力激盪想出重視飲食、教育、陪伴鼓勵與提醒、減少障礙等多種改善的方案;「製作原型」階段,設計一個「乳品攝取養成計畫」的介入方案,透過4週營養教育的課程提升對飲食的重視,提供攝取乳品類食物的知識與技巧,及辦理挑戰賽的活動,透過陪伴、鼓勵與提醒高齡者攝取乳品類食物,再將挑戰獎勵回饋給據點,可供應乳品類作為高齡者在社區的點心。最後於社區據點進行「測試」,結果發現高齡者乳品類的認知、奶粉及鮮奶的攝取量與總乳品類攝取量達顯著提升,多數高齡者對於規劃的課程表示滿意。本研究發現透過設計考對於促進社區高齡者的乳品攝取有所助益,建議未來可推廣到更多社區以增加高齡者乳品攝取。

    This study applied Design Thinking to develop intervention strategies for improving older adults’ dairy intake and examined the effectiveness of these interventions. The study was conducted using five steps of design thinking proposed by the Stanford d. School. In the “Empathy” stage, we interviewed 15 older adults from seven community care stations; in the “Test” stage, we investigated 41 older adults from two community care stations to confirm the effectiveness of the intervention. The results showed that most older adults consumed dairy products in the “Empathy” stage, but their dairy intake was insufficient. This was because older adults neither expected nor thought about the consumption or considered their nutritional intake sufficient. Some participants demonstrated intake deficiency because of financial or physiological factors. In the “Define” stage, the respondents were categorized into five personas: financial stress, physiological factors, cognitive deficit, lack of trigger, and dependent. In the "Ideate" stage, brainstorming was used to develop improvement plans focused on diet, education, companionship, encouragement, reminders, and reducing obstacles. In the “Prototype” stage, we designed a program for developing a regular dairy intake plan. The four-week nutrition education program was designed to raise the awareness of a healthy diet and impart the knowledge and cooking skills required to include dairy intake. We also conducted a challenge to accompany, encourage, and remind participants to consume dairy products and delivered their rewards to the community care stations as refreshments. The final stage was the “Test” stage, which took place at the community care stations. The results revealed that participants’ recognitions of dairy products, “milk powder” and “fresh milk” intake, and dairy consumption significantly increased after the intervention. Most participants were satisfied with the program. This study’s findings demonstrated that older adults’ recognition and consumption of dairy products improved significantly after the four-week nutrition education program. The results indicate that a Design Thinking approach can promote dairy product intake among older adults in the community. This program can be extended to more communities to improve older adults’ dairy intake

    第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 3 第三節 名詞解釋 3 第二章 文獻探討 5 第一節 乳品類食物攝取對高齡者的重要性 5 第二節 高齡者飲食行為選擇的影響因素 13 第三節 促進乳品類攝取的介入方案 15 第四節 設計思考 18 第三章 研究方法 25 第一節 研究設計 25 第二節 研究對象 26 第三節 研究流程與步驟 27 第四節 研究方法與工具 29 第五節 資料整理與分析 40 第四章 研究結果與分析 41 第一節 同理階段 41 第二節 定義階段 72 第三節 創意發想階段 80 第四節 製作原型 83 第五節 測試階段 94 第五章 討論 103 第一節 討論 103 第二節 研究限制 108 第六章 研究結論與建議 109 第一節 研究結論 109 第二節 研究建議 111 參考文獻 113

    一、中文部分
    中華民國骨質疏鬆症學會. (2021). 2021 台灣成人骨質疏鬆症防治之共識及指引 Retrieved from 中華民國骨質疏鬆症學會:http://www.toa1997.org.tw/download/

    朱春林. (2019). 跨域協同教學與設計思考之行動研究:以高等教育課程為例. [An Action Research on Interdisciplinary Collaborative Teaching and Design Thinking in a Higher Education Course]. 雙溪教育論壇(8), 23-48.

    吳莉君(譯) (2010). 設計思考改造世界 (原作者:T. Brown). 臺北:聯經.

    邱奕儒、謝婉華. (2020). 設計思考融入農村議題之課程設計與反思-以「創意農村大作戰」通識課程為例. [Curriculum Design and Reflection on the Integrationof Design Thinking into Rural Issues-Takingthe 「Regenerating the Countryside」 General Course as an Example]. 慈濟大學教育研究學刊(16), 141-167. doi:10.6754/tcuj.202008_(16).0005

    林薇, 杭極敏, & 鄭惠文. (2011). 提升國中生乳製品攝取營養教育課程設計及成效評估. [Design and Evaluation of a Dairy Products Nutrition Education Program for Adolescents]. 台灣公共衛生雜誌, 30(1), 45-57. doi:10.6288/tjph2011-30-01-06

    陳敏郎. (2015). 健康意識、生活型態以及飲食行為的認知與影響因素之研究-以中部某海線地區民眾為例 [The Level of Understanding towards Health Awareness, Lifestyle and Dietary Behavior and the Impact Factors Thereof-A Case Study of a Seashore Town in Central Taiwan]. 健康科技期刊, 3(1), 68-91. https://doi.org/10.6979/tjhs.201511_3(1).0005

    楊盈盈. (2010). 台中縣立沙鹿國中學生乳品攝取行為相關因素之研究. 國立臺灣師範大學, Available from Airiti AiritiLibrary database. (2010年)

    廖長彥. (2019). 結合遊戲化與設計思考於跨領域小組的衛教影片製作. [Integrating gamification into a design thinking approach to form an inter-disciplinary group creating health videos]. 國立臺灣科技大學人文社會學報, 15(3), 241-256.

    鄭惠文. (2006). 國中生乳製品營養教育課程成效評估. 國立臺灣師範大學, Available from Airiti AiritiLibrary database. (2006年)

    潘文涵, & 吳思芸. (2020). 如何讓銀髮族吃得巧、吃得健康!. 台灣公共衛生雜誌, 39(3), 231-234. https://doi.org/10.6288/tjph.202006_39(3).Pf03

    蔡仁傑. (2013). 應用設計思考於遠距照護服務之初探-以某教學醫院為例. 臺灣大學商學研究所學位論文, 1-63.

    衛生福利部國民健康署. (2019a). 中華民國106年老人狀況調查報告. Retrieved from 衛生福利部國民健康署: https://dep.mohw.gov.tw/dos/cp-1767-38429-113.html

    衛生福利部國民健康署. (2019b). 國民營養健康狀況變遷調查102-105年成果報告. Retrieved from 衛生福利部國民健康署:https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=3999&pid=11145

    劉世南. (2021). 設計思考課程教材 Design thinking toolkit.

    二、英文部分
    Afshin, A., Sur, P. J., Fay, K. A., Cornaby, L., Ferrara, G., Salama, J. S., . . . Murray, C. J. L. (2019). Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 393(10184), 1958-1972. doi:https://doi.org/10.1016/S0140-6736(19)30041-8

    Artaza-Artabe, I., Sáez-López, P., Sánchez-Hernández, N., Fernández-Gutierrez, N., & Malafarina, V. (2016). The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas, 93, 89-99. doi:10.1016/j.maturitas.2016.04.009

    Aune, D., Navarro Rosenblatt, D. A., Chan, D. S. M., Vieira, A. R., Vieira, R., Greenwood, D. C., . . . Norat, T. (2015). Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. The American Journal of Clinical Nutrition, 101(1), 87-117. doi:10.3945/ajcn.113.067157

    Bandler, D. K. and Singh, . R. Paul (2021, April 8). dairy product. Encyclopedia Britannica. https://www.britannica.com/topic/dairy-product

    Bauer, J. M., Verlaan, S., Bautmans, I., Brandt, K., Donini, L. M., Maggio, M., . . . Cederholm, T. (2015). Effects of a Vitamin D and Leucine-Enriched Whey Protein Nutritional Supplement on Measures of Sarcopenia in Older Adults, the PROVIDE Study: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of the American Medical Directors Association, 16(9), 740-747. doi:https://doi.org/10.1016/j.jamda.2015.05.021

    Bernstein, M. A., Nelson, M. E., Tucker, K. L., Layne, J., Johnson, E., Nuernberger, A., . . . Singh, M. F. (2002). A Home-Based Nutrition Intervention to Increase Consumption of Fruits, Vegetables, and Calcium-Rich Foods in Community Dwelling Elders. Journal of the American Dietetic Association, 102(10), 1421-1427. doi:https://doi.org/10.1016/S0002-8223(02)90315-9

    Bloom, I., Lawrence, W., Barker, M., Baird, J., Dennison, E., Sayer, A. A., . . . Robinson, S. (2017). What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK. Public Health Nutr, 20(15), 2685-2693. doi:10.1017/s1368980017001203

    Blynn, E., Harris, E., Wendland, M., Chang, C., Kasungami, D., Ashok, M., & Ayenekulu, M. (2021). Integrating Human-Centered Design to Advance Global Health: Lessons From 3 Programs. Glob Health Sci Pract, 9(Suppl 2), S261-s273. doi:10.9745/ghsp-d-21-00279

    Brown, T. (2008). Design Thinking. Harvard Business Review, 86, 84-92

    Chang, C.-F., Wang, J.-Y., Kuo, T.-H., Lin, Y.-L., & Yang, S.-Y. (2022). Stages of Change in Dairy Intake among Older Adults: Application of the Transtheoretical Model. International Journal of Environmental Research and Public Health, 19(3), 1146. Retrieved from https://www.mdpi.com/1660-4601/19/3/1146

    Chen, Z., Ahmed, M., Ha, V., Jefferson, K., Malik, V., Ribeiro, P. A. B., . . . Drouin-Chartier, J. P. (2021). Dairy Product Consumption and Cardiovascular Health: a Systematic Review and Meta-Analysis of Prospective Cohort Studies. Adv Nutr, 13(2), 439-454. doi:10.1093/advances/nmab118
    Council, D. (2015). What is the framework for innovation? Design Council’s evolved Double Diamond. Design council. Retrieved from https://www.designcouncil.org.uk/news-opinion/what-framework-innovation-design-councils-evolved-double-diamond

    Crocker, T. F., Brown, L., Clegg, A., Farley, K., Franklin, M., Simpkins, S., & Young, J. (2019). Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis. Qual Life Res, 28(8), 2041-2056. doi:10.1007/s11136-019-02149-1

    Deng, Y., Misselwitz, B., Dai, N., & Fox, M. (2015). Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients, 7(9), 8020-8035. Retrieved from https://www.mdpi.com/2072-6643/7/9/5380

    Design, H. P. I. o. (2010). An introduction to design thinking: Process guide. Retrieved from https://www.alnap.org/help-library/an-introduction-to-design-thinking-process-guide

    Gimeno-Mallench, L., Sanchez-Morate, E., Parejo-Pedrajas, S., Mas-Bargues, C., Inglés, M., Sanz-Ros, J., . . . Gambini, J. (2020). The Relationship between Diet and Frailty in Aging. Endocr Metab Immune Disord Drug Targets, 20(9), 1373-1382. doi:10.2174/1871530320666200513083212

    Hardcastle, S. J., Thøgersen-Ntoumani, C., & Chatzisarantis, N. L. (2015). Food Choice and Nutrition: A Social Psychological Perspective. Nutrients, 7(10), 8712-8715. doi:10.3390/nu7105424

    Hidayat, K., Chen, G. C., Wang, Y., Zhang, Z., Dai, X., Szeto, I. M. Y., & Qin, L.-Q. (2018). Effects of milk proteins supplementation in older adults undergoing resistance training: A meta-analysis of randomized control trials. The journal of nutrition, health & aging, 22(2), 237-245. doi:10.1007/s12603-017-0899-y

    Hoogendijk, E. O., Afilalo, J., Ensrud, K. E., Kowal, P., Onder, G., & Fried, L. P. (2019). Frailty: implications for clinical practice and public health. Lancet, 394(10206), 1365-1375. doi:10.1016/s0140-6736(19)31786-6

    Host, A., McMahon, A. T., Walton, K., & Charlton, K. (2016). Factors Influencing Food Choice for Independently Living Older People-A Systematic Literature Review. J Nutr Gerontol Geriatr, 35(2), 67-94. doi:10.1080/21551197.2016.1168760

    Hsu, P. T., Chen, J. J., & Ho, Y. F. (2021). The Effects of Empowerment Education on Daily Dairy Intake in Community-Dwelling of Older Asian Women. Int J Environ Res Public Health, 18(9). doi:10.3390/ijerph18094659

    Huang, L. P., Condello, G., & Kuo, C. H. (2021). Effects of Milk Protein in Resistance Training-Induced Lean Mass Gains for Older Adults Aged ≥ 60 y: A Systematic Review and Meta-Analysis. Nutrients, 13(8). doi:10.3390/nu13082815

    IDEO. (2013). Design Thinking for Educators. Retrieved from https://www.ideo.com/post/design-thinking-for-educators

    Kim, K., Reicks, M., & Sjoberg, S. (2003). Applying the theory of planned behavior to predict dairy product consumption by older adults. J Nutr Educ Behav, 35(6), 294-301. doi:10.1016/s1499-4046(06)60343-6

    Kim, S. H., Myers, C. G., & Allen, L. (2017). Health care providers can use design thinking to improve patient experiences. Harvard business review, 95(5), 222-229.

    Lee, M.-S., Huang, L.-Y., Chen, M.-C., & Wahlqvist, M. L. (2009). The Demography of Food in Health Security: Current Experience with Dairy Consumption in Taiwan. [糧食與衛生安全之人口學:目前乳製品攝取之台灣經驗]. Asia Pacific Journal of Clinical Nutrition, 18(4), 585-589. doi:10.6133/apjcn.2009.18.4.19

    Lee, M.-S., Wahlqvist, M. L., & Peng, C.-J. (2015). Dairy Foods and Health in Asians: Taiwanese Considerations. [亞洲人的乳製品與健康:臺灣健康]. Asia Pacific Journal of Clinical Nutrition, 24(S1), s14-s20. doi:10.6133/apjcn.2015.24.s1.03

    Leung, C. L., Naert, M., Andama, B., Dong, R., Edelman, D., Horowitz, C., . . . Vedanthan, R. (2020). Human-centered design as a guide to intervention planning for non-communicable diseases: the BIGPIC study from Western Kenya. BMC Health Serv Res, 20(1), 415. doi:10.1186/s12913-020-05199-1

    Levis, S., & Lagari, V. S. (2012). The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep, 10(4), 296-302. doi:10.1007/s11914-012-0119-y

    Lorenzo-López, L., Maseda, A., de Labra, C., Regueiro-Folgueira, L., Rodríguez-Villamil, J. L., & Millán-Calenti, J. C. (2017). Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatrics, 17(1), 108. doi:10.1186/s12877-017-0496-2

    Malafarina, V., Uriz-Otano, F., Iniesta, R., & Gil-Guerrero, L. (2013). Effectiveness of Nutritional Supplementation on Muscle Mass in Treatment of Sarcopenia in Old Age: A Systematic Review. Journal of the American Medical Directors Association, 14(1), 10-17. doi:https://doi.org/10.1016/j.jamda.2012.08.001

    Martin, R. (2011). 設計思考就是這麼回事 (李仰淳、林麗冠, Trans.). 台北: 天下文化.

    McLaughlin, J. E., Wolcott, M. D., Hubbard, D., Umstead, K., & Rider, T. R. (2019). A qualitative review of the design thinking framework in health professions education. BMC Med Educ, 19(1), 98. doi:10.1186/s12909-019-1528-8

    Melse-Boonstra, A. (2020). Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits. Front Nutr, 7, 101. doi:10.3389/fnut.2020.00101

    Michaëlsson, K., Wolk, A., Langenskiöld, S., Basu, S., Warensjö Lemming, E., Melhus, H., & Byberg, L. (2014). Milk intake and risk of mortality and fractures in women and men: cohort studies. Bmj, 349, g6015. doi:10.1136/bmj.g6015

    Nikniaz, Z., Tabrizi, J. S., Ghojazadeh, M., Farhangi, M. A., Hosseini, M. S., Allameh, M., . . . Nikniaz, L. (2020). Community-based interventions to increase dairy intake in healthy populations: a systematic review. Public Health Rev, 41, 18. doi:10.1186/s40985-020-00135-4

    Pereira, P. C. (2014). Milk nutritional composition and its role in human health. Nutrition, 30(6), 619-627. doi:10.1016/j.nut.2013.10.011

    Phillips, S. M., & Martinson, W. (2019). Nutrient-rich, high-quality, protein-containing dairy foods in combination with exercise in aging persons to mitigate sarcopenia. Nutr Rev, 77(4), 216-229. doi:10.1093/nutrit/nuy062

    Plastow, N. A., Atwal, A., & Gilhooly, M. (2015). Food activities and identity maintenance in old age: a systematic review and meta-synthesis. Aging & Mental Health, 19(8), 667-678. doi:10.1080/13607863.2014.971707

    Pouresmaeili, F., Kamalidehghan, B., Kamarehei, M., & Goh, Y. M. (2018). A comprehensive overview on osteoporosis and its risk factors. Ther Clin Risk Manag, 14, 2029-2049. doi:10.2147/tcrm.S138000

    Ratajczak, A. E., Zawada, A., Rychter, A. M., Dobrowolska, A., & Krela-Kaźmierczak, I. (2021). Milk and Dairy Products: Good or Bad for Human Bone? Practical Dietary Recommendations for the Prevention and Management of Osteoporosis. Nutrients, 13(4). doi:10.3390/nu13041329

    Rizzoli, R., & Biver, E. (2018). Effects of Fermented Milk Products on Bone. Calcif Tissue Int, 102(4), 489-500. doi:10.1007/s00223-017-0317-9

    Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016). A design thinking framework for healthcare management and innovation. Healthc (Amst), 4(1), 11-14. doi:10.1016/j.hjdsi.2015.12.002

    Roberts, S. B., Silver, R. E., Das, S. K., Fielding, R. A., Gilhooly, C. H., Jacques, P. F., . . . Booth, S. (2021). Healthy Aging-Nutrition Matters: Start Early and Screen Often. Adv Nutr, 12(4), 1438-1448. doi:10.1093/advances/nmab032

    Robinson, S. M. (2018). Improving nutrition to support healthy ageing: what are the opportunities for intervention? Proc Nutr Soc, 77(3), 257-264. doi:10.1017/s0029665117004037

    Sandholdt, C. T., Cunningham, J., Westendorp, R. G. J., & Kristiansen, M. (2020). Towards Inclusive Healthcare Delivery: Potentials and Challenges of Human-Centred Design in Health Innovation Processes to Increase Healthy Aging. Int J Environ Res Public Health, 17(12). doi:10.3390/ijerph17124551

    Schlüter, N., & Groß, P. (2019). [Special aspects of nutrition in elderly]. Swiss Dent J, 129(11), 929-936.

    Scott, D., Sarah, H., Perry, K., Kathryn, S., & Jeremy, U. (2018). Design Thinking Bootleg. Retrieved from https://dschool.stanford.edu/resources/design-thinking-bootleg
    Shlisky, J., Bloom, D. E., Beaudreault, A. R., Tucker, K. L., Keller, H. H., Freund-Levi, Y., . . . Wu, D. (2017). Nutritional considerations for healthy aging and reduction in age-related chronic disease. Advances in nutrition, 8(1), 17.

    Thorning, T. K., Raben, A., Tholstrup, T., Soedamah-Muthu, S. S., Givens, I., & Astrup, A. (2016). Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence. Food Nutr Res, 60, 32527. doi:10.3402/fnr.v60.32527

    Van de Grift, T. C., & Kroeze, R. (2016). Design Thinking as a Tool for Interdisciplinary Education in Health Care. Acad Med, 91(9), 1234-1238. doi:10.1097/acm.0000000000001195

    Vesnaver, E., Keller, H. H., Payette, H., & Shatenstein, B. (2012). Dietary resilience as described by older community-dwelling adults from the NuAge study “If there is a will – there is a way!”. Appetite, 58(2), 730-738. doi:https://doi.org/10.1016/j.appet.2011.12.008

    WHO. (2001). Men, ageing and health : achieving health across the life span. In. Geneva: World Health Organization.

    WHO. (2020). Life expectancy and Healthy life expectancy Data by WHO region. Retrieved from https://apps.who.int/gho/data/view.main.SDG2016LEXREGv?lang=en

    Wilson, D., Jackson, T., Sapey, E., & Lord, J. M. (2017). Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev, 36, 1-10. doi:10.1016/j.arr.2017.01.006

    Yannakoulia, M., Ntanasi, E., Anastasiou, C. A., & Scarmeas, N. (2017). Frailty and nutrition: From epidemiological and clinical evidence to potential mechanisms. Metabolism, 68, 64-76. doi:https://doi.org/10.1016/j.metabol.2016.12.005

    Yeung, S. S. Y., Kwan, M., & Woo, J. (2021). Healthy Diet for Healthy Aging. Nutrients, 13(12). doi:10.3390/nu13124310

    Zanini, B., Simonetto, A., Zubani, M., Castellano, M., & Gilioli, G. (2020). The Effects of Cow-Milk Protein Supplementation in Elderly Population: Systematic Review and Narrative Synthesis. Nutrients, 12(9). doi:10.3390/nu12092548

    無法下載圖示 電子全文延後公開
    2027/09/21
    QR CODE