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研究生: 林旭龍
Shiuh-long Lin
論文名稱: 應用跨理論模式於大學女生身體活動之主客觀評價的研究
Application of Transtheoretical Model with Objective and Subjective Evaluation of Physical Activity on College Female Students
指導教授: 呂昌明
Lu, Chang-Ming
學位類別: 博士
Doctor
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2000
畢業學年度: 88
語文別: 中文
論文頁數: 243頁(含目錄﹑參考文獻及附錄等)
中文關鍵詞: 跨理論模式身體活動運動行為三度空間加速器七日回憶訪談法三日回憶記錄法女大學生能量消耗
英文關鍵詞: transtheoretical model, physical activity, exercise behavior, TriTrac-R3D accelerometer, 7-d PAR, 3-d PAL, college female students, energy expenditure
論文種類: 學術論文
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  • 中文摘要
    本研究運用自我研發之結構式問卷(內含運動自我效能、知覺運動障礙與知覺運動利益三個分量表)、Marcus & Simkin (1993)之運動階段分類量表、身體活動客觀測量法之TriTrac-R3D三度空間加速器、身體活動主觀估計法之七日回憶訪視問卷(seven-day physical activity recall,以下簡稱7-d PAR)以及三日回憶記錄問卷(three-day physical activity log,以下簡稱3-d PAL),其目的旨在驗證跨理論模式中之改變階段模式(The Stage of Change Model)是否具有良好之構念效度(construct validity),能否區別跨理論模式中運動自我效能、衡量作決定(知覺運動障礙與知覺運動利益)三個心理變項之差異,以及是否也能區別由主客觀方法中所估計之能量消耗之差異。本研究也以TriTrac-R3D作為效標探討7-d PAR與3-d PAL之信度和效度,並比較其間之差異、關聯與實用性。
    研究對象共73名,係由88學年度上學期在學之大學院校女生中募集而來。每名研究對象均佩戴TriTrac-R3D八天(共7個完整日),監測其身體活動情形。在訪視員解說後,填寫結構式問卷,並攜回3-d PAL三份,藉以記錄週六、週日及平日任選一日之身體活動情形。一週後接受以訪視員為主(interviewer-administered)之7-d PAR訪視。兩週後,相同之結構式問卷、3-d PAL 與7-d PAR予以重複施測。使用之統計方法包括:敘述統計、驗證式因素分析、one-way MANOVA、two-way repeated measures ANOVA、獨立樣本t 考驗、配對樣本t考驗、線性迴歸、斯皮爾曼等級相關、kappa一致性分析等。本研究所得重要發現與結論如下:
    一、本研究所研發之結構式問卷量表,具有良好之內部一致性信度(r=.87~.89)、再測信度(r=.77~.90)與構念效度,可用於影響大學女生運動行為心理變項(運動自我效能、知覺運動障礙與知覺運動利益)之施測。
    二、Marcus & Simkin (1993)所研發之運動階段分類量表具有良好之內部一致性信度(KR20=.84)、再測信度(The Kappa coefficient of agreement=.81)與構念效度。其再測信度愈高,對於改變階段模式之構念效度也會隨之提升。
    三、跨理論模式中之改變階段模式(The stage of change model)具有良好之構念效度,可區別影響運動行為之心理變項(Pillai’s Trace=.793, F(12,204)=6.106, P< .001, multivariate η2 =.264)以及身體活動量(Pillai’s Trace=.456, F(12, 204)=3.05, P< .001, multivariate η2 =.152)。
    四、跨理論模式中之自我效能理論與衡量作決定理論中之知覺障礙呈現負相關,Spearman rho= -.89(p< .001),與知覺利益間呈現正相關Spearman rho= .50(p< .001)。知覺障礙與知覺利益間呈現負相關Spearman rho= -.41(p< .001)。運動自我效能、知覺運動障礙與知覺運動利益三者皆可預測身體活動量,其中以運動自我效能可解釋之變異量13.6%最大,其次為知覺運動障礙11.5%,而以知覺運動利益10.5%較低。
    五、衡量作決定理論中,知覺運動障礙與知覺運動利益在五個不同運動階段間,兩者均呈現線性關係,而兩線交叉於準備期,其分數略低於平均值。此意味著位於準備期之研究對象雖尚未採取規律運動,但即將產生行為改變。
    六、7-d PAR與3-d PAL具有良好之同時效度(分別為.86與.81,P< .001),與再測信度(分別為.97與.95,p< .001)。其中以7-d PAR與客觀能量消耗數據(TriTrac-R3D數據)較為接近,3-d PAL則有較大之落差。但於大規模社會調查研究或流行病學研究時,3-d PAL施測較為簡便,7-d PAR則須花費較多的人力與時間成本。
    關鍵字:跨理論模式、身體活動、運動行為、三度空間加速器、七日回憶訪談法、三日回憶記錄法、女大學生、能量消耗

    Abstract
    The purpose of this research was to examine the construct validity and utility of the stages of Change Model that is one part of the Transtheoretical Model created by Prochaska and DiClemente. A self-developed structured questionnaire included self-efficacy for exercise scale, perceived barriers to exercise scale, perceived benefits of exercise scale, with Exercise Stage instrument created by Marcus & Simkin were using to this research. Also, the TriTrac-R3D accelerometer as an objective instrument for estimation of physical activity and two subjective instruments: interviewer-administered seven-day physical activity recall questionnaire (7-d PAR), and three-day physical activity log (3-d PAL) were using to examine the construct validity of the stages of change model too. Meanwhile, The concurrent validity and test-retest reliability of 7-d PAR and 3-d PAL were examined and compared by TriTrac-R3D, which was used as a criterion.
    73 female college students were recruited to join this research. They were instructed by interviewer to wear correctly the TriTrac-R3D on their waist site for 7 days, and to record the 3-d PAL seriously 3 days (Saturday, Sunday and one of the weekdays as they preferred). As regard to 7-d PAR the subjects were interviewed one week later. The same structured questionnaire, 7-d PAR and 3-d PAL were retested two weeks later. As the end of data collection the Statistics analytical method such as descriptive statistics, confirmatory factor analysis, one-way MANOVA, two-way repeated measures ANOVA, paired samples t-test, independent samples t-test, univariate linear regression, Spearman rank correlation and The Kappa agreement of measures etc. were used for data analysis. From which the following conclusion were drawn:
    1.The self-developed structured questionnaire has high cofficient of internal consistency (r= .87~ .89), test-retest reliability (r= .77~ .90) and construct validity. They might be used for further research of physical activity in female college students.
    2.The Exercise Stage Instrument created by Marcus & Simkin, which was used in this research, also revealed high coefficient of internal consistency (KR20= .84), test-retest reliability (The Kappa coefficient of agreement= .81) and construct validity. The higher the test-retest reliability be got, the higher construct validity of the stages of change model will be.
    3.The construct validity of the stages of Change Model was verified. Significant differences were revealed in three psychological variables (self-efficacy for exercise, perceived barriers to exercise, and perceived benefits of exercise). (Pillai’s Trace= .793, F (12,204)=6.106, P< .001, multivariate η2 = .264). Also, Significant differences were revealed in TriTrac-R3D, 7-d PAR and 3-d PAL variables. (Pillai’s Trace= .456, F (12, 204)=3.05, P < .001, multivariate η2 = .152).
    4.Negative association found between self-efficacy for exercise and perceived barriers to exercise Spearman rho= -.89(p< .001), it was also found negative association between perceived barriers and perceived benefits of exercise Spearman rho= -.41(p< .001), but positive association found between self-efficacy for exercise and perceived benefits of exercise Spearman rho= .50(p< .001). Linear regression analysis revealed that these three psychological variables could predict physical activity (kcal/d) estimated by TriTrac-R3D. The variance accounted for by self-efficacy was 13.6%, by perceived barriers was 11.5% and by perceived benefits was 10.5%.
    5.At a glance of line chart, it revealed a linear relationship of perceived barriers between pre-contemplation, contemplation, preparation, action and maintenance stage. And conversely linear relationship of perceived benefits between the 5 exercise stages was found. The two lines cross at preparation stage, which T-score was below average. It implies that the subjects in this stage are not ready for exercise but soon will take action when they make decision about the pros and cons of exercise.
    6.Using Spearman rank correlation method to examine the concurrent validity and test-retest reliability of 7-d PAR and 3-d PAL. The concurrent validity of 7-d PAR was .86(p< .001), and 3-d PAL was .81(p< .001), respectively. The test-retest reliability of 7-d PAR was .97(p< .001), and 3-d PAL was .95(p< .001), respectively. For comparison of 7-d PAR and 3-d PAL, The data of estimation of physical activity by 7-d PAR closely followed TriTrac-R3D but underestimated, whereas 3-d PAL had relatively large difference and overestimated compared by TriTrac-R3D. Nevertheless, 3-d PAL is low-cost and practical for large population community-based social survey or epidemiological research.
    Key words: transtheoretical model, physical activity, exercise behavior, TriTrac-R3D accelerometer, 7-d PAR, 3-d PAL, college female students, energy expenditure.

    目 錄 第一章 緒論 1 第一節 研究動機 1 第二節 研究目的 8 第三節 研究問題 9 第四節 研究假設 11 第五節 研究架構 14 第六節 名詞界定 15 第七節 研究限制 19 第二章 文獻探討 23 第一節 跨理論模式(TRANSTHEORETICAL MODEL) 23 壹、改變之階段(The Stages of Change) 24 貳、改變之過程(The Process of Change) 30 參、自我效能(Self-efficacy) 32 肆、衡量做決定(Decisional Balance) 34 第二節 身體活動測量與評估 35 壹、主觀法:七日回憶訪談法(7-d PAR) 36 貳、主觀法:三日回憶記錄法(3-d PAL) 38 參、客觀法:三度空間加速器測量法(TriTrac-R3D) 40 第三章 研究方法 45 第一節 研究對象 45 第二節 研究工具 46 第三節 研究步驟 76 第四節 資料處理與分析 83 第四章 研究結果 91 第一節 研究對象基本資料 91 第二節 不同運動階段之心理變項分析 96 第三節 不同運動階段之身體活動量分析 106 第四節 主客觀身體活動量(能量消耗數據)之比較 112 第五節 身體活動量與心理變項之關係 123 第六節 三個心理變項預測身體活動量(線性迴歸模式) 125 第七節 由3-D PAL及7-D PAR之主觀能量消耗預測TRITRAC客觀身體活動 量(線性迴歸模式) 133 第五章 討論 139 第一節 綜合式結構問卷之信度和效度 139 第二節 改變階段模式之構念效度 143 第三節 主客觀身體活動量之比較 152 第六章 重要發現、結論與建議 163 第一節 重要發現 163 第二節 結論 168 第三節 建議 169 參考文獻 173 附 錄 185 附錄ㄧ 開放式問卷 185 附錄二 結構式問卷:預試階段 186 附錄三 結構式問卷:正式施測階段 193 附錄四 研究合約書 198 附錄五 TRITRAC-R3D 使用須知 200 附錄六 身體活動三日記錄法表格(3-D PAL) 202 附錄七 身體活動七日回憶法訪視表(7-D PAR) 204 附錄八 身體活動七日回憶法訪視員手冊 206

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