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研究生: 陳虹如
Chen Hung-Ru
論文名稱: 我國醫學系營養課程內容及實施方式-德菲研究
The identification of nutrition topics essential for medical schools in Taiwan - Delphi study
指導教授: 林薇
Lin, Wei
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
畢業學年度: 86
語文別: 中文
中文關鍵詞: 營養課程德菲法
論文種類: 學術論文
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  • 本研究之主要目的在確認醫學系營養課程所應涵蓋的內容、及適合醫學系營養課程的實施方式,並比較醫界與營養界專家學者對醫學系營養課程必要性的評定及實施方式的看法。 研究採用Delphi研究法,經由文獻探討發展出問卷,內容包括醫學系營養課程內容必要性評估及醫學系營養課程之實施方式,寄請專家學者(醫界10名,營養界7名)進行三次Delphi問卷填答,並以平均值、百分比、平均數假設t考驗、獨立樣本t考驗、斯皮爾曼等級相關等統計方法進行分析。 研究結果發現:在醫學系營養課程所應涵蓋的項目上,全體專家學者共評定八十四個項目為醫學系營養課程中具有必要性(評定為「必要」或「有點必要」者的內容),而醫界專家學者評定九十九個項目具有必要性,營養界專家學者評定三十三個項目具有必要性,醫界與營養界專家學者共同評定三十一個項目為具有必要性的內容。全體專家學者評定為醫學系營養課程中「必要」的十七個項目可視為醫學系營養課程中最重要的內容,其次為醫界與營養界專家學者共同評定為具有必要性的三十一個項目。在醫學系營養課程所涵蓋主題之優先順序上,全體專家學者認為以「營養支持」、「營養評估法」、「六大類營養素」、「疾病飲食處方」、「熱量」等為最優先的主題,其次為「營養與藥物」、「生命期營養」、「體重與健康」、「疾病與營養照顧」等四個主題,「飲食行為的影響因素與飲食異常」,「公共衛生營養」、「食品衛生與安全」等三個主題為最後。在適合醫學系營養課程的實施方式方面,超過60%的專家學者認為本研究所提出之十二個主題均需要安排於醫學系營養課程中,且除了「營養與藥物」這個主題宜統整至其他學科外,其餘十一個主題多數專家學者均認為應安排於「獨立營養課程」,且應為「必修課」。在課程安排上,依主題之不同,專家學者建議安排的年級亦有所不同,多數的專家學者認為「六大類營養素」、「熱量」等兩個主題應安排於醫學系的1~4年級,「營養支持」、「疾病飲食處方」、「疾病與營養照顧」、「營養與藥物」、「營養評估法」、「生命期營養」、「體重與健康」及「飲食行為的影響因素與飲食異常」等八個主題應安排於醫學系的5~6年級。在對「獨立營養課程」中所應涵蓋的主題、建議科目名稱及建議學分數之看法上,醫界專家學者多建議開設1~2學分之營養課程;營養界專家學者則多建議開設2學分之營養課程。開設課程名稱以「營養學」或「臨床營養學」為宜,涵蓋內容應有「六大類營養素」、「熱量」、「生命期營養」、「疾病飲食處方」、「疾病與營養照顧」、「營養與藥物」及「營養評估法」等主題,「營養與藥物」則可統整至外科、藥理學等科目中。各主題「建議教學時數」多為0.5~2個小時,總建議教學時數約為10.5~24小時,而營養界專家學者比醫界專家學者建議更多的教學時數。

    The identification of nutrition topics essential for medical schools in Taiwan--Delphi study. The purpose of the study is to identify the nutrition topics essential for medical schools, the opinions of medical professionals (medical educators, and physicians) and nutritional professionals (nutrition scientists, and dietitians) were compared. Delphi method was used in the study, 17 professionals, 10 in medical science, and 7 in nutrition science had completed mailed questionnaires three times. T-test, Spearman rank correlation were used to analyze the questionnaire. 84 items of 12 nutrition topics were evaluated as the essential concepts of nutrition curriculum in medical schools, 17 items were rated as essential items, and 67 items were rated as somewhat essential. Both professionals in medical science and nutrition science rated 31 items to be essential or somewhat essential. The 17 items that both professionals rated essential are recommended as the 〝most important〞 concepts of nutrition curriculum in medical schools, and the 31 items that professionals in medical science and nutrition science rated either essential or somewhat essential are recommended as the 〝important〞concepts of nutrition curriculum in medical schools. Five topics were ranked as the first priority of nutrition curriculum in medical schools, including nutrition support, nutrition assessment, basic nutrients, the prescription of the disease and energy. Four topics were ranked as the second priority, including nutrition and drug, nutrition in the life cycle, body weight and health, disease and nutrition care. Three topics were ranked as the third priority, including the influences of eating behavior and eating disorder, public health nutrition, food sanitation and safety. More than 60% of the professionals suggested the 12 nutrition topics in the study should be incoporated in the nutrition curriculum in medical schools. All topics except the topic of nutrition and drug should be incoporated in an independent required nutrition course. Most professionals suggested that the topics of basic nutrients and energy could be taught in the first year to the forth year of medical schools. The topics of nutrition support, the prescription of disease, disease and nutrition care, nutrition and drug, nutrition assessments, nutrition in the life cycle, body weight and health and the influences of eating behavior and eating disorder should be taught in the fifth year to sixth year in medical schools. Most professionals in medical science suggested a 1~2 credit in nutrition course in medical schools, while most professionals in nutrition science suggested two credit nutrition course. The suggested title for the course was 〝nutrition〞 or 〝clinical nutrition〞. The topic of nutrition and drug can be integrated into surgery and pharmacology. The content of nutrition course should cover the topic of basic nutrients, energy, nutrition in the life cycle, prescription of the diseases, diseases and the nutrition care, nutrition and drug, and nutrition assessment. Most professionals suggested 0.5~2 hours on each topic, the total suggested hours was 10.5~24 hours.

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