本研究目的為設計以使用者（失智症照護家屬）為中心之改良版衛教手冊，使家屬能即時從中汲取、理解並學習照護必備資訊及實務技巧，滿足渠等需求，並強化其照護角色之主動性。具體目標包括：（一）調查失智症照護家屬的知識性需求；（二）發展「以照護家屬為中心」的衛教教材設計準則；（三）驗證本研究設計手冊之理解度與可行性。

研究設計之失智症衛教手冊，以「憶念（取自回憶與信念）」為名，係運用創新產品設計與開發方法進行設計與改良，內容含括朗朗上口且實用的閱讀策略、易讀的文本、主題式架構編排、精心繪製的資訊圖像、在地照護實例及鮮明角色設計。研究發展流程中，照護家屬持續以共同創作者的主動角色參與其中，透過反覆驗證再設計，避免使用者因健康識能及照護能力不足，無法自手冊中獲取醫護知識及心理支持。專家深度訪談、文本可讀性指標自動化分析系統及放聲思考法為本研究驗證可讀性、理解度及使用性的重要工具。

本研究主要效益係透由資訊圖像再設計改良現行衛教手冊，重新轉化專業醫護資訊，使本研究設計之「憶念」手冊，能滿足臺灣地區失智症照護家屬的實務需求，協助他們在照護過程中扮演更主動的角色。本研究之整體架構亦可作為未來衛教手冊開發人員欲在設計開發流程同時納入領域專家及目標使用者時的重要參考。

The research work aims to investigate dementia family caregivers’ (DFCs’) information needs and provide a written health education material (WHEM) for this targeted group which will satisfy their needs and enhance their role as active caregivers. The objectives of this research are to (1) explore current usage problems of WHEMs on dementia in Taiwan, (2) design and develop a dementia care handbook from a family-caregiver-centred perspective, and (3) evaluate the overall feasibility of the proposed WHEM and report preliminary data.

Developed within the innovative product design and development (IPDD) framework, the proposed WHEM consists of a catchy and useful reading strategy, easy-to-read (ETR) texts, a thematic organisation, well-tailored infographics, quotes and actual caregiving experience from previous caregivers, and vivid illustrated characters. The design and development process involved several iterative steps to adapt the information into local circumstances, and to engage DFCs as active co-designers, so that the proposed WHEM can provide requisite information and support for DFCs regardless of their literacy level and healthcare competence. In addition, in-depth expert interviews, the Chinese Readability Index Explore (CRIE) 3.0, the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P), and a Think-Aloud method are used to thoroughly evaluate the readability, understandability, actionability, and usability of IDEA.

The primary benefit of this proposed WHEM, IDEA, named as “IDEA (the combination of Memory and Faith in Mandarin)”, is that the simplified healthcare information in the form of infographics can fit into DFCs’ practical needs and local context. The IPDD research framework serves as a solid guidance for designers to evenly consider design thinking, product utility and validation. Therefore, a user-centred and health literacy friendly WHEM is adapted and proposed for practical use. DFCs can obtain requisite caregiving information from WHEMs based on their own needs and current circumstances, thus enhancing their role as active caregivers.

Aldridge, M. D. (2004). "Writing and designing readable patient education materials." Nephrology Nursing Journal 31(4): 373-377.
Barros, I. M., T. S. Alcântara, A. R. Mesquita, A. C. O. Santos, F. P. Paixão and D. P. Lyra (2014). "The use of pictograms in the health care: a literature review." Research in Social and Administrative Pharmacy 10(5): 704-719.
Bernier, M. J. (1993). "Developing and evaluating printed education materials: a prescriptive model for quality." Orthopedic Nursing 12(6): 39-46.
Boots, L. M., M. E. de Vugt, H. E. Withagen, G. I. Kempen and F. R. Verhey (2016). "Development and initial evaluation of the web-based self-management program “partner in balance” for family caregivers of people with early stage dementia: an exploratory mixed-methods study." JMIR research protocols 5(1): e33.
Braun, V. and V. Clarke (2006). "Using thematic analysis in psychology." Qualitative Research in Psychology 3(2): 77-101.
Bull, M. J. (2014). "Strategies for sustaining self used by family caregivers for older adults with dementia." Journal of Holistic Nursing 32(2): 127-135.
Cardenas, C., L. E. Schleimer, M. Olsen, V. Manzo, R. Guay, T. Kim, P.-G. Desameau, R. Damuse, L. N. Shulman, F. W. Huang and A. S. Bhatt (2016). "Global design strategy for cancer patient education materials: Haiti pilot case study." Design Management Journal 11(1): 15-31.
Cowan, C. F. (2004). "Teaching patients with low literacy skills." Fuszard’s innovative teaching strategies in nursing: 278.
Gitlin, L. N., H. C. Kales and C. G. Lyketsos (2012). "Nonpharmacologic management of behavioral symptoms in dementia." Jama 308(19): 2020-2029.
Grace, S. and L. Horstmanshof (2019). "A realist evaluation of a regional Dementia Health Literacy Project." Health Expectations.
Haralambous, B., P. Mackell, X. Lin, M. Fearn and B. Dow (2018). "Improving health literacy about dementia among older Chinese and Vietnamese Australians." Australian Health Review 42(1): 5-9.
Hirschberg, I., G. Seidel, D. Strech, H. Bastian and M.-L. Dierks (2013). "Evidence-based health information from the users’ perspective–a qualitative analysis." BMC Health Services Research 13(1): 405.
Hoffmann, T. and L. Worrall (2004). "Designing effective written health education materials: considerations for health professionals." Disability and rehabilitation 26(19): 1166-1173.
Jacob, A., D. Davis, N. Mansfield and M. C. Logsdon (2016). "Evaluation of Printed Health Materials for Patients with Heart Disease and Chronic Lung Conditions." Kentucky Nurse 64(2).
Jensen, C. J. and J. Inker (2015). "Strengthening the dementia care triad: identifying knowledge gaps and linking to resources." American Journal of Alzheimer's Disease & Other Dementias® 30(3): 268-275.
Jiang, Y., S. M. Sereika, J. H. Lingler, L. K. Tamres and J. A. Erlen (2018). "Health literacy and its correlates in informal caregivers of adults with memory loss." Geriatric Nursing 39(3): 285-291.
Kagan, S. H. (2018). "Using story and art to improve education for older patients and their caregivers." Geriatric Nursing 39(1): 119-121.
King, R. H. and N. Baum (2018). "How to Write Easy-to-Read Healthcare Materials for Blogs and Websites that Result in New Patients." The Journal of Medical Practice Management: MPM 33(6): 392-394.
Ley, P. (1988). Communicating with patients: Improving communication, satisfaction and compliance, Croom Helm.
Locoro, A., F. Cabitza, R. Actis-Grosso and C. Batini (2017). "Static and interactive infographics in daily tasks: a value-in-use and quality of interaction user study." Computers in Human Behavior 71: 240-257.
McCrorie, A., C. Donnelly and K. McGlade (2016). "Infographics: healthcare communication for the digital age." The Ulster Medical Journal 85(2): 71.
Morony, S., K. J. McCaffery, S. Kirkendall, J. Jansen and A. C. Webster (2017). "Health literacy demand of printed lifestyle patient information materials aimed at people with chronic kidney disease: are materials easy to understand and act on and do they use meaningful visual aids?" Journal of health communication 22(2): 163-170.
Papachristou, I., G. Hickeys and S. Iliffe (2018). "Involving caregivers of people with dementia to validate booklets on food-related activities: a qualitative think-aloud study." Journal of Applied Gerontology 37(5): 644-664.
Pei, Y.-C., J.-L. Chen, A. M. Wong and K. C. Tseng (2017). "An evaluation of the design and usability of a novel robotic bilateral arm rehabilitation device for patients with stroke." Frontiers in neurorobotics 11: 36.
Peterson, K., H. Hahn, A. J. Lee, C. A. Madison and A. Atri (2016). "In the Information Age, do dementia caregivers get the information they need? Semi-structured interviews to determine informal caregivers’ education needs, barriers, and preferences." BMC Geriatrics 16(1): 164.
Protheroe, J., E. V. Estacio and S. Saidy-Khan (2015). "Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness." Br J Gen Pract 65(632): e192-e197.
Rathnayake, S., W. Moyle, C. J. Jones and P. Calleja (2018). "Development of an mHealth application for family carers of people with dementia: A study protocol." Collegian.
Raynor, D. (1998). "The influence of written information on patient knowledge and adherence to treatment." Adherence to treatment in medical conditions: 83-111.
Sabogal, F., R. Otero-Sabogal, R. J. Pasick, C. N. Jenkins and E. J. Pérez-Stable (1996). "Printed health education materials for diverse communities: suggestions learned from the field." Health Education Quarterly 23(1_suppl): 123-141.
Sand-Jecklin, K. (2007). "The impact of medical terminology on readability of patient education materials." Journal of Community Health Nursing 24(2): 119-129.
Schulz, R., A. B. Mendelsohn, W. E. Haley, D. Mahoney, R. S. Allen, S. Zhang, L. Thompson and S. H. Belle (2003). "End-of-life care and the effects of bereavement on family caregivers of persons with dementia." New England Journal of Medicine 349(20): 1936-1942.
Shoemaker, S. J., M. S. Wolf and C. Brach (2014). "Development of the Patient Education Materials Assessment Tool (PEMAT): A new measure of understandability and actionability for print and audiovisual patient information." Patient Education and Counseling 96(3): 395-403.
Smith, F., C. Wallengren and J. Öhlén (2017). "Participatory design in education materials in a health care context." Action Research 15(3): 310-336.
Steiner, V., L. L. Pierce and D. Salvador (2016). "Information needs of family caregivers of people with dementia." Rehabilitation Nursing 41(3): 162-169.
Sung, Y.-T., T.-H. Chang, W.-C. Lin, K.-S. Hsieh and K.-E. Chang (2016). "CRIE: An automated analyzer for Chinese texts." Behavior Research Methods 48(4): 1238-1251.
Thompson, G. N. and K. Roger (2014). "Understanding the needs of family caregivers of older adults dying with dementia." Palliative & Supportive Care 12(3): 223-231.
Tseng, K., W. Su and C. Hsu (2014). A tele-rehabilitation service mode for patients with adhesive capsulitis. Workshop on Interactive Systems in Healthcare (WISH).
Tseng, K. C. (2013). An IPDD approach for systematic innovation of products, processes, and services: a case study on the development of a healthcare management system. The 5th IASDR World Conference on Design Research. Tokyo.
Tseng, K. C. and C.-L. Hsu (2016). "Implementation of a User-oriented Model for Collaborative Product Development: An Example from the Medical-equipment Industry." International Journal of Robotics and Mechatronics 2(3): 87-92.
Tseng, K. C., S.-H. Tseng and H.-Y. K. Cheng (2016). "Design, development, and clinical validation of therapeutic toys for autistic children." Journal of physical therapy science 28(7): 1972-1980.
Werner, N. E., B. Stanislawski, K. A. Marx, D. C. Watkins, M. Kobayashi, H. Kales and L. N. Gitlin (2017). "Getting what they need when they need it. Identifying barriers to information needs of family caregivers to manage dementia-related behavioral symptoms." Applied clinical informatics 8(1): 191-205.
Whitlatch, C. J. and S. Orsulic-Jeras (2018). "Meeting the informational, educational, and psychosocial support needs of persons living with dementia and their family caregivers." The Gerontologist 58(suppl_1): S58-S73.
Wilson, E. A. H., G. Makoul, E. A. Bojarski, S. C. Bailey, K. R. Waite, D. N. Rapp, D. W. Baker and M. S. Wolf (2012). "Comparative analysis of print and multimedia health materials: A review of the literature." Patient Education and Counseling 89(1): 7-14.