中文摘要
研究目的：
本研究設計以一個剛起步發展達文西機械輔助手術一年的區域醫院為範圍，採用知識態度行為研究模型，在外科門診診間發放紙本問卷，研究對象為外科門診就醫病患及家屬。本研究意在探討門診就診病患對於達文西手術的知識，態度與行為之間的關聯性。在目前的全民健保制度下，達文西機械輔助手術仍有需病患自費負擔約20至40萬不等的金額，目前就醫民眾最關心的除了療效等醫學問題外，即是自費負擔等相關議題，本問卷中亦包含個人醫療保險額度、每月可支配金錢額度等相關問項。
研究方法：
本研究於IRB通過後，進行專家效度分析及問卷前測，正式問卷發放時間為2022年03月22日至2022年06月30日，共計100日，正式問卷最後共回收330份，刪除填答傾向一致或趨於中性之無效問卷13份後，有效問卷回收率為96.0%。本研究以SPSS 24.0版與R語言4.2.1版之統計軟體進行資料處理與分析，本研究分析以描述性統計、皮爾森相關分析、獨立樣本T檢定及單因子變異數分析進行資料統計分析。
研究結果：
由皮爾森相關分析結果可見，在外科門診的就診病患中，對於達文西手術的知識、態度和行為三構面相互皆為正相關，由此得知在達文西機械手臂輔助手術的選擇上，知識面向掌握程度越高，對於態度和行為會更趨於正向；值得探討的為「是否接受過手術」和「是否接受過癌症手術」兩題項獨立分析中，在於知識面向未有統計上的顯著差異，卻在態度面向上發現了顯著的統計差異，而在行為上卻又為顯著的統計差異。在「每月可支配金額」結果中，發現金額(收入)高低會影響病患對於達文西手術的知識及行為，卻在態度影響無顯著差異，其結果與過去研究中的發現相符。影響病患選擇術式最顯著的因素依序為：醫師建議、安全性、術後傷口大小。本研究結果亦符合Schwartz 的KAB理論的模型四：知識直接或間接的影響行為，並由態度作為中介。
結論：
由研究結果得知，民眾對於達文西機械手臂輔助手術的知識態度行為兩兩均呈現正相關，符合對於在初引進並推廣達文西機械手臂輔助手術的醫院中，尤其是在區域教學醫院這樣的等級，可多增加此類手術相關之資訊，在門診及住院期間用各種管道教育病患，以利提升民眾對於達文西機械手臂輔助手術之知識，進而提高在未來選擇達文西機械手臂輔助手術之態度及行為。
關鍵字：達文西機械輔助手術系統、腹腔鏡手術、癌症手術、知識態度行為模型、外科門診

Purpose:
This study was conducted in a regional hospital that had just started developing Da Vinci robotic-assisted surgery for one year. The study applied a knowledge-attitude behavior research model, and distributed paper questionnaires in surgical outpatient clinics. This study aims to explore the association between knowledge, attitudes and behaviors of outpatient visits patients about the adoption of such surgery. Under the current national health insurance system, Da Vinci robotic-assisted surgery still requires patients to pay about NT$200,000 to 400,000 out-of-pocket money, and the current patients are more concerned about issues such as efficacy, self-payment burden, etc. This questionnaire also includes personal medical insurance amounts, monthly income limits, and other related questions.
Methods:
After receiving the IRB approval, the expert validity analysis and questionnaire pre-test were carried out, and the official questionnaire was distributed from March 22, 2022 to June 30, 2022, for a total of 100 days, and a total of 330 formal questionnaires were finally received. The effective questionnaire recovery rate was 96.0% after deleting 13 invalid questionnaires with consistent or neutral answers. In this study, SPSS version 24.0 and R version 4.2.1 statistical software were used for data processing and analysis. The analyses included descriptive statistics, Pearson correlation analysis, independent sample t-test, and one-way ANOVA analysis.
Results:
Pearson's correlation analysis showed that the three constructs of knowledge, attitude, and behavior of da Vinci surgery are positively correlated with each other among patients attending surgical clinics. The higher the level of knowledge the more positive the attitude and behavior toward the choice of da Vinci robotic-assisted surgery. In the independent analysis of the two questions "Have you undergone surgery" and "Have you undergone cancer surgery", there was no statistically significant difference in knowledge aspect, but had significant statistical differences in attitude behavior. However, the analysis of the results of the 'monthly disposable amount' shows that the amount (income) affects the patient's knowledge and behavior of da Vinci's surgery, but there is no significant difference in attitude. The finding is consistent with previous research. The most significant factor influencing the patient's choice of surgical method is the doctor's recommendation, followed by safety, and the third is the size of the postoperative wound. The results of this study are also in line with the model four of Schwartz's KAB theory: knowledge directly or indirectly influences behavior and is mediated by attitudes.
Discussion and Conclusion:
The study results indicated that the public's knowledge and attitude toward da Vinci robotic-assisted surgery are positively correlated. Therefore, for a regional teaching hospital that has initially introduced and promoted da Vinci robotic-assisted surgery, more information related to such surgery can be provided, and various ways can be used to educate patients during outpatient and inpatient visits. Thus it could improve the public's knowledge of da Vinci robotic arm-assisted surgery, and then improve the attitude and behavior toward choosing da Vinci robotic-assisted surgery in the future.
Keywords: da Vinci surgery, robotic assisted laparoscopic surgery, cancer surgery, knowledge attitude behavior model, surgical outpatient clinics 

目錄
論文審定書i
中文摘要 ii
英文摘要 iv
圖次 viii
表次 ix
第一章緒論1
第一節研究背景與動機1
第二節研究問題2
第三節研究目的2
第四節研究流程3
第二章文獻探討4
第一節達文西機器手臂手術輔助系統發展與現況4
第二節癌症(惡性腫瘤)在台灣的發生率、原因與治療8
第三節癌症病患手術術式決策過程10
第四節達文西手術系統在癌症手術的應用11
第五節知識態度行為模型16
第六節小結18
第三章研究方法19
第一節研究架構與假設問題19
第二節問卷設計與資料蒐集方法20
第三節研究變項與操作型定義21
第四節資料處理與統計分析方法23
第五節專家效度與問卷前測結果分析25
第六節正式問卷信效度分析27
第四章研究結果30
第一節資料發放與蒐集30
第二節描述性統計分析31
第三節推論性統計分析39
第四節研究架構與假設檢驗50
第五章討論與建議52
第一節討論52
第二節建議56
第三節研究限制57
第四節研究貢獻58
第五節結論58
參考文獻60
附錄一67
附錄二68
附錄三73

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二、 網路文獻
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