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研究生：	康靜雯 Kang, Chign-Wen
論文名稱：	探討主照護者與幼童潔牙行為之研究 Teeth cleaning behavior of Caregiver and young toddlers
指導教授：	馬敏元 Ma, Min-Yuan
學位類別：	碩士 Master
系所名稱：	規劃與設計學院 - 工業設計學系 Department of Industrial Design
論文出版年：	2022
畢業學年度：	111
語文別：	英文
論文頁數：	140
中文關鍵詞：	遊戲化策略、尚.皮亞傑-他律與自律、幼童潔牙、涉入理論、對應分析
外文關鍵詞：	Gamification-Octalysis, Piaget-Heteronomy-Autonomy Strategies, Children's Teeth Cleaning, Involve Theory, Correspondence analysis
ORCID：	0009-0002-3823-4577
相關次數：	點閱：78 下載：0
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衛生福利部國民健康署於2020年委託執行108-109年度我國兒童口腔健康調查計畫結果顯示，12歲幼童恆齒齲齒經驗指數平均值從2000年的3.31顆，直至2020年下降為2.01顆，但與世界衛生組織(World Health Organization) 2025所設定的目標仍有距離。
本研究由瑞士心理學家尚.皮亞傑(Jean Piaget, 1962)最著名的學說「兒童認知發展」他律與自律主義，欲探討主照護者輔導幼童學習潔牙過程，主照護者輔導學齡前的幼童潔牙行為(Akkaya & Sezici, 2021)，捕捉有關遊戲化（Gamification）八角框架（Octalysis）策略及相關策略影響幼童潔牙的他-自律行為。
以涉入理論（Involve Theory）問卷找出涉入程度高的主照護者，涉入程度高的主照護者，能衡量引導策略的成效，採半結構式訪談（Semi-structured interviews）與KJ法歸納遊戲化型式項目，以第2次問卷分析主照護者自評遊戲化成效，從皮亞傑他-自律主義歸納3大類別：1.遵循規範、2.共伴關係、3.認知探索，從類別發現「他-自律型15項要素策略」、遊戲化與他-自律型策略的成效關聯性。
在對應分析圖高分群區High(>8)*b、S7、S8、S9、S10的「共伴關係-④互動引導」自評分數高，亦教導成效佳，故建議幼童學習潔牙以④互動引導來讓幼童建構自主「認知探索-⑦探索學習」的樂趣，需先增進親子互動關係；建立幼童持續潔牙先「遵循規範-②規範設定」創造目標，建議運用遊戲化(一)重大使命與呼召、(二)賦予創造力與回饋來影響幼童自主性持續投入口腔保健的應用。

The results of the 2020 Children's Oral Health Survey, commissioned by the Ministry of Health and Welfare, showed that the average decayed, missing, and filled teeth (DMFT) index for 12-year-old children in Taiwan decreased from 3.31 in the year 2000 to 2.01 in 2020. However, this still falls short of the target set by the World Health Organization for the year 2025.
This study aims to explore the guidance provided by primary caregivers to young children in the toothbrushing process, based on the well-known theory of "Child Cognitive Development" by Swiss psychologist Jean Piaget. The study examines the interplay between external guidance (heteronomy) and internal motivation (autonomy) in shaping young children's toothbrushing behavior. It also delves into the impact of gamification strategies, specifically using the Octalysis framework, and how they influence young children's transition from external guidance to self-regulation in toothbrushing behavior.
By employing the Involve Theory, the study identifies primary caregivers with high levels of involvement, which serves as a measure of the effectiveness of the guidance strategies. Semi-structured interviews and the KJ method are employed to synthesize gamification strategies from the perspectives of the caregivers. The analysis of the second round of questionnaires completed by the primary caregivers assesses the effectiveness of the gamification approach. The study categorizes these strategies into three main types based on Piaget's theory: 1. Following Norms, 2. Shared Companionship, and 3. Cognitive Exploration. From these categories, the study identifies a set of "15 Autonomy-Related Strategies," and "The Effectiveness Relationship between Gamification and Autonomy-Oriented Strategies.
In the High Scoring Group of the Correspondence Analysis Chart (High > 8), with the factors of *b, S7, S8, S9, and S10, the "Collaborative Relationship - ④ Interactive Guidance" received high self-evaluation scores and demonstrated effective teaching. Therefore, it is recommended to guide young children's teeth cleaning through ④ Interactive Guidance to help them develop a sense of autonomous "Cognitive Exploration - ⑦ Exploratory Learning" and to enhance parent-child interaction. To establish consistent teeth cleaning habits in young children, it is suggested to start with "Adhering to Norms - ② Norm Setting" to create goals. For effective implementation, the utilization of gamification strategies such as (1) Enabling a Sense of Mission and Calling ，(2) Providing Creativity and Feedback is recommended to influence young children's sustained engagement in oral health care autonomously.

摘要 i
SUMMARY ii
誌謝 iv
目錄 v
表目錄 ix
圖目錄 x
符號與縮寫列表 xi
CHAPTER 1 INTRODUCTION  1
1 Research Background  1
2 Purpose of Research  2
3 Limitations of the Study  2
4 Structure graph of research  3
CHAPTER 2 Literature Research  4
1 Oral Hygiene 4
1.1 World Health Organization  4
1.2 Dental status of children in Taiwan  5
2 Early Childhood Learning and Development  5
2.1 Jean Piaget  6
3 Difference between Game and Gamification  8
3.1 Definition of a Game  8
3.2 Definition of Gamification  9
3.3 Gamification Octalysis  9
4 Methods  10
4.1 Involve Theory  10
4.2 Semi-structured interview 12
4.3 KJ Method  12
5 Conclusion  13
CHAPTER 3 Research Methods and Experimental Procedures  14
1 Experimental steps  15
2 Involvement Screening  16
3 Semi-structured interviews  16
4 Summary of the KJ Method 18
5 Gamification Strategies  18
5.1 Questionnaire Design  18
5.2 Questionnaire Collection  21
6 Heteronomy-Autonomy Strategies  22
6.1 Conclusion  25
CHAPTER 4 ANALYSIS RESULTS AND DISCUSSION  26
1 Correspondence analysis  26
2 Correspondence Analysis of Gamification vs. Self-Discipline  26
3 Discussion of Gamification vs. Self-Discipline Strategies  28
3.1 Overall Observation  29
3.2 Vector Analysis - Preference Ranking (Part 1)  30
3.3 Vector Analysis - Preference Ranking (Part 2)  31
3.4 Vector Angle: Cosine Theorem (Part 1)  32
3.5 Vector Angle: Cosine Theorem (Part 2)  33
4 Discussion  34
CHAPTER 5 CONCLUSION  35
第1章 緒論  36
1 研究背景與動機  36
2 研究目的  37
3 研究範圍與限制  38
4 研究流程與架構  39
第2章 文獻探討  40
1 口腔衛生  40
1.1 世界衛生組織  40
1.2 台灣兒童口腔狀況  41
2 幼童學習發展  44
2.1 尚.皮亞傑 (Jean Piaget)  44
3 遊戲（Game）、遊戲化（Gamification）差異 47
3.1 遊戲(Game)定義  48
3.2 遊戲化(Gamification)定義  48
3.3 遊戲化（Gamification）八角框架  49
4 研究方法  54
4.1 涉入理論（Involve Theory）  54
4.2 半結構式訪談（Semi-structured interviews）  57
4.3 ＫＪ法 (KJ Method)  57
5 小結  59
第3章 研究與實驗規劃  60
1 實驗規劃  61
2 涉入度篩選  62
3 半結構訪談  64
4 KJ 法歸納內容  66
5 遊戲化策略  67
5.1 遊戲化問卷  68
5.2 遊戲化問卷回收  68
6 他-自律型策略  72
6.1 小結  79
第4章 實驗結果與討論  80
1 對應分析 (Correspondence analysis)  80
2 遊戲化VS. 他-自律對應分析  81
3 遊戲化VS. 他-自律策略討論  83
3.1 對應分析-總體觀察  84
3.2 向量分析-偏好排序（一）  86
3.3 向量分析-偏好排序（二）  88
3.4 向量夾角：餘弦定理（一）  90
3.5 向量夾角：餘弦定理（二）  92
4 綜合討論  94
第5章 結論與建議  95
參考文獻  99
附錄一 涉入程度問卷(一) 104
附錄二 高涉入使用之分數排序表  108
附錄三 中涉入使用之分數排序表  111
附錄四 低涉入使用之分數排序表  115
附錄五 高涉入程度受訪者資料一覽表  118
附錄六 ＫＪ彙整幼童學習潔牙類目  121
附錄七 歸納遊戲化八角  126
附錄八 遊戲化項目問卷(二) 132
附錄九 分類整理（自律-他律/遊戲化—T-Score(合併)）  138
附錄十 列點維度分數  139
附錄十一 欄點維度分數  140
                                    

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