隨著再生醫學研究的蓬勃發展，幹細胞也成為未來醫療的焦點，長生不老、青春永駐，將不再是夢想；慢性疾病、罕見疾病等的治癒都可預期。其中臍帶血幹細胞的移植已可取代骨髓移植治療惡性血液疾病、免疫疾病，成功率與預後狀況都比骨髓移植更好。所以將臍帶血保存下來的觀念，已普遍成為產前衛教的一課，台灣約有一成以內的父母會自費將寶寶的臍帶血保存下來。 活動理論是俄國心理學家Vygotsky（1978）所提出的，強調主體必須透過工具才能達成客體目標，並架構人類基本活動的六個元素：主體、中介工具、客體、規則、社群與分工。單一活動中各元素為動態的互動關係，會隨著時間軸改變。 本研究深入訪談六位臍帶血保存戶後，透過活動理論元素強度分析比較臍帶血保存戶的生活脈絡，了解其關鍵點，同時也將業界行銷做法與活動理論進行比對分析，再參酌人性中「理性」與「非理性」的心理反應，做為未來行銷策略的參考。 結果顯示，客戶的生活脈絡中「主體-工具-客體」之三角關係最強，其中工具扮演不可或缺的角色；「主體-客群-客體」之三角關係次之，社群仍是活動中互動最密切的一群；規則與分工對生活脈絡的影響較小，反映出臍帶血保存是一個新產業，法規與分工都還沒有深入發揮影響力。在訪談業代與分析業者行銷策略後，瞭解未來在行銷保存臍帶血時，需兼具產品與服務的特性，並加強研發的能力，強化在再生醫療中的角色，才能讓此產業更蓬勃發展。 活動理論可將思維結構化並進行盤點，使離散的概念統整，對整個活動有一個清楚的全貌。應用在例行思考上，不論是事前評估規劃，或是事後執行檢討，均可迅速而清晰的將藍圖完整呈現。 / The use of stem cells becomes a key area of research and therapy followed by the fast development in regenerative medicine. Because the existence of stem cells, immortality or staying young forever will no longer be just a dream, and serious diseases and rare disorder are expected to be cured. Umbilical cord blood transplants have higher success and recovery rates than Bone Marrow transplants in treating blood disorders and diseases of the immune system. The concept of ‘cord blood storage’ has become an instruction prenatally. There are about 10% of parent will keep their baby’s cord blood in private cord blood banks at present in Taiwan. ‘Activity Theory’ was initiated by Lev Vygotsky（1978）in the 1920s. He created the idea of mediation. Following to the activity theory, Leont’ev (1981) structured the general context model into six elements: Subject、Tool、Object、Rules、Community and Labor Division. The interaction among elements for each activity is dynamic and can be changed over time. Six customers stored the cord bloods of their babies were interviewed in this study. The life contexts were studied and the strength of the six elements was compared among these customers based on the activity theory to analyze the reason of storing their baby’s cord blood, and to build the activity theory model. In addition, the marketing methods in the industry were compared and analyzed with the activity theory, and the psychological responses of reasoning and nonreasoning in human nature were further referred to build the future marketing strategy. The relation among Subject-Tool-Object was found to be the most important part in the model, where tool played the key role. The relation among Subject-Community-Object was the second important, where community interacted closely with activity. Rules and Labor Division were the less effective elements. This result indicates that private Cord Blood Bank is a new business, which is not affected by Rules and Labor Division yet. In the future, product and service characters should be combined, and the significance of R&D of stem cells in cord blood should be enhanced in Regenerative Medicine to promote the development of this business. Activity theory was proved beneficial in seeing a whole picture of activity by structuralizing the thinking and integrating the diverse ideas. A clear blue print in routine thinking can be seen either in the beforehand evaluation or the post-implementation review.

臍帶血幹細胞移植自1988年首次被應用在異體的臨床治療至今，在各國衍生出許多以「利他」為目的的公捐臍帶血庫，以及鼓吹「自存自用」的私人臍帶血銀行。類似的情況也在台灣發生，第一家私人公益臍帶血庫在1997年底成立，第一家私人臍帶血銀行在2000年8月成立。然而，有關臍帶血儲存在台灣的發展歷史，卻甚少被討論。本論文嘗試以「創新的擴散」的四大因素—創新、溝通管道、時間及社會體系，詮釋自費儲存臍帶血在台灣的擴散過程和實質的內涵。 藉由中國時報報系和聯合報系有關臍帶血儲存的相關報導，估算出台灣自費儲存臍帶血的接受率在時間軸上的變化，發現台灣自費儲存臍帶血的接受率從2000年到2004年快速地成長，2004年以後成長趨緩。另外，從資料蒐集、文獻整理，以及台灣最大的親子社群網站”Babyhome”(寶貝家庭親子網)中有關臍帶血儲存的相關議題討論，觀察到台灣社會體系中的主管機關、私人臍帶血銀行、醫界和學界、公捐血庫、媒體等各成員之間的互動，直接或間接地影響潛在接受者對自費儲存臍帶血的意願和認知。在創新和溝通管道的探討中，則利用初探性質的網路問卷調查，探索台灣的接受者對於自費儲存臍帶血的創新認知屬性和資訊來源的溝通管道，並歸納出台灣的接受者對於自費儲存臍帶血的主要認知為：相容於「保險」的概念，以及代表「心安」的相對優勢。 是否應該自費儲存臍帶血實為一爭議性的話題，本研究也透過以上的分析，探討自費儲存臍帶血在台灣擴散所造成的後果並提出相關建議，期望台灣社會體系能夠從自費儲存臍帶血的擴散中，獲得創新的最大的利益又不至於造成社會體系的瓦解。 / Since the first umbilical cord blood transplant was performed in 1988 for allogeneic transplantation, many cord blood banks came out in countries, including public cord blood banks for an altruistic purpose and private blood banks which claim to bank umbilical cord blood for autologous use. Similar cases happened in Taiwan, the first public cord blood bank run by a private organization was founded in the end of 1997, then the first private cord blood bank was founded in August 2000. The history about banking umbilical cord blood in Taiwan, however, is rarely discussed. Based on the four main elements of “Diffusion of Innovations”, innovation, communication channels, time and social system, this study attempts to interpret the diffusion and substantial content of banking umbilical cord blood for autologous use in Taiwan. I estimated the adoption rate of banking umbilical cord blood for autologous use in Taiwan in the course of time by searching news reports from the databases of China Times Inc. and United Daily News Group. The adoption rate grown rapidly from 2000 to 2004 and the growth became slowly after 2004. By data collection, the survey of literatures and searching the relevant topics about storing umbilical cord blood from BabyHome, the biggest social networking website for parent-child relationship in Taiwan, I also found that the interaction among authority body, private cord blood bank, medical professional bodies, public cord blood bank and media, which are the members of Taiwan social system would affect the cognition and willingness of potential adopters directly or indirectly. In addition, I used a pilot online- questionnaire to explore the characteristics of innovation and communication channels of banking umbilical cord blood in Taiwan, which concludes that, the main characteristics of innovation sensed by the adopter who banking umbilical cord blood in Taiwan are compatibility with the concept of insurance and the relative advantage of feeling at ease. To store or not to store umbilical cord blood in private cord blood bank is actually a controversial issue. Through the analysis described above, the consequence of banking umbilical cord blood diffused in Taiwan is studied. I also make some suggestions and hope that Taiwan social system could gain the maximum social benefit from the diffusion of banking umbilical cord blood, and would not collapse by it.