WHO IS THE MORE INFLUENTIAL DECISION-MAKER? : SPA TRAVEL IN BALI AIMING AT TAIWANESE AND MAINLAND CHINESE COUPLE TOURISTS

Wen-Yu Chen,Chia-Yuan Hsu,Magdalena Samidjen 글로벌지식마케팅경영학회 2014 Global Marketing Conference Vol.2014 No.5

Spa tourism is part of wellness tourism, which has been prosperously booming over the past decade. In accordance to the aforesaid, the spa-tourism-oriented marketing strategy is exceedingly significant for businesses akin to hotel, resort and even governments which aim at appealing to more tourists. For the future success, spa tourism needs to appreciate the changing demands of the spa market while providing enough capacity to satisfy them (Henderson, 2004). The worldwide spa industry revenue is growing up from US 60 billion in 2007 to US 73 billion in 2012 (Global Spa & Wellness Summit, 2012). Spa market is one of the fastest growing leisure markets both on the supply and demand sides. Nevertheless, spa industry is utterly fragmented with each segment catering for different customer needs (Harmsworth, 2004). Bali is a popular tourist destination renown for its nature beauty, which attracts both domestic and international tourists. Over the years, it has been dubbed as “the morning of the world”, “the last paradise” and “island with a thousand temples”. According to Indonesian Central Bureau of Statistics (BPS, 2013), it was chosen as the most favorite tourist destination worldwide with a number of tourists totaled at 2,756,579. Among the foreign spa tourism patrons, Mainland Chinese tourists ranked the second while Taiwanese tourists being the fifth in ranking. CNN Travel (2012) reported that the Indonesian government estimated one million Mainland Chinese tourists would patronize the spa tourism in Bali by 2014. Regardless Mainland China and Taiwan are dual sovereignties which identically possess similar culture, there are still some aspects such as gender issue that distinguishes one from another. Furthermore, age, occupation, education, family structure, and life experience are some other aspects that differentiate Taiwanese and Mainland Chinese. In summation, the main objectives of this paper is threefold: (1) to compare the decision making process between Taiwanese and Chinese tourists, specifically, amid the wedded/unwedded couples; (2) to identify the most influential decision maker among the wedded-couple tourists/unwedded-couple tourists in Taiwan and Mainland China; (3) to assist travel agencies which aim at luring couple tourists to concoct the customized package tours. This research develops a quantitative survey for data collection, inference and the resulting data. The first part of questionnaire evaluates the influence regarding wedded / unwedded couples over how much influence each other have (problem recognition, information search, and a final decision) (Davis & Rigaux, 1974). The second part consists of fourteen sub-decisions: the destination (Bali), budget (how much money to spend), days (how much time to spend), accommodation (where to stay), and departure time (when to go) (Belch, Belch, & Ceresino, 1985; Szybillo & Sosanie, 1977); airline, restaurant, local transportation, shopping, travel agency, tour leader, tour guide, optional tour, and spa activities (Wang, Hsieh, & Huan, 2000; Heung & Chu, 2000) and the other kinds of activities (Jenkins, 1979) complete with five-point Likert scale, ranging from “no influence at all” to “all of the influence”. The third part provides some questions asking respondents regarding where they receive the information about Bali. The fourth part asking the respondents provide information such as frequency of visiting destination; how long have the couples been together and how the package tour was booked. Eventually, this questionnaire provides information related to socio-demographic variables, including gender, respondents’ age, occupation, monthly income, and the highest education level (Howard & Madrigal, 1990; Darley & Lim, 1986; Fodness, 1992). The ultimate version of the questionnaire items are refined through the purification process. Above all, this study invites three experts to examine the validity and reliability concerning the questionnaire. 350 valid questionnaires were collected (consists of 171 Taiwanese tourists and 179 Chinese tourists) which was adequate to questions only one spouse in summer period. There is merely one significant discrepancy exists between the wedded and unwedded couples in the decision-making stages, that is, “Information search” conducted under the joint decision making. The nature beauty and wellness services combined with evening entertainment are relatively satisfactory in Bali. During the check-in process, wellness tourists are supposed to be notified of all the spa-oriented services in the spa area. Overall, the satisfaction level of spa in Bali is exceedingly-high. With hindsight, customer service seems to be the greatest asset in Bali. The presented study is an unprecedented research focusing on the behavioral disparity between Taiwanese and Chinese spa tourists when it comes to decision-making stages. The results of this study unfurls the different decision making process between Taiwanese and Chinese couples; according to the research result, the unwedded couples possess more influence than the wedded couples in decision making stages. Moreover, the findings of this research do not entirely support earlier statement given by Tourism Queensland (2013), which mentioned considerable spa customers are female, married, and age approximately 34 to 52 year olds. According to our research, actually, men accounts for a quarter of spa users. The research result indicates the mini-tour is a niche business in the tourism industry that can both benefit Taiwan and Mainland China; mini-tour is a novel concept mentioned in a previous research, which focuses on seniors’ GPT (Wang et al., 2013). This study provides information concerning customer satisfaction level in Bali spa business and travel agency services. The sub-decisions regarding couple tourists are thoroughly researched. Therefore, this presented study can potentially bring benefits to all parties (spa prov

Fuzzy AHP Approach to TQM Strategy Evaluation

Ming-Lang Tseng,Yuan-Hsu Lin,Anthony SF Chiu,Chia Yi Chen 대한산업공학회 2008 Industrial Engineeering & Management Systems Vol.7 No.1

In recent years, many electronics producing firms have looked upon total quality management (TQM) strategy as a means by which they could maintain competitive advantage. This empirical research evaluates TQM strategic factors in order to determine the critical success factors in environmental uncertainty. Fuzzy analytic hierarchy process (FAHP) is the proposed research methodology to discuss and tackle the different decision criteria like effective leadership, people management, customer focus, strategic plan and process management, being involved in identifying the TQM strategic critical success factors with uncertainty. The result shows that effective leadership is the most critical success factor in TQM strategy.

Fuzzy AHP Approach to TQM Strategy Evaluation

Tseng, Ming-Lang,Lin, Yuan-Hsu,Chiu, Anthony SF,Chen, Chia Yi Korean Institute of Industrial Engineers 2008 Industrial Engineeering & Management Systems Vol.7 No.1

In recent years, many electronics producing firms have looked upon total quality management (TQM) strategy as a means by which they could maintain competitive advantage. This empirical research evaluates TQM strategic factors in order to determine the critical success factors in environmental uncertainty. Fuzzy analytic hierarchy process (FAHP) is the proposed research methodology to discuss and tackle the different decision criteria like effective leadership, people management, customer focus, strategic plan and process management, being involved in identifying the TQM strategic critical success factors with uncertainty. The result shows that effective leadership is the most critical success factor in TQM strategy.

WHO IS THE MORE INFLUENTIAL DECISION-MAKER? SPA TRAVEL IN BALI AIMING AT TAIWANESE AND MAINLAND CHINESE COUPLE TOURISTS

Wen-Yu Chen,Chia-Yuan Hsu,Magdalena Samidjen 글로벌지식마케팅경영학회 2014 Global Marketing Conference Vol.2014 No.7

Spa tourism is part of wellness tourism, which has been prosperously booming over the past decade. In accordance to the aforesaid, the spa-tourism-oriented marketing strategy is exceedingly significant for businesses akin to hotel, resort and even governments which aim at appealing to more tourists. For the future success, spa tourism needs to appreciate the changing demands of the spa market while providing enough capacity to satisfy them (Henderson, 2004). The worldwide spa industry revenue is growing up from US 60 billion in 2007 to US 73 billion in 2012 (Global Spa & Wellness Summit, 2012). Spa market is one of the fastest growing leisure markets both on the supply and demand sides. Nevertheless, spa industry is utterly fragmented with each segment catering for different customer needs (Harmsworth, 2004). Bali is a popular tourist destination renown for its nature beauty, which attracts both domestic and international tourists. Over the years, it has been dubbed as “the morning of the world”, “the last paradise” and “island with a thousand temples”. According to Indonesian Central Bureau of Statistics (BPS, 2013), it was chosen as the most favorite tourist destination worldwide with a number of tourists totaled at 2,756,579. Among the foreign spa tourism patrons, Mainland Chinese tourists ranked the second while Taiwanese tourists being the fifth in ranking. CNN Travel (2012) reported that the Indonesian government estimated one million Mainland Chinese tourists would patronize the spa tourism in Bali by 2014. Regardless Mainland China and Taiwan are dual sovereignties which identically possess similar culture, there are still some aspects such as gender issue that distinguishes one from another. Furthermore, age, occupation, education, family structure, and life experience are some other aspects that differentiate Taiwanese and Mainland Chinese. In summation, the main objectives of this paper is threefold: (1) to compare the decision making process between Taiwanese and Chinese tourists, specifically, amid the wedded/unwedded couples; (2) to identify the most influential decision maker among the wedded-couple tourists/unwedded-couple tourists in Taiwan and Mainland China; (3) to assist travel agencies which aim at luring couple tourists to concoct the customized package tours. This research develops a quantitative survey for data collection, inference and the resulting data. The first part of questionnaire evaluates the influence regarding wedded / unwedded couples over how much influence each other have (problem recognition, information search, and a final decision) (Davis & Rigaux, 1974). The second part consists of fourteen sub-decisions: the destination (Bali), budget (how much money to spend), days (how much time to spend), accommodation (where to stay), and departure time (when to go) (Belch, Belch, & Ceresino, 1985; Szybillo & Sosanie, 1977); airline, restaurant, local transportation, shopping, travel agency, tour leader, tour guide, optional tour, and spa activities (Wang, Hsieh, & Huan, 2000; Heung & Chu, 2000) and the other kinds of activities (Jenkins, 1979) complete with five-point Likert scale, ranging from “no influence at all” to “all of the influence”. The third part provides some questions asking respondents regarding where they receive the information about Bali. The fourth part asking the respondents provide information such as frequency of visiting destination; how long have the couples been together and how the package tour was booked. Eventually, this questionnaire provides information related to socio-demographic variables, including gender, respondents’ age, occupation, monthly income, and the highest education level (Howard & Madrigal, 1990; Darley & Lim, 1986; Fodness, 1992). The ultimate version of the questionnaire items are refined through the purification process. Above all, this study invites three experts to examine the validity and reliability concerning the questionnaire. 350 valid questionnaires were collected (consists of 171 Taiwanese tourists and 179 Chinese tourists) which was adequate to questions only one spouse in summer period. There is merely one significant discrepancy exists between the wedded and unwedded couples in the decision-making stages, that is, “Information search” conducted under the joint decision making. The nature beauty and wellness services combined with evening entertainment are relatively satisfactory in Bali. During the check-in process, wellness tourists are supposed to be notified of all the spa-oriented services in the spa area. Overall, the satisfaction level of spa in Bali is exceedingly-high. With hindsight, customer service seems to be the greatest asset in Bali. The presented study is an unprecedented research focusing on the behavioral disparity between Taiwanese and Chinese spa tourists when it comes to decision-making stages. The results of this study unfurls the different decision making process between Taiwanese and Chinese couples; according to the research result, the unwedded couples possess more influence than the wedded couples in decision making stages. Moreover, the findings of this research do not entirely support earlier statement given by Tourism Queensland (2013), which mentioned considerable spa customers are female, married, and age approximately 34 to 52 year olds. According to our research, actually, men accounts for a quarter of spa users. The research result indicates the mini-tour is a niche business in the tourism industry that can both benefit Taiwan and Mainland China; mini-tour is a novel concept mentioned in a previous research, which focuses on seniors’ GPT (Wang et al., 2013). This study provides information concerning customer satisfaction level in Bali spa business and travel agency services. The sub-decisions regarding couple tourists are thoroughly researched. Therefore, this presented study can potentially bring benefits to all parties (spa providers, travel agencies, and spa goers); simultaneously, it contributes greatly to the theory of “decision-making”. In conclusion, there are three management implications. First, wedded women, who are the crucial patrons in the spa industry, have more influence in the spa travel decision-making. Therefore, the marketing planners shall regard women as significant decision makers. Nevertheless, unwedded couples are more influential in spa travel when comparing to wedded couples, hence, spa providers shall make spa facilities more enjoyable, romantic, and rivate. Second, sub-decisions are regarded relatively pivotal when it comes to couple tourists. The findings shed some light on several factors of “sub-decision,” which are considered crucial by couple tourists when buying spa package tour. Third, Indonesian government deems Taiwan and Mainland China markets as tremendously paramount, especially when it comes to spa travel to Bali (CNN, 2012). As far as travel agencies are concerned, they need to create more appealing mini-package tours based on customer demographic. For spa providers, in order to efficiently maximize their revenue, they shall improve spa quality and the affiliated facilities and services.

Negative effects on medical students’ scores for clinical performance during the COVID-19 pandemic in Taiwan: a comparative study

Eunice Jia-Shiow Yuan,Shiau-Shian Huang,Chia-An Hsu,Jiing-Feng Lirng,Tzu-Hao Li,Chia-Chang Huang,Ying-Ying Yang,Chung-Pin Li,Chen-Huan Chen 한국보건의료인국가시험원 2023 보건의료교육평가 Vol.20 No.-

Purpose Coronavirus disease 2019 (COVID-19) has heavily impacted medical clinical education in Taiwan. Medical curricula have been altered to minimize exposure and limit transmission. This study investigated the effect of COVID-19 on Taiwanese medical students’ clinical performance using online standardized evaluation systems and explored the factors influencing medical education during the pandemic. Methods Medical students were scored from 0 to 100 based on their clinical performance from 1/1/2018 to 6/31/2021. The students were placed into pre-COVID-19 (before 2/1/2020) and midst-COVID-19 (on and after 2/1/2020) groups. Each group was further categorized into COVID-19-affected specialties (pulmonary, infectious, and emergency medicine) and other specialties. Generalized estimating equations (GEEs) were used to compare and examine the effects of relevant variables on student performance. Results In total, 16,944 clinical scores were obtained for COVID-19-affected specialties and other specialties. For the COVID-19-affected specialties, the midst-COVID-19 score (88.51–3.52) was significantly lower than the pre-COVID-19 score (90.14–3.55) (P<0.0001). For the other specialties, the midst-COVID-19 score (88.32–3.68) was also significantly lower than the pre-COVID-19 score (90.06–3.58) (P<0.0001). There were 1,322 students (837 males and 485 females). Male students had significantly lower scores than female students (89.33–3.68 vs. 89.99–3.66, P=0.0017). GEE analysis revealed that the COVID-19 pandemic (unstandardized beta coefficient=-1.99, standard error [SE]=0.13, P<0.0001), COVID-19-affected specialties (B=0.26, SE=0.11, P=0.0184), female students (B=1.10, SE=0.20, P<0.0001), and female attending physicians (B=-0.19, SE=0.08, P=0.0145) were independently associated with students’ scores. Conclusion COVID-19 negatively impacted medical students' clinical performance, regardless of their specialty. Female students outperformed male students, irrespective of the pandemic.

Type 2 Diabetes Mellitus Increases Peritonsillar Abscess Susceptibility: Real-World Evidence

Ching-Lung Wu,Ming-Shao Tsai,Ta-Jen Lee,Yun-Ting Wang,Chia-Yen Liu,Yao-Hsu Yang,Yao-Te Tsai,Cheng-Ming Hsu,Ching-Yuan Wu,Pey-Jium Chang,Geng-He Chang 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.3

Objectives. Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. Methods. We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. Results. In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P<0.001); moreover, PTA incidence was higher at 1 to 5 years after T2DM diagnosis than at <1 and >5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P<0.001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥1, P=0.006 and 1.81 for aDCSI=0, P=0.002). T2DM patients with a high aDCSI (≥1) had a nonsignificantly longer hospitalization duration and a higher rate of DNI complications than did those with a low aDCSI (=0). Conclusion. In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, T2DM patients should be particularly careful about PTA within 1 to 5 years after the diagnosis, and physicians should keep in mind that the prognosis of PTA was correlated with T2DM severity.

Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study

Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.