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  • 學位論文

社區健康促進活動與老人健康:比較性研究

Health Promotion Activities and Elderly Health within a Community : A Comparative Study

指導教授 : 鄭惠珠

摘要


背景與目的:為了提高老年人的健康,近年來陸續推動社區老人健康促進活動,但實際上參與健康促進活動的老人並非多數。因此,本研究將以一個小型社區來探討,參與及未參與健康促進活動對老人在生理、心理,以及社會支持因素上是否有差異,進而瞭解社區老人未參與健康促進活動的原因,以提供健康促進活動的修正及可能的改善建議。 研究方法:本研究社區位於高雄都市邊緣,社區中的老人之前多數務農,在老化及都市發展中漸漸退出農人角色。社區中參與健康促進活動65歲以上老人共37人,為了比較基礎的一致性,我們在社區主要活動中心尋找人口變項與健康促進參與者類似的未參與者37人,受訪者總共74人,進行問卷調查與比較分析。問卷內容含基本資料、健康狀況評量、憂鬱量表分數、社會支持及參與活動情形。問卷調查時間為104年4月1日至4月30日,有效回收率為100 %。回收問卷後,使用SPSS軟體進行資料分析。 研究結果:在控制人口變項後,參與/未參與健康促進活動組在生理、心理健康及社會支持面向上皆有顯著性的差異性。在生理健康上,參與組在自評健康分數較高,疾病用藥狀況也較少,自評健康改善狀態也較好;心理健康上,反而參與組的憂鬱量表分數較高,主要原因是參與組有少部分老人在記憶力減退、專注性及做事緩慢上填答分數較高所致。參與組感受到的朋友、家人及環境上的社會支持也較多。參與組也較認同健康促進活動的意義,並認同下列參與的原因:有朋友同伴參與、有空閒時間、活動環境安全性、無需照顧家人等。沒有參加健康促進活動的老人,在開放性問題中得到的回答最多為下列原因:活動內容無趣、身體不好及距離活動現場太遠,因而無法參加。 研究結論:就研究社區調查結果,參加健康促進活動確實對老人的健康有益處。研究中參與/未參與組都表示有空閒時間和無需照顧家人,表示未參與組是有時間可參與健康促進活動,未參與組在同伴關係分數較低,因此,在活動宣導過程可以設計更多同儕互相鼓勵的方案,活動內容也可以因應不同老年狀況而修正。距離因素的解決更是健康促進活動成功的要件,對許多老人安全出門並不是件容易的事,解決家裡到活動場所的交通問題,需要更多的公共資源的投注。

並列摘要


Background and Purposes: In order to improve the physical and mental health of the elderly, the government has promoted community health activities for senior citizens. However, the numbers of elderly who participate the health promotion activities is still not much. This study aims to investigate the differences between physical, mental and social support factors between the elderly who participated in the health promotion activities and those who did not. The study also aims to understand the reasons why certain groups did not enroll in the activities, in order to provide suggestions for improvement of the activities and outreach. Methods: The study community is located at the edge of Kaohsiung City. The elderly in this community were mostly engaged in agriculture, and retired due to aging and urban development. Participants included 37 elders who were over 65 years old and joined the community health promotion activity (case group). This study also gathered 37 elders who had similar characteristics but did not join the health promotion activity (control group). In total, 74 elders were included in this study, and after the participants filled out a questionnaire survey, a comparison analysis was done. The questionnaire included basic demographic information, the general health condition of the participant, ratings from the Taiwanese Depression Questionnaire, the degree of social support, and the status of activity participation. The survey was conducted from April 1, 2015 until April 30, 2015, with 100% efficiency response rate. The method of analysis used was SPSS. Results: After controlling the demographic variables, the case and control group have significant differences in physical health, mental health and social support. In physical health, the case group has higher self-reported health scores, take fewer medications, and self-report that the activities have increased their overall level of fitness. In mental health, the case group has higher scores on the depression scale, with the main reasons reported being some of the participants have higher scores in memory loss, loss of concentration, and bradykinesia. The case group receives more social support from friends, family, and the overall environment. Additionally, the case group also recognizes the meaning of health promotion activities and the reasons for joining the activities: companionship, having an overabundance of free time, the safety of the activity environment, without the need for care from family members, etc. The most reported reason in open questionnaires for not joining the health promotion activity are boring content, personal health conditions, and living distance from the activity place. Conclusions: The study results reveal that the health promotion activities have positive effects on the health condition of senior citizens. All the participants in the case and control groups reported that they have free time and are not dependent on any family member for care. The control group shows lower scores in the category of peer relationships. Therefore, the activity promotion process among seniors should include more peer-to-peer activities, and also adjust the activities based on the health conditions of different elders. The key point of the success of the health promotion activity is to solve the problem of distance to the activity location, with particular regard to the level of mobility of the elderly. The need for improved public transportation methods will require more resources from the government.

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