教育介入對社區老年人營養知識與飲食行為影響之探討

Effect of Educational Intervention on Nutrition Knowledge and Dietary Behavior of the Community Elderly

黃昭琪(Chao-Chi Huang)

指導教授 ： 徐慧娟

亞洲大學/健康學院/長期照護研究所/碩士(2006年)

摘要

本研究為準實驗設計，其主要研究目的在於探討教育介入對老年人營養知識及飲食行為上的影響。研究者採2005年「台灣老人之成功老化Ⅲ：介入計畫與評估」所收集資料。針對居住苗栗縣之65歲以上社區老年人進行營養教育介入及資料收集。實驗組所含區域為苗栗市東區、公館與通霄，而對照組則包含苗栗市西區、卓蘭與後龍，實驗組社區的老年人都被邀請參與教育介入。營養教育介入內容包括六大類食物、食物選擇、食物營養素等。參與教育介入者共有90位，但只有45位是研究名單內的老年人。在介入12週後進行所有樣本面訪以收集資料，完訪後之樣本資料為實驗組人數41位與對照組425位，分析方法採線性及邏輯式迴歸模式分析社區老年人營養教育介入之營養知識與飲食行為與前傾因素、使能因素、增強因素控制變項。
研究結果發現：
(一)營養知識總分為18分，社區老年人平均得分為12.2分；六大類食物攝取頻率中，每天攝取奶類佔45.5%、五穀根莖類佔88.2%、蛋豆魚肉類佔84.1%、蔬菜類佔89.9%、水果類佔55.4%、油脂類佔66.5% 。
(二)經營養教育介入後，實驗組營養知識得分較對照組稍高，但未達顯著差異；對照組之六大類食物攝取頻率中，油脂類每天攝取比率低於實驗組且達顯著差異。
(三)複迴歸分析營養知識結果顯示出外省族群且教育程度越高、沒有IADLs障礙、沒有腸胃問題、有牙齒問題、會注意營養訊息、沒有因病少吃、與他人進餐及自我效能越高者，其營養知識得分越高；但性別、年齡、居住情形、ADLs障礙、罹病情況、選擇食物及教育介入與營養知識得分情形則無相關。
(四)經邏輯迴歸分析結果指出性別、年齡、教育程度、IADLs障礙、選擇食物及自我效能與六大類食物攝取情形有顯著相關性：即男性、年齡長者、不識字、不可以選擇食物、自我效能低者六大類食物攝取較有問題；但族群、居住情形、ADLs障礙、罹病情況、教育介入與六大類食物攝取情形則無相關。
本教育介入影響營養知識及飲食行為表現雖不顯著，但研究發現社區老年人六大類食物攝取仍顯不足，建議未來相關單位在實施營養計畫時，可針對老年人主要問題及需求，給予適當的營養教育計畫，增加老年人飲食學習興趣，以提高老年人執行飲食行為狀況。

關鍵字

準實驗設計 ； 教育介入 ； 飲食行為 ； 營養知識 ； 六大類食物

並列摘要

The purpose of this quasi-experimental design study was to assess the effect of educational intervention on nutrition knowledge and dietary behavior of community elderly. Data was from the “Successful Aging of the Elderly in Taiwan Ш: Intervention and Evaluation” 2005. We implemented the educational intervention program and collected the data of the participants for the elderly aged 65 or above in Miaoli County communities. Miaoli City East District, Gongguan and Tongsiao Townships were the experimental communities, and Miaoli City West District, Jhuolan and Houlong Townships were the controlled communities. All the samples in experimental communities were invited to participate the intervention program. The contents of intervention program included six categories of food, food choice, nutrients of food, etc. Totally 90 persons participated the intervention programs, but only 45 of them were on the invitation list. And then we collected the data by a face-to-face survey for all the samples in our research area after 12 weeks. There were 41 experimental-group participants and 425 controlled-group participants completed the survey. Linear regression and logistic regression model were used for analyze the effect of intervention to nutrition knowledge and dietary behaviors by controlling the predisposing factors, enabling factors, and reinforcing factors.
The main findings of this study included:
1. The score of nutrition knowledge ranged 0-18, and the average score of community elderly were 12.2. The percentages of daily intake of six category of food were: 45.5% for milk products, 88.2% for grain products, 84.1% for the meat/eggs/fish/beans, 89.9% for vegetables, 55.4% for fruits, and 66.5% for oils.
2. After nutrition educational intervening, the score of nutrition knowledge on the experimental group was higher than the controlled group slightly but without significant difference. Daily oil intake rate of the controlled group was lower than the experimental group on the six categories of food and had significant difference.
3. By the multiple regression analysis, the result showed that elderly from Mainland provinces, higher education, without IADL disability, without gastrointestinal problem, having teeth disease, more likely to pay attention to nutrition information, eating less due to illness, eating with someone else, and higher self-efficacy, had higher score of nutrition knowledge.
4. By the logistic regression, male, older, illiterate, unable to choose food, and low self- efficacy elderly had more problems on the intake of six categories of food. Ethnic group, inhabitancy, ADLs disability, disease condition and participation of the intervention had no significant effect on the six categories of food.
Although the intervention program did not show significant effects on nutrition knowledge and dietary behavior, there is insufficiency of the six categories of food for the community elderly in Miaoli. We suggest that the future intervention program for elderly diet or nutrition should aim at the main health problems to design the intervention program to increase their interest for participation.

並列關鍵字

quasi-experimental design ； educational intervention ； dietary behavior ； nutrition knowledge ； six categories of food

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