資訊與生活的鑲嵌：臺灣老年人的健康資訊實踐

相較於青壯年人，老年人通常有著較多健康或疾病問題。因此，老年人可能有著較強的動機、需求與機會，接觸、運用從不同管道來的健康資訊。不過，臺灣老年人拒絕採納醫師或專家提供的健康資訊，而聽信廣播電台或街坊鄰居之言購買來路不明的健康食品、補品或偏方的狀況，時有所聞，這些行為可能影響他們的健康狀況與疾病因應策略。究竟為什麼有些老年人容易從這些管道獲取並採納健康資訊、有些則否？這些健康資訊管道對他們的意義是什麼？他們又如何詮釋這些健康資訊？然國內研究多從認知行為取向、透過量化研究方法進行探究，較未能從老年人所處的情境中解釋他們有著這些行動的原因。自這些問題出發，本研究欲從重視情境與行動的日常生活觀點，探究臺灣老年人的健康資訊實踐，包含：主動搜尋、被動取得、詮釋理解與採納健康資訊的狀況。由質性研究取徑進行研究，採立意抽樣與滾雪球抽樣，透過半結構深度訪談法訪問35位65歲以上能獨立生活、非居住於機構內且無心智失能或精神疾病的老年人。訪談時間為1至2.5小時之間，訪談過程皆經研究受訪者同意後全程錄音並轉錄逐字稿，再運用主題性編碼歸納分析。研究發現，不論是活動、媒體或人際網絡，皆不只是老年人獲取健康資訊的管道而已，還是構成其生活節奏樣貌的要素，藉此回應老年生活的種種需求，例如，退休或子女離巢後欲設定生活目標、維持人際互動，或期待擁有成就感等需求。只是老年人所擁有的生活條件有所差異，讓活動、媒體或人際網絡所佔的生活份量與角色不同，也形塑了不同的生活節奏樣貌，包含：都會活動型、社區活動型、在職工作型、親友鄰居互動型、仰賴家人型與託付媒體型。這六大生活節奏樣態的老年人，各別依著他們習以為常的方式生活，而作為日常生活行動一部分的健康資訊實踐，便鑲嵌於其中，使得彼此的健康資訊實踐狀況有所不同。因此，老年人的健康資訊議題，不能僅就健康醫療層面來看，而要從整體生活情境來看才有意義。建議在健康促進上，應考量老年人情境中的需求、能力與資源，以及自情境形塑出的生活節奏樣態，依此擬定適合的健康資訊傳播與溝通策略，如：鑲嵌於他們生活節奏中、能提供人際互動、達學習成就感、讓生活有目標的健康促進活動，讓健康資訊鑲嵌於老年人的日常生活中，更達健康促進目標。

關鍵字

健康資訊；健康資訊實踐；生活節奏；日常生活觀點；老年人

並列摘要

The elderly tend to have more disease or health problems compared to young people. Therefore, they may have stronger motivation, needs, and are more likely to obtain health information from various channels. However, it is common for Taiwanese elderly to believe the health information they hear from relatives and friends or on the radio, instead of taking medical advice from doctors. It would be of interest to know why some elderly obtain and adopt health information from these channels, while some don't. What do these channels mean to them? And how do the elderly interpret these health information? However, the research in Taiwan are mostly conducted from cognitive psychological approach and through quantitative research methods; they fail to explain the contextual reasons for these actions. Therefore, to answer the questions, this study explores Taiwanese elderly’s health information practice, including active seeking, passive receiving, interpreting and adopting from everyday life perspective, which emphasizes the importance of context and practice. The study use semi-structured interviews. Through purposive sampling and snowball sampling, there are 35 elderly over 65 years old recruited. The interviews are between 1 to 2.5 hours. The finding is that activities, media and social network are not just health information channels, but the important elements in elderly’s daily life rhythm, and play important roles to meet the needs in old ages, such as life goals setting, social interaction and so on. However, the life conditions of the elderly are different, which makes activities, media and social network play different roles in their life, and shape different kind of daily life rhythm. Therefore, health information practices embedded in theses daily life rhythm are different between different elderly. From this viewpoint, we can’t only explore elderly’s health information practice from health care perspective, but from the point of view of their overall life situation. Recommendations on health promotion are making the health information embedded in the daily lives of the elderly. To do so, considering the needs, abilities and resources of older persons in its geographical context as well as the daily life rhythm shaped by the context is needed.