以社區長者觀點描繪健康資訊搜尋行為與健康識能之關聯：融合研究

Depicting the relationship between health information seeking behavior and health literacy from the perspective of community elders: a mixed-method study

林珀攸(Po-You Lin)

指導教授 ： 陸玓玲

中山醫學大學/健康管理學院/公共衛生學系/碩士(2021年)

https://doi.org/10.6834/csmu202100113

摘要

研究目的：
本研究有二項目的：(一)了解社區長者之健康訊息搜尋行為，包括：健康資訊之訊息來源、訊息內容、尋找動機、及其對長者的影響。(二)探討長者描述之健康訊息搜尋行為(質性)與健康識能(透過「簡式健康識能量表(量性)」測量)的關係。
材料與方法：
本研究使用融合研究法的併列設計，透過受標準化訓練之訪員使用半結構式問卷對鹿港及二水地區長者進行深度訪談，訪談日期介於民國109年11月18日至民國110年1月28日之間，訪談時間介於2分至18分，以訊息飽和為停止收案之原則，共完訪51位長者 (鹿港鎮28位、二水鄉23位)。問卷之量化測量部分包括：簡式健康識能量表及社會人口學變項，健康資訊來源、內容、搜尋動機及影響皆以訪談大綱透過質性訪談蒐集相關訊息。研究對象較多為女性(35人)及教育程度國小以下(36人)。所有訪談轉為逐字稿之後，以主題分析法進行資料分析。
結果：
1.經主題分析法之分析與歸納，長者搜尋資訊的動機包括：促進自身健康、改善自身病情、避免增加家人負擔。長者主動提及之健康資訊內容涵蓋疾病預防的三段五級。健康資訊來源包含個人、組織及大眾媒體層次。長者健康資訊對長者之影響包含感受及行為兩個面向。
2.搜尋資訊之動機及來源會因地區、性別及教育程度而異，訊息對長者之影響有地區上的差異。
3.在本研究訪談之51位長者中，健康識能有限者多為女性和教育程度國小以下者。
4.健康識能對搜尋資訊之動機和內容的影響均不明顯，而健康識能越好的長者，搜尋資訊之來源越多元且資訊對長者的影響也會產生越多面向之感受和行為。

結論：
本研究在不設定任何主題或前提的訪問中，得知長者可以在沒有任何提醒或暗示的狀況下，自發性說出涵括疾病預防三段五級的多元性的健康訊息內容，也展現出長者健康訊息來源的多元管道、多重動機、以及多面向的影響，同時發現健康識能不足者在健康訊息來源較侷限，且健康訊息之影響面較小。在大量針對特定健康議題訊息搜尋行為之量化研究中，本研究透過質性訪談之結果可為長者健康訊息搜尋行為提供不同的理解視角，並可提供未來相關研究者及實務工作者在規劃健康訊息時之參考。

關鍵字

健康識能 ； 健康資訊搜尋行為 ； 社區 ； 長者

並列摘要

Objectives:
This study has two purposes: (1) To understand the health information-seeking behavior of the elderly, including the content and sources of health information, motivation, and the impact of health information on the elderly. (2) To explore the relationship between health information-seeking behavior (qualitative) and their health literacy which is measured by ‘‘Brief Health Literacy Screening Tool(BRIEF) (quantitative)’’.
Methods:
Used a mixed-methods research convergent design, this study recruited the elderly in Lukang and Ershui areas as the research objects and conducted face-to-face in-depth interviews by standard-trained interviewers using semi-structured questionnaires. The interview date was between November 18, 2020, and January 28, 2021. The interview time was between 2 and 18 minutes. With the data saturation as the principle to stop recruiting, a total of 51 elders (28 in Lugang Township and 23 in Ershui Township) were interviewed. The quantitative measurements of the questionnaire included a brief health literacy screening tool and sociodemographic variables. The source, content, motivation, and influence of health information are collected through qualitative interviews based on interview outlines. The participants are mostly women (35 people) and below elementary school education level (36 people). After all the interviews were converted into verbatim manuscripts, data analysis was carried out using thematic analysis.
Results:
1. After the analysis and induction of the thematic analysis method, the motivation of the elderly to seek information includes promoting one's health, improving one's disease condition, and avoiding increasing the burden on their family members. The health information content actively mentioned by the elderly covered three levels of disease prevention. Health information sources include individuals, organizations, and mass media levels. The impact of health information on the elderly includes feelings and behaviors.
2. The motivation and source of information-seeking varied by area, gender, and education level. The impact of information on the elderly varies in areas.
3. Among the 51 elders interviewed in this study, those with limited health literacy are more likely to be women and have below elementary school education level.
4. Health literacy has no obvious influence on the motivation and content of information-seeking. The better the health literacy, the more diverse the sources of information-seeking. Furthermore, the better the health literacy, the more impact the information has on the elderly, and the more kinds of feelings and behaviors will be generated.
Conclusions:
This study is without presupposition in the interview and knowing that the elderly can spontaneously speak out multiple health information covering three stages and five levels of disease prevention without any reminders or hints. It also shows the multiple channels, multiple motivations, and multifaceted influence for the elderly to seek health information. At the same time, we found that people with limited health literacy have limited health information sources, and have less impact on them with health information. In a large number of quantitative researches on information seeking-behaviors for specific health issues, the results of this study through qualitative interviews can provide different perspectives on the health information seeking-behaviors of the elderly, and provide a reference for relevant researchers and practitioners in planning health information.

並列關鍵字

Health literacy ； health information-seeking behavior ； community ； the elderly

參考文獻

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