老年人就醫行為生態系統脈絡研究

本研究旨在了解老年人就醫行為受生態系統脈絡影響之過程，老年人在微系統、中介系統、外系統、鉅系統及時間系統的生態系統脈絡下，如何形塑出個人健康概念與就醫行為。本研究採深度訪談方式進行，訪談六位研究參與者，三位男性三位女性，年齡介於66歲至86歲之間，透過訪談過程了解老年人健康概念與就醫行為，研究主要發現如下：一、老年人健康概念包括：老化是自然的現象，盡量不要生病就是健康；保持心情愉快是健康基本要素；維繫人際關係就是健康；擁有經濟自主權是維持健康基石等。二、老年人就醫行為：研究結果發現老年人偏向以預防性的健康就醫行為，方式包括積極維持良好生活習慣是預防性就醫行為之基石；維持運動，提升老年人身體健康；維持休閒興趣，提升心理健康；不斷學習，增加健康新知；投入宗教活動，提升靈性健康；服用保健藥品或藥酒做為預防疾病的方法；醫療諮詢與就醫問題找親友；疾病處理模式：小問題找藥局、小疾病看診所、大病上大醫院等八項。三、老年人就醫行為之生態系統脈絡：微系統對老年人就醫行為有決定性的影響力、中介系統可成為改變老年人就醫行為的重要橋梁、外系統間接影響老年人就醫行為、鉅系統潛移默化中影響了老年人就醫行為、時間系統衝擊或改變老年人的就醫行為。研究者根據上述研究結果進行討論，並提供若干建議以作為未來研究、相關老年政策、工作者等以利於提升老年健康預防與就醫行為之參考。

關鍵字

老年人；就醫行為；生態系統

並列摘要

The purpose of this study is to understand how the medical seeking behavior of the elderly is affected by the ecological system. Ecological system theory includes microsystem, mesosystem, exosystem, marcosystem and chronosystem. The study data was collected by depth interview method. The participants ware six elderly who were born in 1931 to 1951. Results were as following: Fist, the health conception of the elderly include:aging is a natural phenomenon, try not to be sick is healthy; to maintain a happy mood is the basic elements of health; to maintain interpersonal relationships is healthy; to maintain a healthy body is dependent on economic autonomy . Second, medical seeking behavior of the elderly include: (1) the positive maintenance of good habits is the foundation of preventive medical seeking behavior; (2) to maintain the exercises enhance the health of the elderly; (3) to maintain leisure interest enhance mental health; (4)Lifelong Learning increase the health knowledge;(5) to participate the religious activities enhance spiritual health; (6) take drugs or wine as a way to prevent disease; (7) seek medical advice and medical problems from relatives and friends; (8) disease treatment model: small problem to find pharmacies, sickness go to the clinics, serious illness have to the large hospital. Third, the medical seeking behavior of the elderly is affected by the ecological system: (1) microsystem have a decisive influence; (2) mesosystem are the important bridge to change the medical seeking behavior of the elderly; (3) exosystem indirectly affect the medical seeking behavior of the elderly; (4) marcosystem subtle influence on the medical seeking behavior of the elderly; (5) chronosystem impact or change the medical seeking behavior of the elderly. Finally, according to the above content and discussion of this study, there are some conclusions and recommendations as the reference in order to improve the elderly medical seeking behavior.