臺灣地區老人健康行為對身體功能之影響

The Effects of Health Behavior on Physical Function for the Elderly in Taiwan

劉紘志(Liu Hong Zhi)

指導教授 ： 徐慧娟

亞洲大學/健康學院/健康管理研究所/碩士(2004年)

摘要

本研究針對台灣地區67歲以上老年人影響其身體功能障礙之因子。在控制人口基本特性、身體健康狀況下，探討健康行為因素對日常生活功能、工具性日常生活功能、身體活動功能、淨身體活動功能等四種測量身體功能的影響。
研究資料取自台灣地區中老年保健與生涯規劃調查，資料分析取第三次1996年的調查資料，對象包括1989年起的追蹤樣本共2669位個案。本研究目的有三：(1)瞭解台灣地區老年人之身體功能之情況；(2)瞭解台灣地區老年人健康行為；(3)分析老人身體功能障礙與健康行為間之關係。本研發現重要結果如下：
在功能障礙結果方面，約有一成老人日常生活活動能力障礙；約有五成老人工具性日常活動能力障礙；約有六成老人身體活動能力障礙；在扣除日常生活與工具性日常生活失能個案後，所得之淨身體功能活動結果顯示，約有兩成五左右的老人無法執行較困難的淨活動功能；且研究發現有38.2%的老人皆無上述任何一項功能障礙。
在健康行為方面，本研究將分為健康維護行為及健康危害行為，研究中發現有規律的運動及良好的睡眠行為者有較好的身體功能(四項功能測量皆有顯著相關)。與本研究假設相異部分:(1)在良好飲食型態對工具性日常生活功能、身體活動功能及淨身體活動功能(勝算比分別為1.465、1.322及1.457)有障礙；(2)每天抽一包煙以上者對工具性日常生活功能、身體活動功能(勝算比分別為0.643、0.683)較少障礙；(3)每月飲酒十次以下者對日常生活、工具性日常生活、身體活動功能(勝算比分別為0.231、0.642、0.683)較少障礙；(4)吃檳榔行為對身體活動功能、淨活動功能(勝算比0.607、0.482)較少障礙
在其他因素方面，年齡、性別、教育程度及疾病的情況皆為影響身體功能狀況的顯著因素。
建議未來研究欲探討健康行為與老人身體功能障礙間的特性，可加入更多有關於地區環境、老人生活型態等因素，並可與往後的追蹤調查的老年資料結果前後呼應比較，以更加釐清健康行為對老人身體功能障礙的影響，以做為老年健康生活的重要指標。

關鍵字

身體功能障礙 ； 健康行為 ； 老年人

並列摘要

This study focuses on the factors that have a negative impact on the physical function of people 67 years or older in Taiwan. Under the condition of understanding human nature and health, we study the impact of the health behavior on the results of four scales that measure the general functionality of a person, namely: the Activities of Daily Living, the Instrumental Activities of Daily Living, the Nagi Scale , and the Completely Nagi Scale.
We obtained our data from the investigation on health care and career planning of the middle to old age people in Taiwan. The data come from the third investigation in 1996 which include 2,669 sample case and their follow-up studies since1989. There are three objectives for our study:

(1)To understand the status of physical function of the old people in Taiwan
(2)To understand the health behavior of the old people in Taiwan
(3)To analyze the correlation between the physical dysfunction and health behavior of the old people in Taiwan

The key findings of our study are as following:

On the physical dysfunction we find that about 10% of the old people have difficulty in their activities in daily living, about 50% of the old people have difficulty in their instrumental activities of daily living, and about 60% of the old people have difficulty in their Nagi Scale. After we removed the difficulty in the activities in daily living and that in the instrumental activities of daily living, we found that about 50% of the old people have difficulty in their Completely Nagi Scale. However, 38.2% of the old people have none of the aforementioned dysfunction.
On the health behavior, we differentiate the effect of health protection behavior and health risk behavior. We find that people who sleep well and exercise regularly have better physical functionality. (The functional measurements of all four scales are correlated.)

The findings that deviate from our assumptions:

(1)Healthy eating habit is detrimental to the instrumental activities of daily living, the Nagi Scale , and the Completely Nagi Scale. (the odds ratio are 1.465, 1.322, and 1.457 respectively)
(2)People who smoke one pack of cigarette a day have less difficulty in the instrumental activities of daily living and the Nagi Scale. (the odds ratio are 0.643 and 0.683 respectively)
(3)People who drink 10 times a month or less have less difficulty in the activities of daily living, the instrumental activities of daily living, and the Nagi Scale. (the odds ratio are 0.231, 0.642, and 0.683 respectively)
(4)People who chew areca have less difficulty in the activities of daily living and the Completely Nagi Scale. (the odds ratio are 0.607 and 0.482 respectively).

As for the other factors, age, sex, education, and sickness all have major impact on the physical functionality of old people.

We recommend that to study the characteristics of physical dysfunction and health behavior in the future, people should include factors such as local environment and living pattern of old people. It is also very important to correlate the results with follow-up studies in the future in clarifying the impact of health behavior upon physical dysfunction. This way we can gain a more comprehensive understanding on how to improve and maintain the health of old people.

並列關鍵字

physical dysfunction ； health behavior ； olderly

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