台灣六十歲以上老年人健康檢查之相關因素

Factors Associated with Health Examination of the Elderly 60 Years and Older in Taiwan

洪婉菁(Hung Wan-Ching)

指導教授 ： 徐慧娟

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2004年)

摘要

本研究的目的在於瞭解台灣60歲以上老年人健康檢查利用之情形及原因，並分析影響其利用健康檢查的相關因素，藉以提出建議供未來健康促進計畫參考。
本研究資料來源為行政院衛生署國民健康局的1999年「台灣地區老人保健與生活狀況長期追蹤調查系列研究調查資料庫」，並擷取60歲以上，扣除代答個案，共3,244個樣本進行分析，樣本完訪率為90.3%。分析方法採用邏輯迴歸模式對健康檢查利用情形與人口與社經地位基本特質、疾病情形、社會支持等自變項進行分析，以瞭解老年人健康檢查行為的相關因素。
研究結果顯示：
(一)台灣60歲以上老年人的健康檢查利用率為52.2%。
(二)年齡、性別、教育程度、婚姻狀況、籍貫、年收入及居住地區別皆與老年人是否採取健康檢查行為有相關。
(三)曾經罹患高血壓、白內障、胃潰瘍或胃部疾病、心臟病、肺炎或氣喘等肺部疾病、腎臟疾病、痛風、中風、癌症或惡性腫瘤等九種疾病及目前罹患疾病數皆與老年人是否採取健康檢查行為有相關。
(四)同住者是否有大專以上學歷及生病時的依靠皆與老年人是否採取健康檢查行為有相關。
(五)邏輯迴歸分析中，指出教育程度愈高、外省籍、收入愈高、曾經罹患上述四種疾病及覺得家人很可以依靠的老年人，去做健康檢查的勝算比皆較高。
根據研究結果提出以下之建議：
(一)許多未做健康檢查的老年人因為不覺得自己需要做健康檢查而未做，因此建議相關單位應透過更多的調查研究或深入社區去發掘不覺得需要健康檢查的真正原因，以使這些服務達到最大效用。
(二)對於許多健康狀況較佳的老年人，建議透過媒體廣告、醫護人員、人際互動等方法加強教育宣導；或是增加受檢的便利性，提供更便利的的受檢管道；更可以落實家庭醫師制度，與老年人建立良好的互動關係，進而鼓勵老年人接受健康檢查。
(三)宣導與教育不應只針對老年人本身，尚須包含其家人、同住者或照顧者；而針對沒有社會支持或是良好的家庭互動的老年人，應由外界提供更多的社會支持，如義工、社工、社區健康營造等方式，以提升家庭成員對健康檢查的認同及重視，進而提高老年人去做健康檢查的意願。

關鍵字

健康檢查 ； 老年人 ； 健康行為

並列摘要

The purpose of this research is to investigate the utilization of health examination and its related factors for the elderly over 60 in Taiwan and to make policy suggestions for health promotion.
The source of data used in this study was based on the database of the long-term follow-up and investigation surveys on health and living status of the elderly in Taiwan published by Bureau of Health Promotion, Department of Health in 1999. Totally 3244 samples over 60 were selected and replaced respondents were excluded. Response rate was 90.3%. The logistic regression model was adopted to analyze the related factors of use of health examination, including the demographic variables and social and economic status, morbidity of chronic diseases and conditions, and social support.
The results have found that:
(1) The rate of health examination use for the elderly over 60 in Taiwan was 52.2%.
(2) Factors like age, gender, educational background, marital status, ethnicity, annual income and residence district correlate with health examination behavior of the elderly.
(3) Nine types of diseases old people used to contract, including hypertension, cataract, gastric ulcer or stomach illness, heart disease, lung diseases like pneumonia or asthma, renal diseases, gout, stroke, cancer or malignant tumors and the number of diseases old people are suffering currently correlate to health examination behavior of the elderly.
(4) Whether the cohabitant has a degree over college or not and if the cohabitant can be relied on when old people get sick are correlated to health examination behavior of the elderly.
(5) The logistic regression analysis indicates that old people with higher education, ethnicity of mainlander, higher income, used to contract the aforesaid four diseases and have reliable family are more likely to have a health examination.
Based on the results of the study, suggestions are presented as follows:
(1) Some of the old people who did not think to take a health examination. It is suggested that involved organizations ought to explore the real reasons of their averseness by conducting more investigations to make these services well.
(2) For old people with better health conditions, it is advised that educational promotion can be reinforced via media, advertisements, medical personnel and interpersonal interactions. Convenience of receiving a health examination may be increased by providing more checkup ways. A good interactive relationship can be established with the old people through practice of family doctors.
(3) The target of health promotion should not only be aimed at the old people; instead, their families, cohabitants or caregivers need to be included. For senile citizens without social support or good interactions with their families, more social support should be offered externally like volunteer workers, social workers. Accordingly, the recognition and emphasis on health examinations of family members will be enhanced and the willingness of receiving a health examination can be increased for the elderly.

並列關鍵字

alth examination ； the elderly ； health behavior

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