目的:本研究主要目的是探討健康素養、自我效能以及預防保健服務使用三者之間的關係。 方法:本研究利用行政院衛生署國民健康局人口與調查研究中心2003年、2007年之「中老年身心社會生活狀況長期追蹤調查系列研究」之資料進行分析,樣本3479人。本研究先以結構方程模式建構健康素養之測量,分析其與自我效能、服務利用間之關係後,再以邏輯式迴歸分析與複迴歸分析進行分析各項服務之使用相關因素。 結果:結構方程模式結果之配適度良好,發現疾病知識、教育年數與認知功能可建構為健康素養良好之替代性測量指標。且健康素養不僅對於自我效能以及預防保健服務具有直接正向之影響外,亦可透過自我效能對於保健服務利用造成間接的正向影響。邏輯式迴歸分析結果則顯示,年齡越高、居住北部地區以及鄉鎮與鄉村、自評健康狀況較差、疾病數目較多、疾病知識較高與自我效能較高者,其多項服務使用有較高的趨勢。 結論:健康素養有助於提升自我效能和預防保健利用。建議衛生政策可透過健康教育或衛教宣導,以提升國人的健康素養。
Purpose: The purpose of this study was to examine the relationships among health literacy, self-efficacy and preventive care utilization of the older adults in Taiwan. Methods: The data were from a longitudinal survey “Taiwan Longitudinal Study in Aging” in 2003 and 2007. The participants included in the analysis were in total 3479 persons. The structural equation modeling (SEM) was used to construct the measure of health literacy, and then the effects of health literacy on self-efficacy and preventive care utilization were examined. Next, the logistic regression and multiple regression models were applied to examine health literacy, self-efficacy, and other factors of preventive care utilization. Results: The model fit of health literacy measurement model was good. Health literacy had positive direct effect to self-efficacy and preventive care utilization, and also had positive indirect effect to the use of preventive care utilization. The older adults who were older, living in northern and rural area, having poor self-related current health status, having more chronic diseases, having better knowledge of disease and higher self-efficacy, were more likely to use preventive care. Conclusions: Health literacy increases the utilization of preventive care and self-efficacy. Health education and promotion is suggested in health policy to improve health literacy.