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研究生: 黃品瑄
Huang, Pin-Hsuan
論文名稱: 以跨理論模式探討臺灣高齡者從事肌力活動行為與慢性疾病風險之研究
Using the Transtheoretical model to examine the associations of muscle-strengthening activity with risks of chronic diseases among Taiwanese older adults
指導教授: 廖邕
Liao, Yung
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2020
畢業學年度: 108
語文別: 中文
論文頁數: 90
中文關鍵詞: 高齡者肌力活動高血壓糖尿病行為改變階段
英文關鍵詞: elderly, strength training behavior, hypertension, diabetes, stage of change
DOI URL: http://doi.org/10.6345/NTNU202000270
論文種類: 學術論文
相關次數: 點閱:253下載:81
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  • 目的:肌力活動行為是高齡者維持日常活動及預防失能的重要因子,亦能夠帶來許多健康益處,如增加肌力、減少骨質流失等。然而國內探討肌力活動行為與疾病關係及關聯因素之相關文獻卻付之闕如,因此本研究欲以跨理論模式為基礎,旨在瞭解臺灣高齡者從事肌力活動行為之現況,以及其與慢性疾病風險之關聯性。方法:本研究採用橫斷式調查法,以電腦輔助電話訪問的方式,蒐集臺灣高齡者從事肌力活動行為之行為改變階段、慢性疾病狀況,以及社會人口學變項,共取得1,064份有效樣本,並以二元邏輯斯迴歸進行分析。結果:一、高齡者從事肌力活動行為之行為改變階段,有24.0%的人處在維持期,有18.0%的人是處在意圖期-行動期,而有58.1%的人處在無意圖期,即近半數之高齡者從未考慮從事肌力活動行為;二、在社會人口學變項與肌力活動之關聯性方面發現,年齡超過85歲以上、教育程度為高中職以下者,較不容易從事肌力活動行為;三、處在無意圖期的高齡者,相較處在維持期者,增加1.52倍的機率有高血壓及1.50倍的機率有第二型糖尿病的風險。結論:本研究發現高齡者從事肌力活動行為與高血壓及糖尿病之風險有關。然而目前臺灣高齡者人口仍有58.1%的人未考慮從事肌力活動行為,建議未來政策執行者在擬訂預防慢性病及相關政策時,能夠將肌力活動行為納入考量,運用跨理論模式中的改變過程,來為處在不同行為階段的對象設計適合的策略,並且優先針對年齡超過85歲、教育程度為高中職以下者進行介入,以利提升從事肌力活動行為之人口,進而達到活躍老化之願景。

    Background: Strength training behavior has been considered as a key factor for older adults to maintain daily activity and prevent disability. However, there is little evidence between strength training behavior and the risk of chronic disease. Thus, this study used the Transtheoretical model to examine the associations between strength training behavior and the risk of chronic disease in older Taiwan adults. Methods: A telephone-based cross-sectional survey targeting older Taiwanese adults was conducted in 2017. Data related to stages of change for strength training behavior, chronic diseases, and socio-demographic variables were obtained from 1,064 older adults. Adjusted binary logistic regression was then performed. Results: a. 58.1% of the participants were in Pre-contemplation stage, and 24% of them were in Maintenance stage. b. Participants who were 85 years or older, or with lower education levels were less likely to engage in strength training. c. After adjusting for potential confounders, older adults of pre-contemplation stage were more likely to have hypertension (OR=1.52; 95%CI 1.12-2.06) and diabetes (OR=1.50; 95%CI 1.01-2.24) compared with those of maintenance stage. Conclusions: These findings suggest that engagement in strength training behavior was related to the risk of hypertension and diabetes in older adults. However, there were still 58.1% of the elderly people in Taiwan didn’t consider engaging in strength training. Therefore, it is important to promote the suitable strategies on the basis of Transtheoretical model, especially for older adults who were 85 years +, and with lower education levels.

    謝辭 I 摘要 II Abstract III 目錄 V 表目錄 VII 圖目錄 VIII 第壹章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 5 第三節 研究問題 5 第四節 操作型定義 6 第五節 研究限制 7 第貳章 文獻探討 8 第一節 高齡者與慢性疾病 8 第二節 肌力活動行為之健康益處 12 第三節 高齡者從事肌力活動行為之相關研究 24 第四節 跨理論模式 33 第參章 研究方法 39 第一節 研究架構與研究假設 40 第二節 研究對象 42 第三節 研究工具 44 第四節 研究流程 46 第五節 資料處理與分析 47 第肆章 研究結果與討論 50 第一節 高齡者從事肌力活動之行為改變階段的分布現況 50 第二節 社會人口變項與高齡者從事肌力活動行為之關聯性 61 第三節 高齡者從事肌力活動行為與慢性疾病風險之關聯性 64 第伍章 結論與建議 71 第一節 結論 71 第二節 建議 72 參考文獻 74 附錄 82 附錄一、國立臺灣師範大學研究倫理委員會審查核可證明書 82 附錄二、臺灣高齡者重量訓練與慢性疾病風險之調查問卷 83

    內政部 (2019)。統計月報。Retrieved from https://www.moi.gov.tw/files/site_stuff/321/1/month/month.html
    古博文、孫文榮、陳俐蓉 (2016)。老年人靜態行為問卷之發展。大專體育學刊18(1),41-55。
    行政院衛生福利部國民健康署 (2009)。老人健康促進計畫(2009-2012)。Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=530&pid=561
    兵逸儂、鄭惠美 (2010)。應用跨理論模式於北市士林區高中學生每日五蔬果行爲之調查研究。學校衛生(56),39-58。
    吳雅汝、周怡君、詹鼎正 (2014)。文獻回顧-肌少症與衰弱症。內科學誌,25(3),131-136。
    吳蔓君 (2015)。肌少症簡介。家庭醫學與基層醫療,30(4), 103-107。
    李淑卿、郭鐘隆 (2005)。跨理論模式戒菸教育計畫介入應用於大專生之成效評價研究。衛生教育學報(23),145-159。
    李蘭 (2010)。健康促進與衛生教育。巨流圖書公司。台北。
    林宗慶、張立盈、林芸代、李尹鑫、相子元 (2014)。循環式油壓阻力訓練對於停經後老年婦女功能性體適能之效益。 台灣老年醫學暨老年學雜誌,9(1),15-27。
    洪子智、陳五洲 (2014)。中高齡者阻力訓練之初探。運動知識學報(11),119-129。
    范光中、許永河 (2010)。台灣人口高齡化的社經衝擊。台灣老年醫學會暨老年學雜誌,5,149-168。
    馬上閔、林育燕 (2011)。運用跨理論模式於職業婦女休閒運動行為之研究。休閒與社會研究(4),39-57。
    國家發展委員會 (2014)。中華民國人口推計(103至150年)。 Retrieved from http://www.ndc.gov.tw/Content_List.aspx?n=84223C65B6F94D72.
    張量懿、黃清雲 (2015)。高齡者運動階段與知覺運動障礙之研究:以雲林縣樂齡中心為例。嘉大體育健康休閒期刊,14(1),75-82。 doi:10.6169/ncyujpehr.14.1.08
    陳上迪、姜義村 (2011)。阻力訓練對於安養機構高齡者跌倒預防之效益與執行建議。彰化師大體育學報(10),11-25。
    陳怡如、黃滄海、林麗娟 (2011)。老年人的肌肉適能變化與彈力帶阻力訓練。大專體育(113),77-86。
    陳孟鈺、林麗娟、林泰祐、羅詩文、謝閔繐、蔡岳璋、沈彥廷 (2014)。不同運動訓練類型對中老年人骨質密度暨等速肌力之影響。體育學報,47(4),503-516。
    陳慶餘 (2014)。肌少症。臺灣醫學,18(3),288-289。
    黃姃姃 (2013)。不同阻力訓練對跆拳道選手下肢能力表現的影響-以新北市錦和高級中學為例 (未出版碩士論文) 輔仁大學;新北市。
    曾琮萱 (2014)。上肢輕阻力訓練對棒球選手等速肌力與球速之影響(未出版博士論文) 中國文化大學;臺北市。
    曾鈺婷、蔡佳良。(2010)。阻力運動訓練對老年人認知功能之輔助效益。大專體育,(111),75-82。
    詹美玲、陳妍慧、吳國輝、陳淑貞 (2015)。阻力訓練對老年人的生理影響。中原體育學報,(6),1-11。
    趙叔蘋 (2008)。改善高齡者步行能力之因素探討。中華體育季刊,22(2),34-44。
    劉美媛、呂昌明 (2005)。探討大一學生的吸菸行為-跨理論模式的應用。衛生教育學報(24),47-70。
    劉淑媛、陳佳慧 (2014)。老年人的肌肉質量流失。臺灣醫學,18(1),99-103。
    劉影梅 (2004)。國際身體活動量表台灣中文版之發展與信效度驗證 (未出版博士論文) 國立臺灣大學;臺北市。
    蔡仁貞、梁穎、洪美英 (2003)。成人內外科護理 (上冊)。偉華:臺北市。心臟疾病之護理,625 頁。
    蔡佳宏 (2000)。應用跨理論模式於老人運動行為之研究--以臺北市中山區長青學苑學員為例。臺灣師範大學;臺北市
    衛生福利部 (2017)。中華民國105年死因統計 Retrieved from file:///C:/Users/Picasso/Desktop/1204/%E6%B0%91%E5%9C%8B105%E5%B9%B4%E6%AD%BB%E5%9B%A0%E7%B5%B1%E8%A8%88%E5%B9%B4%E5%A0%B1%E9%9B%BB%E5%AD%90%E6%9B%B8。pdf
    衛生福利部國民健康署 (2013)。高血壓防治學習手冊。新北市。
    衛生福利部國民健康署 (2016)。2013年「國民健康訪問調查」結果報告 國家衛生研究院 (Ed.)
    鄭宜蕙、陳怡親、賴奕睿、黃景旋、林益卿 (2015)。老人高血壓的診斷與治療。家庭醫學與基層醫療,30(10),283-291。
    Anton, M. M., Cortez-Cooper, M. Y., DeVan, A. E., Neidre, D. B., Cook, J. N., & Tanaka, H. (2006). Resistance training increases basal limb blood flow and vascular conductance in aging humans. Journal of Applied Physiology, 101(5), 1351-1355.
    Baechle, T. R., & Westcott, W. L. (2010). Fitness Professional's Guide to Strength Training Older Adults. Human Kinetics.
    Bampton, E. A., Johnson, S. T., & Vallance, J. K. (2016). Correlates and preferences of resistance training among older adults in Alberta, Canada. Can J Public Health, 107(3), 272-277.
    Baumgartner, R. N., Koehler, K. M., Gallagher, D., Romero, L., Heymsfield, S. B., Ross, R. R., . . . Lindeman, R. D. (1998). Epidemiology of sarcopenia among the elderly in New Mexico. American journal of epidemiology, 147(8), 755-763.
    Bopp, M., Wilcox, S., Oberrecht, L., Kammermann, S., & McElmurray, C. T. (2004). Correlates of strength training in older rural African American and Caucasian women. Women & Health, 40(1), 1-20.
    Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public health reports, 100(2), 126.
    Centers for Disease Control Prevention. (2014). National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services, 2014.
    Chan, D.-C. D., Tsou, H.-H., Yang, R.-S., Tsauo, J.-Y., Chen, C.-Y., Hsiung, C. A., & Kuo, K. N. (2012). A pilot randomized controlled trial to improve geriatric frailty. BMC Geriatrics, 12(1), 1-12.
    Chevan, J. (2008). Demographic determinants of participation in strength training activities among US adults. The Journal of Strength & Conditioning Research, 22(2), 553-558.
    Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological science, 14(2), 125-130.
    de Camargo Smolarek, A., Ferreira, L. H. B., Mascarenhas, L. P. G., McAnulty, S. R., Varela, K. D., Dangui, M. C., . . . Souza-Junior, T. P. (2016). The effects of strength training on cognitive performance in elderly women. Clinical interventions in aging, 11, 749.
    Dela, F., & Kjaer, M. (2006). Resistance training, insulin sensitivity and muscle function in the elderly. Essays in biochemistry, 42, 75-88.
    Dergance, J. M., Calmbach, W. L., Dhanda, R., Miles, T. P., Hazuda, H. P., & Mouton, C. P. (2003). Barriers to and benefits of leisure time physical activity in the elderly: differences across cultures. Journal of the American Geriatrics Society, 51(6), 863-868.
    Drenowatz, C., Jakicic, J. M., Blair, S. N., & Hand, G. A. (2015). Differences in correlates of energy balance in normal weight, overweight and obese adults.Obesity research & clinical practice,9(6), 592-602.
    Emerson, N. S., Stout, J. R., Fukuda, D. H., Robinson, E. H., Scanlon, T. C., Beyer, K. S., . . . Hoffman, J. R. (2015). Resistance training improves capacity to delay neuromuscular fatigue in older adults. Archives of gerontology and geriatrics, 61(1), 27-32.
    EU Working Group. (2008). EU Physical Activity Guidelines-Recommended Policy Actions in Support of Health-Enhancing Physical Activity: Brussels.
    Fagard, R. H. (2006). Exercise is good for your blood pressure: effects of endurance training and resistance training. Clinical and Experimental Pharmacology and Physiology, 33(9), 853-856.
    Grøntved, A., Rimm, E. B., Willett, W. C., Andersen, L. B., & Hu, F. B. (2012). A prospective study of weight training and risk of type 2 diabetes mellitus in men.Archives of internal medicine,172(17), 1306-1312.
    Gallagher, K. M., Fadel, P. J., Smith, S. A., Norton, K. H., Querry, R. G., Olivencia-Yurvati, A., & Raven, P. B. (2001). Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise. Journal of Applied Physiology, 91(5), 2351-2358.
    Galuska, D. A., Earle, D., & Fulton, J. E. (2002). The epidemiology of US adults who regularly engage in resistance training. Research quarterly for exercise and sport, 73(3), 330-334.
    Hallal, P.C., Gomez, L.F., Parra, D.C., Lobelo, F., Mosquera, J., Florindo, A.A., … et al. (2010). Lessons learned after 10 years of IPAQ use in Brazil and Colombia. Journal of Physical Activity and Health, 7(2), S259–S264.
    Harada, K., Oka, K., Shibata, A., Ota, A., Okada, J., & Nakamura, Y. (2008a). Factors associated with the stages of change for strength training behavior. International Journal of Sport and Health Science, 6, 251-263.
    Harada, K., Oka, K., Ota, A., Shibata, A., & Nakamura, Y. (2008b). Prevalence and correlates of strength training among Japanese adults: analysis of the SSF National Sports-Life Survey 2006. International Journal of Sport and Health Science, 6, 66-71.
    Humphries, B., Duncan, M. J., & Mummery, W. K. (2010). Prevalence and correlates of resistance training in a regional Australian population. British journal of sports medicine, bjsports48975.
    Hunter, G. R., Bryan, D. R., Wetzstein, C. J., Zuckerman, P. A., & Bamman, M. M. (2002). Resistance training and intra-abdominal adipose tissue in older men and women. Medicine & Science in Sports & Exercise, 34(6), 1023-1028.
    Hupin, D., Roche, F., Gremeaux, V., Chatard, J.-C., Oriol, M., Gaspoz, J.-M., . . . Edouard, P. (2015). Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged≥ 60 years: a systematic review and meta-analysis. Br J Sports Med, bjsports-2014-094306.
    Karlsdottir, A. E., Foster, C., Porcari, J. P., Palmer-McLean, K., White-Kube, R., & Backes, R. C. (2002). Hemodynamic responses during aerobic and resistance exercise. Journal of cardiopulmonary rehabilitation and prevention, 22(3), 170-177.
    Kaul, K., Tarr, J. M., Ahmad, S. I., Kohner, E. M., & Chibber, R. (2013). Introduction to diabetes mellitus Diabetes (pp. 1-11): Springer.
    Keuerleber, J., & Henschke, N. (2012). Progressive resistance strength training can reduce physical disability in older adults. Br J Sports Med, 46(5), 323-324.
    Kim, T. N., Yang, S. J., Yoo, H. J., Lim, K. I., Kang, H. J., Song, W., . . . Baik, S. H. (2009). Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. International Journal of Obesity, 33(8), 885-892.
    Kuwahara, K., Honda, T., Nakagawa, T., Yamamoto, S., Nanri, A., Kurotani, K., ... & Mizoue, T. (2015). Strength training and risk of type 2 diabetes in a Japanese working population: A cohort study. Journal of diabetes investigation, 6(6), 655-661.
    Langsetmo, L., Hitchcock, C., Kingwell, E., Davison, K., Berger, C., Forsmo, S., . . . Prior, J. (2012). Physical activity, body mass index and bone mineral density—associations in a prospective population-based cohort of women and men: The Canadian Multicentre Osteoporosis Study (CaMos). Bone, 50(1), 401-408.
    Liu, C. j., & Latham, N. K. (2009). Progressive resistance strength training for improving physical function in older adults. The Cochrane Library.
    Lovell, D. I., Cuneo, R., & Gass, G. C. (2009). Resistance training reduces the blood pressure response of older men during submaximum aerobic exercise. Blood pressure monitoring, 14(4), 137-144.
    Maslow, A. L., Sui, X., Colabianchi, N., Hussey, J., & Blair, S. N. (2010). Muscular strength and incident hypertension in normotensive and prehypertensive men. Medicine and science in sports and exercise, 42(2), 288.
    Martyn-St James, M., & Carroll, S. (2006). High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporosis international, 17(8), 1225-1240.
    McGuire, A., Seib, C., & Anderson, D. (2016). Factors predicting barriers to exercise in midlife Australian women. Maturitas, 87, 61-66.
    Mendis, S., Puska, P., & Norrving, B. (2011). Global atlas on cardiovascular disease prevention and control: World Health Organization.
    Miyachi, M., Kawano, H., Sugawara, J., Takahashi, K., Hayashi, K., Yamazaki, K., ... & Tanaka, H. (2004). Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study. Circulation, 110(18), 2858-2863.
    Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., . . . Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1094.
    O'Donovan, G., Blazevich, A. J., Boreham, C., Cooper, A. R., Crank, H., Ekelund, U., . . . Gill, J. M. (2010). The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. Journal of sports sciences, 28(6), 573-591.
    Ogurtsova, K., da Rocha Fernandes, J., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N., . . . Makaroff, L. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40-50.
    Oka, K., & Shibata, A. (2012). Factors associated with the stages of change for dog walking among Japanese dog owners. Journal of Physical Activity and Health, 10(1), 124-133.
    Oliveira, P. F. A., Gadelha, A. B., Gauche, R., Paiva, F. M. L., Bottaro, M., Vianna, L. C., & Lima, R. M. (2015). Resistance training improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women. Clinical interventions in aging, 10, 1299.
    Population Reference Bureau. (2017). 2017 WORLD POPULATION DATA SHEET. Retrieved from http://www.prb.org/pdf17/2017_World_Population.pdf
    Rhodes, R. E., Lubans, D. R., Karunamuni, N., Kennedy, S., & Plotnikoff, R. (2017). Factors associated with participation in resistance training: a systematic review. Br J Sports Med, 51(20), 1466-1472.
    Seguin, R., & Nelson, M. E. (2003). The benefits of strength training for older adults. American journal of preventive medicine, 25(3), 141-149.
    Shimizu, R., Hotta, K., Yamamoto, S., Matsumoto, T., Kamiya, K., Kato, M., . . . Kamada, Y. (2016). Low-intensity resistance training with blood flow restriction improves vascular endothelial function and peripheral blood circulation in healthy elderly people. European journal of applied physiology, 116(4), 749-757.
    Shiroma, E. J., Cook, N. R., Manson, J. E., Moorthy, M. V., Buring, J. E., Rimm, E. B., & Lee, I. M. (2017). Strength training and the risk of type 2 diabetes and cardiovascular disease.Medicine and science in sports and exercise,49(1), 40.
    Socha, M., Frączak, P., Jonak, W., & Sobiech, K. A. (2016). Effect of resistance training with elements of stretching on body composition and quality of life in postmenopausal women. Przeglad menopauzalny= Menopause review, 15(1), 26.
    Straight, C. R., Lindheimer, J. B., Brady, A. O., Dishman, R. K., & Evans, E. M. (2016). Effects of resistance training on lower-extremity muscle power in middle-aged and older adults: a systematic review and meta-analysis of randomized controlled trials. Sports medicine, 46(3), 353-364.
    Surakka, J., Alanen, E., Aunola, S., Karppi, S. L., & Lehto, P. (2004). Adherence to a power-type strength training programme in sedentary, middle-aged men and women. Advances in Physiotherapy, 6(3), 99-109.
    Tanasescu, M., Leitzmann, M. F., Rimm, E. B., Willett, W. C., Stampfer, M. J., & Hu, F. B. (2002). Exercise type and intensity in relation to coronary heart disease in men. Jama, 288(16), 1994-2000.
    US Department of Health and Human Services. (2008). Physical activity guidelines advisory committee report. Paper presented at the Washington (DC): US Department of Health and Human Services.
    US Department of Health and Human Services. (2009). Healthy people 2020. Retrieved from http://www.healthypeople.gov/hp2020/
    Vincent, K. R., Braith, R. W., Bottiglieri, T., Vincent, H. K., & Lowenthal, D. T. (2003). Homocysteine and lipoprotein levels following resistance training in older adults. Preventive cardiology, 6(4), 197-203.
    Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., . . . Jones, D. W. (2017). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology.
    World Health Organization. (2010). Global recommendations on physical activity for health.

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