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  • 學位論文

台灣老人肥胖及非肥胖族群其自覺健康狀況及生活方式之差異:民國九十一年國民健康促進知識、態度與行為調查結果

The Difference of Perceived Health Status and Life Styles Among Elderly Population of Obese Group and Non-Obese Group:Results of the National Survey on Health Promotion Knowledge, Attitude, and Practice (HP-KAP Survey) in 2002

指導教授 : 張浤榮 周明智

摘要


目的:此橫斷性研究的主要目的是了解台灣肥胖及非肥胖老人的自覺健康狀況及生活方式之差異。 材料與方法:本研究使用行政院衛生署國民健康局「民國九十一年台灣地區國民健康促進知識、態度與行為調查」資料,此調查是一全台灣地區性抽樣調查,凡居住在台灣地區各縣市年滿十五歲以上之本國籍人口,均為調查對象。訪視期間為2002年10月至2003年3月,全部實際抽出樣本數為32,660人,全部實際完訪樣本數為26,755人,完訪率為81.9%。本研究以樣本母群體中所有在65歲以上之肥胖(N=596)及非肥胖(N=3,343)者為對象。資料分析使用了平均數、百分比、卡方檢定、斯皮爾曼等級相關(Spearman rank-order correlation)和羅吉斯迴歸(Logistic regression)等方法。 結果:根據本研究總共有15.1%65歲以上的老人是肥胖的,男性老人肥胖的比例是12.8%,女性老人肥胖的比例是17.7%。男性和女性的比例是52.3%比47.7%,平均年齡是73.1±6.1歲,平均教育程度是11.2±4.2年,平均身體質量指數是23.5±3.6(公斤/公尺2 )。就分析自覺健康狀況與其相關因子方面,以斯皮爾曼等級相關分析肥胖老人的自覺健康狀況及其相關因子之相關性,發現慢性病中以高血壓、高血脂、心臟病、中風、糖尿病、骨質疏鬆症及腎臟病與肥胖老人的自覺健康狀況有相關;而非肥胖老人的自覺健康狀況及慢性病之相關性中,除了跟肥胖老人一樣外,還與氣喘有相關;個人健康行為方面,運動習慣與肥胖及非肥胖老人的自覺健康狀況均有相關。用自覺健康狀況的獨立危險因子和欲探討之變項進入羅吉斯迴歸模型結果發現年紀越大(勝算比為1.03,95%信賴區間為1.01- 1.04)、沒有運動(勝算比為2.23,95%信賴區間為1.92- 2.58)、慢性病個數越多(勝算比為1.62,95%信賴區間為1.53- 1.72)、獨居(勝算比為1.27,95%信賴區間為1.01- 1.60)、過去一個月內有利用西醫門診(勝算比為2.12,95%信賴區間為1.81- 2.50)、過去一個月內有利用中醫門診(勝算比為1.74,95%信賴區間為1.36- 2.23)、過去一個月內有利用民俗療法(勝算比為1.39,95%信賴區間為1.02- 1.88)的老人傾向不好的自覺健康狀況。就分析生活方式與肥胖之相關性方面,用斯皮爾曼等級相關分析發現,年紀、身體質量指數、高血壓、糖尿病、心臟病、吸菸狀況與肥胖呈現相關。將肥胖的獨立危險因子及預探討之變項進入羅吉斯迴歸模型,且調整年紀、性別、教育程度之後,現在有嚼檳榔(勝算比為1.63,95%信賴區間為1.01- 2.61)與過去曾吸菸(勝算比為1.46,95%信賴區間為1.07- 1.97)的老人與肥胖呈現獨立之相關性。 結論:我們的結論為不管是肥胖或非肥胖老人其自覺健康狀況與某些慢性病和運動行為是相關的;因此,當國家衛生政策擬定健康促進計畫時,慢性病的控制及培養老人運動習慣方面也應該多加注意。另外,透過本研究發現嚼檳榔、過去吸過菸與肥胖是有相關,希望這樣的研究結果能提供政策制定者未來政策擬定的方向,所以未來在老人族群中預防肥胖時,生活方式的調節將扮演重要的角色。

並列摘要


Objective: This cross-sectional study was conducted to explore the difference of perceived health status and life styles among elderly population of obese group and not-obese group in Taiwan. Materials and Methods: This study utilized cross-sectional data from the Bureau of Health Promotion, Department of Health in Taiwan. The information was collected during the National Survey on Health Promotion Knowledge, Attitude, and Practice (HP-KAP Survey) in 2002. This population-based cross-sectional survey was conducted by face-to-face interview of 26,755 Taiwanese, and had a response rate of 81.9%. The participants (596 obese and 3343 non-obese) in our study were aged 65 and over. Means, percentages, Chi-Square test, Spearman rank-order correlation and Logistic regression were used for data analysis. Results: The prevalence of obesity among Taiwanese elderly was 12.8% in men and 17.7% in women. When using Spearman rank-order method to analyze the obese group, prominent correlations were found between the current perceived health status and chronic diseases, such as hypertension, hyperlipidemia, heart disease, stroke, diabetes mellitus, osteoporosis, and renal disease. Similar results were seen within the non-obese group. When using Logistic regression, a correlation was identified in the elderly population in which those being older(OR= 1.03, 95% CI: 1.01- 1.04), non-exercisers (OR= 2.23, 95% CI: 1.92- 2.58), having more chronic diseases(OR= 1.62, 95% CI: 1.53- 1.72), living independently(OR= 1.27, 95% CI: 1.01- 1.60), visiting Western clinic(OR= 2.12, 95% CI: 1.81- 2.50), visiting Chinese clinic(OR= 1.74, 95% CI: 1.36- 2.23) and visiting alternative medicine clinic(OR= 1.39, 95% CI: 1.02- 1.88) in the past 1 month usually reported a poorer self-perceived health status. Significant correlation of age, BMI, hypertension, heart disease, diabetes mellitus, and the habit of smoking with obesity was found using Spearman rank-order correlation. After adjusting for age, gender, and years of formal education, logistic regression showed the risk of obesity was higher in elderly betel nut chewers than non-chewers(OR= 1.63, 95% CI: 1.01- 2.61) and elderly ex-smokers of cigarettes than non-smokers (OR = 1.46, 95% CI: 1.07 - 1.97). Conclusions: Perceived health status among elderly population is correlated with the presence of chronic diseases as well as regular exercise. Therefore, our health care systems should be fully aware of these issues and consequently provide better control or care for those elderly patients with chronic diseases and simultaneously encourage them to participate more in regular exercise. More attention to the relationship between betel nut chewing and obesity in the elderly should be paid by our health care system to provide better care for this subgroup of obese elderly.

並列關鍵字

obesity perceived health status life styles

參考文獻


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