中高齡者參與樂齡健康促進課程對其健康信念與行為改變之研究-以高血壓課程為例

Study on the middle-age and elderly participation the elderly health promotion programs to change their health beliefs and behaviors-An example in hypertension programs.

陳清惠(CHING-HUI CHEN)

指導教授 ： 胡夢鯨

國立中正大學/教育學院/成人及繼續教育系高齡者教育研究所/博士(2016年)

摘要

高齡社會的來臨，中高齡者健康促進政策已成為當今社會重要議題。中高齡者須從個人的自我健康管理著手，積極的健康促進。樂齡教育應擬定健康促進相關課程，提供健康維護學習機會，使中高齡者具有預防疾病、促進健康識能，以提升自我預防保健能力，而能獨立生活，讓中高齡者健康老化。
本研究主要以樂齡學習中心之中高齡學員為研究對象，主要在探討：1.調查樂齡學員健康需求與參與健康保健課程的現況；2.探討中高齡學員參與樂齡健康促進課程之健康信念改變狀況；3.分析中高齡學員參與樂齡健康促進課程之健康行為改變情形。為達到研究目的，本研究分為兩個階段執行，第一階段以焦點團體訪談法探討樂齡學員健康需求與參與健康保健課程的現況；第二階段為準實驗設計研究法執行樂齡健康促進課程的規劃、設計樂齡高血壓慢性疾病健康促進評估表；並以樂齡健康促進課程進行實驗操作與健康促進評估表的問卷調查，獲得中高齡學員高血壓健康信念與行為改變之情形。
研究結果發現，壹、健康需求為:一、健康信念方面：自覺健康狀態良好，對疾病自覺罹患性低；罹患多種慢性病，對疾病自覺嚴重度低；對高血壓認知偏低，對疾病控制自我效能低；二、健康行為方面：長期罹患高血壓，對預防疾病行動自覺效益低；預防疾病行動自覺障礙；無法理解相關醫護知識；貳、參與樂健康保健課程現況：缺乏學習專業醫療照護知識健康教育之行動線索。叁、參與樂齡健康促進課程之健康信念與行為改變狀況：女性學員之高血壓健康信念與行為較佳；高教育程度與高血壓健康信念與行為無直接關係，但高教育程度有助於學習；罹患高血壓慢性疾病時間越久、症狀明顯，提昇高血壓健康信念與行為；良好生活習慣者高血壓健康信念與行為較佳；參與課程，高血壓健康信念與行為明顯增高。
針對研究目的，歸納結論如下：
一、中高齡者健康需求主要為慢性疾病預防
二、現今樂齡健康促進課程缺乏增進健康識能的專業學科課程
三、樂齡健康促進課程可增進健康信念與行為，扮演好健康促進的角色
四、樂齡健康促進識能可促使中高齡者健康自主性，建立新健康價值觀
五、樂齡健康促進學習可促使中高齡者健康老化
根據研究結果，茲提供建議如下：
一、對樂齡教育機構之建議
(一)樂齡教育機構應規劃以活躍老化為教育目的之健康促進課程
(二)樂齡教育機構應建置學科化專業的健康促進課程以增進樂齡學員健康效能
(三)樂齡健康促進課程，亦須著重中高齡女性之健康促進
二、對中高齡者之建議
(一)中高齡者應建立新健康價值觀念，增強個人健康促進的角色
(二)中高齡者應積極健康促進，實踐維護健康之責任
三、未來研究之建議
(一)擴增多樣化之樂齡健康促進課程
(二)全面性探究樂齡健康促進課程對健康信念與行為之影響
(三)深入探討中高齡者個人獨特性健康促進經驗

關鍵字：中高齡者、樂齡健康促進課程、健康信念、健康行為、改變

關鍵字

健康信念 ； 樂齡健康促進課程 ； 中高齡者 ； 健康行為 ； 改變

並列摘要

The advent of an aging society, the health promotion policy has become an important issue in today's society. The middle-age and elderly are required to from the individual's self-health management. Elderly education should be formulated to promote related programs provide learning opportunities for health maintenance, in order to enhance the self-care ability, so that they can health aging.
This study mainly in elderly learning centers among the middle-age and elderly participants for the study, Mainly discussing:1.Survey the health needs of the middle-age and elderly students and participate in elderly health promotion programs status; 2. Discussion of the middle-age and elderly students participants in health promotion programs changes of the health beliefs; 3. Analysis of the middle-age and elderly students participants in health promotion programs changes of the health behaviors. To achieve the purpose, the Study is divided into two phases. The first phase of exploration with focus group interviews to discuss the health needs and participate in status of elderly health promotion programs of the middle-age and elderly students; The second phase of the Quasi-Experimental Design implementation of elderly Health Promotion programs planning, design elderly hypertensive health promotion questionnaire, to the programs experimental operation and investigation the middle-age and elderly students with hypertension health beliefs and health behaviors change.
The results find, 1. The health needs: 1.1. The health beliefs: perceived health in good condition, low of perceived susceptibility; Suffering from multiple chronic conditions, low of perceived severity ; Low of cognitive of hypertension, and low of self-efficacy for disease control; 1.2. The health behavior: The longer suffering from hypertension, disease prevention actions low of Perceived Benefits; Disease prevention action perceived barriers; They can`t understand related medical knowledge; 2. Participation in elderly healthcare program Status: Lack of health education to learn the professional healthcare knowledge of cues to action. 3. Participation of elderly health promotion program of health beliefs and behaviors change status: Female students of hypertension health beliefs and behaviors better; Highly educated and hypertension health beliefs and behaviors not directly related, but the high level of education contribute to learning; The longer suffer from hypertension and symptoms obvious, hypertension to enhance their health beliefs and behaviors; Good habits of hypertension health beliefs and behavior better; Participation health promotion program hypertension health beliefs and behavior significantly increased.
For research purposes, the conclusions are summarized as follows:
1. The health needs of the middle-age and elderly mainly for chronic disease prevention.
2. Today's lack of elderly health promotion professional programs can improve health literacy.
3. Elderly health promotion professional programs can improve health beliefs and health behaviors, and play a good role in health promotion.
4. Elderly health promotion literacy can promote the middle-age and elderly healthy autonomous, and to establish a new health values.
5. Elderly health Promotion learning can promote health aging of the middle-age and elderly.
Based on the findings, It provided the following recommendations:
1. The recommendation of elderly education institutions
(1) Elderly educational institutions should be planned with the active aging education purposes to health promotion programs .
(2) Elderly educational institutions should build professional discipline of health promotion programs to enhance the health effectiveness of the middle-age and elderly students.
(3) Elderly health promotion programs should also focus on health promotion in the middle-age and elderly women.
2. Recommendation of the Middle-age and Elderly
(1) The Middle-age and Elderly should establish a new health values, enhance the role of individual health promotion.
(2) The Middle-age and Elderly should actively health promotion to practices responsibility for health maintenance.
3. Suggestions for future research
(1) Amplification of diversification of elderly health promotion programs.
(2) A comprehensive exploring elderly health promotion programs influence of health beliefs and health behaviors.
(3) Depth discussions of the middle-age and elderly individual unique Health Promotion experience.

keywords: the middle-age and elderly, elderly health promotion programs, health beliefs, health behaviors ,change

並列關鍵字

health beliefs ； elderly health promotion programs ； the middle-age and elderly ； health behaviors ； change

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