A Study of Factors Associated with Health Examination among Elderly Men Living in Suburban District –An Example from Tianliao District, Kaohsiung, Taiwan
偏遠地區 ； 健康檢查 ； 老年男性 ； 社會支持網絡 ； 健康信念 ； Health examination ； Elderly men ； Suburban district ； Social support networks ； Health belief
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我國在1993年已進入高齡化社會。老年人口的增加衍生許多照顧服務、醫療保健及生活娛樂層面等多元化需求，且老年人口成為現今醫療利用主群體，並以慢性病之醫療使用居多，其醫療照顧需求日益受關注。尤其，偏遠地區因醫療資源分布相對缺乏，導致老年人就醫困難，在維持健康上亦較為不易。本研究參考Rosenstock(1974)健康信念模式及相關文獻，探討影響高雄市田寮區的老年男性，在使用健檢服務上的相關影響因素。本研究有效樣本共計414位，問卷調查資料包含社會人口學資料、社會支持以及個人健康信念變項等。 本研究目的如下： 1. 探討田寮區老年男性健檢之受檢狀況與社會人口學變項、健康信念、社會支持之相關性。 2. 瞭解田寮地區老年男性使用健檢行為之影響因素。 3. 瞭解田寮地區老年男性使用免費健檢行為之影響因素。 期藉由瞭解偏遠地區居民健檢狀況，並改善阻礙健檢行為之影響因子，以提昇偏遠地區預防性醫療行為之資源利用程度。研究結果以描述性分析、交叉分析和羅吉斯迴歸分析呈現。 研究結果： 1. 年齡越大、定期參加養生保健及休閒娛樂活動等社交活動者較傾向於使用免費或自費健檢服務，此結果與過去文獻相符。 2. 獨居、過去無喝茶習慣、罹患骨質疏鬆症傾向於使用免費健檢。獨居型態差異因素亦與過去文獻結果類似。 研究討論： 1. 社會支持網絡係影響偏遠社區利用社會福利服務的重要因素，並屬於健康信念模式的外部行動線索，包含大眾傳播媒體或醫師的醫囑、親朋好友的經驗分享等個人之外的環境訊息等。 2. 獨居老人僅於免費健檢呈顯著意義則係受限於自費訊息的接收程度、經濟支持(月收入)及社交互動上相對薄弱，且有基層公部門與社區活動管道作為社福資源傳遞的媒介，因而提高受關注獨居老人在健保健檢的使用率。 未來對策： 1. 建構正式組織福利輸送體系，落實積極性預防並整合多元化福利，運用區內具專業權威性及資源整合窗口之衛生所進行衛教宣導，適時傳遞專業醫療及照顧相關資訊，改善居民的健康認知。於區內設置整合各項福利服務的單一窗口，適時引入外部資源輔助社區方案的推動與支持，提升服務使用的效率及效能。 2. 連結在地化支持網絡，善用非正式資源且致力於厚植社會資本，強化社區行動力、結合志願性團體及志工等非正式資源，以多元化形式推廣老人健檢及慢性病防治服務。採取參與、學習、培力和伙伴的策略運作模式，培育草根社區領袖，營造審議式民主為基礎的社區。
Due to the advance in medical technology, the extension of average life span, the transformation of social structure value and the decrease in birth rate, Taiwan has stepped into the aging society in 1993. The increase in aging population has resulted in the multiple needs of care service, medical and health care, and life entertainment…etc. Furthermore, aging population has also become the main group in the present use of medical treatment, primarily in the chronic disease, and hence the elderly need in treatment is also taken into much more consideration. In addition, the lack of medical resource in the remote area has made it difficult for the elderly to take the medical treatment and maintain the health life. This research refers to the health belief model and relevant documents by Rosenstock(1974), and probes into the relevant effects in which the elder men take physical examination service in Tian-liao district in Kaohsiung city. The effective samples in this research amount to 414 people, and the variable includes socio-demographic, social support, and the personal health belief. The research purposes are as follows: 1. To probe into the relativity among the physical examination taken by the elderly men and the socio-demographic variable, health belief, and social support. 2. To realize the effects that the elderly men choose to take free physical examination in Tian-liao district 3. To grasp the effects that the elderly men choose not to take free physical examination in Tian-liao district. By grasping the condition that the residents take physical examination in the remote area, this research is to improve the effects that impede the action of physical examination and to enhance the efficient use of resource for the action of preventive medical treatment in the remote area. The research result will be presented under descriptive analysis, cross analysis, and logistic regression analysis. Results: 1. Olderly, regularly participate in health and recreational activities were more inclined to use physical examinations in free of charge, this results is consistant with previous research. 2. The residents who living alone, didn’t have a habit of drinking tea in the past, and the patients with osteoporosis were tended to use free physical examinations. These factors were also in line with results in previous literatures. Discussion: 1. Social networks and support play an important role which affects the use of social welfare services at the rural community. Moreover, it is also related to the external “Cues to action” in Health Belief Model, including the mass media, physicians' orders, and environmental infirmations from other relatives or friends by sharing their experiencies. 2. An elderly who lives alone would consider significantly in free physical examinations only because he/she relatively receives limited messages, financial support (monthly income) and social interaction. Furthermore, basic level community activities in social welfare resources can be transferred by public sectors. Thus, it will help to increase the usages of free physical examinations in elderly who in needs. Future Strategy: 1. To construct a system of formal organization in order to deliver the social welfares and implement diversified prevention services. Health guidance could be strengthened by public health sector with professionals and resources in community. By deliver health information in time, the public health center can improve the health perception of residents. Set up a single unit service center can introduce the external resources and support the community-based programs. 2. Linking up localized support networks and using resources which strengthened the motivation of community, combined with volunteers to promote the elderly health examination and Chronic Disease Prevention services. By participation, learning, and empowerment, the partnership strategies could help with the “Local community leader” to create a democracy community.
醫學院 > 老年學研究所