性別差異在健康行為與健康相關生活品質之影響因素分析：以臺灣社區老人為例

A Study of the Impact of Gender on Healthy Behavior and Health Related Quality of Life among the Community-Dwelling Elderly in Taiwan

本研究為次級資料分析採描述相關性研究(descriptive-correlational study)設計探究台灣社區居住老人因性別差異在健康行為對健康相關生活品質所造成之影響。以台灣國家衛生研究院2001年所完成「國民健康訪問調查」原始資料檔為研究分析來源，以資料中完成SF-36問卷共2070位65歲以上老人為研究對象，結果發現，不同性別之老年人，在社經狀況、健康狀況、健康行為及健康相關生活品質都有顯著差異，老年男性個案中有飲酒及規律運動行為者其健康相關生活品質比較高，在老年女性個案則發現有規律運動及非體位過輕者其健康相關生活品質比較高。使用逐步複迴歸分析發現，顯著預測健康相關生活品質中生理功能健康構面(physical component summary, PCS)的因素為：當日常活動無困難、疼痛項數愈少、年齡愈輕、慢性疾病數愈少、男性、平均月收入大於10000及有規律運動者，其生理健康生活品質較佳，可共同解釋41.8%變異量。顯著預測健康相關生活品質中心理功能健康構面(mental component summary, MCS)的因素為：當疼痛項數愈少、受教育年數大於7年、日常活動無困難、年齡愈大、非體位過輕者、慢性疾病數愈少及規律運動者其心理健康狀況較佳，可共同解釋14.9%變異量。健康照護人員未來擬定健康促進介入措施與提升健康相關生活品質計畫，需考量因性別差異所造成之不同。

Objectives: This study aims to investigate the impact of gender on healthy behavior and HRQOL among the community-dwelling elderly in Taiwan. Design: This study is a cross-sectional, descriptive design. Setting: Participants and data collection were drawn from the 2001 Taiwan National Health Interview Survey (NHIS), representative of the community-dwelling elderly population in Taiwan. Participants: 2,458 elderly (over age 65) participants were surveyed and 388 participants were excluded due to not completing the SF-36 questionnaires. A total of 2,070 people were selected as research participants. Methods: Health related quality of life (HRQoL) was measured with the Taiwan version of the Short Form-36 Health Survey Questionnaire (SF-36). Healthy behavior checklist developed by the researchers through literature review was measured with smoking, alcohol consumption, exercise, and body mass index (BMI). Results: The results indicated that (1) there was significance difference between alcohol consumption and regular exercise and HRQoL for elderly men; there was significance difference between regular exercise and body weight maintenance for elderly women; (2) disability in activities of daily living (ADLs), number of pain, co-morbidity, age, gender, income, and xercise were significant predictors of physical component summary (PCS), and could explain 41.8% of the total variance; (3) number of pain, disability in ADLs, education level, age, co-morbidity, exercise and body weight control were significant predictors of mental component summary (MCS), and could explain 14.9% of the total variance. Conclusion: Gender was shown to influence the relationship between healthy behavior and HRQoL. When developing health promotion intervention for the elderly, nurses need to take gender into consideration.