台灣社區老人的健康行為及其相關因素研究

Prevalence of health behaviors and related factors among the elderly of Taiwan

本研究旨在探討台灣社區老人健康行為及其影響因素，並追蹤各因素的改變對健康行為改變之影響。研究方法為縱貫性資料分析，由2003年「台灣地區中老年身心社會生活狀況長期追蹤調查」全台分層抽樣資料庫中，選取2659位居住於社區之65歲以上老人以分析其健康行為，並以t檢定、單因子變異數分析、複迴歸分析來檢定各項因素與健康行為的關係。再追溯該樣本於1999年的資料，以廣義估計方程式（GEE）探討各因素的改變對健康行為改變之影響。研究結果發現：1）.有運動行為者佔六成五，目前有吸菸、不當喝酒及吃檳榔者分別佔17.9%、9.6%、3.0%。2）.複迴歸分析顯示，教育程度、居住地區、自評健康狀況、身體功能、認知功能、非同住網絡、社會互動網絡顯著影響老人運動程度；性別、年齡、自評健康、身體功能、慢性病數同時顯著影響老人吸菸及喝酒程度；而年齡、籍貫、教育程度、居住地區及非同住網絡顯著影響老人吃檳榔程度。3）.廣義估計方程式分析結果則顯示：搬遷到較城區、自評健康及身體及認知功能變好、慢性病數變多、改變為與配偶同住、社會網路增加者，規律運動行為會增加。搬遷到鄉鎮、改變為有偶、身體功能變好、慢性病數減少、改變為獨居者，吸菸行為會增加。年齡較小、搬遷到縣轄市、自評健康變好、身體功能變好、慢性病數減少、認知功能變好者，喝酒行為會增加。搬遷到鄉鎮、身體功能變好者，嚼檳榔行為會增加。因為社會支持與健康狀態對老人健康行為有著顯著影響，故建議強化老人家庭社會支持力量與健康宣導，以提昇社區老人的健康。

The purpose of this study is to discuss the prevalence and relevant factors of health behaviors among community elderly in Taiwan, and to trace the effects on the health behaviors due to changes of relevant factors. The subjects were 2,659 elderly people, aged over 65 and living in communities throughout Taiwan, sourced from the database of stratified samples. The correlations among the four health behaviors – regular exercise, smoking, drinking, and chewing beetle nuts- and their relevant factors were discussed based on one-way ANOVA and multiple regression analysis. Furthermore, based on the behavior data of the elderly in 1999, this research used the general estimation equations (GEE) to examine the influences resulted from the changes of relevant factors over the course of four years. The results showed that, 1.about 65% of the elderly had exercise habit, and 17.9%, 9.6%, and 3.0% smoke, inappropriately drink, and chew beetle nut, respectively. 2.The results of multiple regression analysis indicated that education, residential location, self-evaluated health, physical function, cognitive function, non-cohabitant networks, and social interactive networks have significant influence on the exercise habits. Gender, age, self-evaluated health, physical functions, and the numbers of chronic diseases have significant influence on the elderly’s habits of smoking and drinking. Age, ethnicity, education, residential location, and non- cohabitant networks have significant influence on the elderly’s habits of chewing beetle. 3.The analysis of GEE indicated that the frequency of regular exercises would be increased if the elderly relocate to urban areas, perceive better self-evaluated health, increase social networks, live with spouse and children, or have more chronic diseases. The elderly would increase the frequency of smoking if they move to rural area, have a spouse, perceive better physical functions, have fewer chronic diseases, or live alone. The elderly would increase the frequency of drinking if they are younger, move to a rural area, perceive better physical and cognitive functions, or have fewer chronic diseases. The elderly chew beetle nuts more often if move to the rural area, or perceive better physical function. Based on the above findings, it is concluded that the health of the elderly is greatly influenced by their health behaviors and social support, therefore, strengthening the social and family supports for elderly and augmenting health education can enhance their health in communities.