預防失能照護模組對於社區老人體適能、健康相關生活品質、運動自我效能的成效評估──以南投縣為例

The Effect of Disability Prevention Program on Physical Fitness, Health-related Quality of Life, and Exercise Self-efficacy in Community-dwelling Older Adults in Nantou County

目的：探討南投YMCA預防失能照護模組對於南投社區老人體適能、健康生活品質、運動自我效能影響。方法：類實驗研究設計，實驗組是參加課程社區老人（n=42），對照組是未參與課程社區老人（n=31）。複迴歸測試南投YMCA預防失能照護模組對於老人體適能、健康生活品質、運動自我效能影響。結果與討論：參與南投YMCA預防失能照護模組（實驗組）社區老人，在體適能項目的起身行走（β= -1.83, SE = 0.44,p < 0.001）、屈膝起立30秒（β=1.15, SE = 0.57, p < 0.05）有改善。實驗組的因身體生理問題角色受限（β= 3.78, SE = 1.61, p = 0.02）、身體疼痛（β= 3.87, SE = 1.45, p <0.01）、活力狀況（β= 3.71, SE = 1.77, p = 0.04）、生理健康層面（β= 4.27, SE = 1.68, p= 0.01）等生活品質獲得改善。南投YMCA預防失能照護模組對老人運動自我效能預期也有助益（β= 2.19, SE = 0.31, p < 0.001）。整體來說，南投YMCA預防失能照護模組，對於南投社區老人體適能、健康生活品質、運動自我效能皆有幫助，尤其是對於維持老人常規活動的「運動自我效能」特具意義，南投YMCA課程值得作為臺灣其他地區發展預防失能照護模組之實證參考。

Objectives: To investigate the effect of Nantou YMCA disability prevention program on physical fitness, health-related quality of life, and exercise self-efficacy in community-dwelling older adults in Nantou County. Methods: Quasi-experimental research design was used in this study. Participants were older adults participating in Nantou YMCA disability prevention program (intervention group, n=42) and older adults from other Nantou communities (control group, n=31). Multiple regression analysis was used to examine the effect of the disability prevention program on community-dwelling older adults’physical fitness, health-related quality of life, and exercise self-efficacy. Results and Discussion: The intervention group showed significant improvement in physical fitness tests of time up and go (β= -1.83, SE = 0.44, p <0.001) and 30-second chair stand (β= 1.15, SE = 0.57, p < 0.05) than the control group. Older adults in the intervention group also gained significant increases in the score of quality of life in role physical (β= 3.78, SE = 1.61, p = 0.02), body pain (β= 3.87, SE = 1.45, p <0.01), vitality (β= 3.71, SE = 1.77, p = 0.04), and sum of physical health (β= 4.27, SE = 1.68, p = 0.01)as well as exercise self-efficacy expectation (β= 2.19, SE = 0.31, p < 0.001) than older adults in the control group. This study indicated that Nantou YMCA disability prevention program was effective on helping community-dwelling older adults to improve their physical function, health-related quality of life, and confidence of exercise which helped maintaining older adults to engage activity regularly. The evidence-based intervention of Nantou YMCA disability prevention program merits implication in other places in Taiwan.