全球高齡人口不斷攀升，高齡者的健康促進及慢性疾病預防已成為世界各國所關心的重要議題，而遛狗行為被認為是可以促進高齡者維持日常身體活動量的有效策略之一。對於臺灣高齡者家中飼養寵物狀態、遛狗行為與其休閒身體活動之關聯性探討有其必要性。本研究擬定之研究目的為 (1) 瞭解臺灣高齡者個人背景因素與家中飼養寵物狀態、遛狗行為、休閒身體活動之現況。(2) 瞭解臺灣高齡者個人背景因素與家中飼養寵物狀態、遛狗行為、休閒身體活動之關聯性。(3) 瞭解臺灣高齡者家中飼養寵物狀態、遛狗行為與休閒身體活動之關聯性。
本研究針對臺灣地區65歲以上高齡者利用分層隨機抽樣進行電話訪問調查，回收之有效樣本為1,074位高齡者，資料以IBM SPSS 22.0進行分析，統計方法包括描述性統計、卡方檢定、二元邏輯斯迴歸及克-瓦二氏檢定(Kruskall-Wallis test)考驗。
研究結果發現，(1) 「居住狀態」與「是否飼養寵物」統計上顯著相關；居住狀態為獨居的高齡者較易飼養寵物。(2) 「居住地區」與「是否養狗」統計上顯著相關；居住在南部地區的高齡者較易養狗。 (3)「居住地區」與「遛狗行為」統計上顯著相關；居住在南部地區的高齡者較易有養狗但沒遛狗。 (4)「年齡」、「居住地區」、「工作狀態」、「教育程度」4個變項與休閒身體活動統計上顯著相關；年齡「65-74歲」、居住地區為「東部及外島地區」、工作狀態為「無全職工作（不固定或兼差）」、教育程度為「國（初）中」、「高中職及大學（專）、研究所（含）以上」的高齡者，較容易每週多於150分鐘休閒身體活動。 (5) 在遛狗行為與休閒身體活動方面，結果顯示不同遛狗行為的高齡者其在每週休閒身體活動的走路時間有顯著不同。
本研究之結果可提供公部門規劃及推動高齡者身體活動相關政策之參考，達到我國高齡者健康促進之目的。建議未來研究可進一步探討不同居住地區中有養狗卻沒有遛狗者之原因，並發展促進有養狗但沒遛狗者以遛狗作為促進休閒身體活動之策略。

With the growing number of elderly population, the issue of health promotion and disease prevention among older adults has become a priority of the world. Dog walking has been widely considered to be a potential method for increasing and maintaining physical activity levels among older adults. It is of value to examine the associations of pet ownership, dog walking behavior with leisure-time physical activity. Therefore, the aims of this study are (1) to describe the prevalence of pet ownership and dog walking according to socio-demographic variables. (2) to examine the association of sociodemographic factors with pet ownership and leisure-time physical activity. (3) to identify the relationship of pet ownership and dog walking with leisure-time physical activity.

A telephone-based cross-sectional survey targeting Taiwanese older adults was conducted. Data related to dog ownership, time spent in dog walking and sociodemographic variables were obtained from 1,074 older adults. Descriptive statistics, chi-square test ,adjusted binary logistic regression and Kruskall-Wallis test were performed using IBM SPSS 22.0

The results showed that (1) Living status is associated with pet ownership; Elderly living alone were more likely to be pet owner. (2) Residential area is associated with dog ownership; Elderly living in the south area were more likely to be dog owner. (3) Residential area is associated with dog walking; Elderly living in the south were more likely to own dogs but not walk their dogs. (4) Age, residential area, work status and educational level are associated with leisure-time physical activity; Elderly who aged 65-74 years, lived in eastern and outer area, not employed and with higher educational level were more likely to meet 150 minutes of leisure-time physical activity per week. (5) Dog walkers had significantly higher time spent in leisure-time walking than non-dog owners and non-dog walkers.

The above-mentioned results are critical to inform policy-makers and physical activity intervention designers for health promotion of the elderly. It is suggested that further studies could focus on examining the barriers of dog walking among those who own dogs but not walk their dogs), for the purpose of promoting their leisure-time physical activity.

摘要 i
ABSTRACT iii
謝誌 v
目次 vi
表目錄 viii
圖目錄 x

第壹章 緒論 1
第一節 研究動機與重要性 1
第二節 研究目的 9
第三節 研究問題 9
第四節 研究假設 10
第五節 名詞操作型定義 10
第六節 研究限制 12

第貳章 文獻探討 13
第一節 高齡者身體活動及建議量 13
第二節 高齡者養狗狀態、遛狗行為與身體活動 23
第三節 高齡者養狗狀態、遛狗行為的健康效益 32

第參章 研究方法 35
第一節 研究架構 35
第二節 研究對象 36
第三節 研究工具 38
第四節 研究流程 40
第五節 資料處理與分析 41

第肆章 結果 44
第一節 本研究個人背景因素與家中飼養寵物狀態、遛狗行為、休閒身體活動之現況 44
第二節 本研究個人背景因素與家中飼養寵物狀態、遛狗行為、休閒身體活動之關聯性 61
第三節 本研究家中飼養寵物狀態、遛狗行為與休閒身體活動之關聯性 70

第伍章 討論 72
第一節 本研究與臺灣現今人口背景現況、國外相關文獻之討論 72
第二節 本研究和國外個人背景因素與家中飼養寵物狀態、遛狗行為、休閒身體活動之討論 76
第三節 本研究和國外飼養寵物狀態、遛狗行為與休閒身體活動之討論 80

第陸章 結論與建議 83
第一節 結論 83
第二節 建議 85

參考文獻 87

附錄 96
附件一：國立臺灣師範大學研究倫理委員會審查核可證明書 96
附件二：臺灣高齡者遛狗行為與休閒身體活動量之調查問卷 97

表目錄
表2-1 高齡者身體活動建議量 21
表2-2 高齡者養狗狀態與身體活動 26
表2-3 高齡者遛狗行為與身體活動 30
表2-4 高齡者飼養寵物的健康助益 34
表3-1 臺灣地區65歲以上高齡者的母體數及應有樣本數 37
表3-2 研究目的、研究假設及統計方法 43
表4-1 個人背景變項分布情形 47
表4-2 個人背景因素與是否飼養寵物之卡方檢定 49
表4-3 個人背景因素與是否養狗之卡方檢定 51
表4-4 個人背景因素與遛狗行為之卡方檢定 53
表4-5 個人背景因素與休閒身體活動之卡方檢定 55
表4-6 個人背景因素與休閒身體活動之平均值、標準差 60
表4-7 個人背景因素與是否飼養寵物之二元邏輯斯迴歸分析 62
表4-8 個人背景因素與是否養狗之二元邏輯斯迴歸分析 64
表4-9 個人背景因素與遛狗行為之二元邏輯斯迴歸分析 66
表4-10 個人背景因素與休閒身體活動之二元邏輯斯迴歸分析 69
表4-11 遛狗行為與每週休閒身體活動之無母數檢定 70
表4-12 家中飼養寵物狀態、遛狗行為與休閒身體活動之二元邏輯斯迴歸分析 71
表5-1 本研究與國外養狗率、遛狗率之討論 75


圖目錄
圖3-1 研究架構 36
圖3-2 研究流程圖 40

中文部分：
于志睿、林晏州 (2010)。遛狗活動之休閒效益。戶外遊憩研究23(4)，25-49。
內政部統計處(2015a)。內政性別統計分析專輯。取自http://sowf.moi.gov.tw/stat/gender/list07.html
內政部統計處(2015b)。內政統計查詢網。取自http://statis.moi.gov.tw/micst/stmain.jsp?sys=100
內政部統計處(2015c)。中華民國統計資料網。取自http://www.stat.gov.tw/mp.asp?mp=4
內政部統計處(2015d)。中華民國統計資料網。取自http://statis.moi.gov.tw/micst/stmain.jsp?sys=220&ym=10400&ymt=10400&kind=21&type=1&funid=c0110403&cycle=4&outmode=0&compmode=0&outkind=1&fldspc=0,12,&cod00=1&cod011=1&cod10=1&rdm=Wn4ciipW
內政部統計處(2016)。http://statis.moi.gov.tw/micst/stmain.jsp?sys=100
方進隆 (2015)。高齡者的運動與全人健康。臺北市：華都文化事業有限公司。
行政院主計總處 (2015)。國民幸福指數年報。取自http://happyindex.dgbas.gov.tw/data/08.%E5%81%A5%E5%BA%B7%E7%8B%80%E6%B3%812015.pdf?y=201506
行政院主計處 (2005)。社會指標統計年報。取自http://ebook.dgbas.gov.tw/public/Data/331311404571.pdf
行政院主計總處 (2016)。國情統計通報。取自http://www.stat.gov.tw/public/Data/4101162931YWQ0W6Y9.pdf
http://www.ndc.gov.tw/en/cp.aspx?n=2E5DCB04C64512CC&s=002ABF0E676F4DB5
行政院主計處 (2016)。民國105年勞動參與率時間數列統計。取自主計處中國華民國統計資訊網：http://www.stat.gov.tw/ct.asp?xItem=37135&ctNode=517&mp=4
行政院衛生署國民健康局 (2001)。國民健康訪問調查。臺北市：作者。
行政院衛生署國民健康局 (2009)。老人健康促進計畫(2009-2012)。取自 http://www.hpa.gov.tw/BHPNet/Portal/File/ThemeDocFile/201110210145126095/980327%E8%80%81%E4%BA%BA%E8%A8%88%E7%95%AB(%E6%A0%B8%E5%AE%9A%E7%89%88).pdf
行政院衛生福利部 (2016)。105年國人死因統計結果。取自http://www.mohw.gov.tw/cp-16-33598-1.html
行政院衛生福利部(2014)。中華民國102年老人狀況調查報告。臺北市：衛生福利部。
行政院衛生福利部中央健康保險署 (2015) 。全民健康保險雙月刊(118)。取自http://www.nhi.gov.tw/epaperN/ItemDetail.aspx?DataID=4327&IsWebData=0&ItemTypeID=3&PapersID=389&PicID=
行政院衛生福利部國民健康署 (2010)。台灣健康體能指引。行政院衛生署國民健康局：邱淑媞。
行政院衛生福利部國民健康署 (2014)。民國一百年台灣地區中老年身心社會生活狀況長期追蹤(第七次)調查成果報告。衛生福利部國民健康署台灣老人研究叢刊系列十二。
沈彥伶 (2009)。休閒涉入、地方依附與忠誠度關係之研究-以寵物犬飼主遛狗之休閒行為模式為例 (未出版碩士論文)。國立雲林科技大學，雲林縣。
吳婉伶 (2012)。遛狗活動參與者涉入程度與休閒效益之研究 (未出版碩士論文)。聖約翰科技大學，新北市。
郭世傑、古博文、周碧瑟 (2014)。中年及老年人閒暇時間身體活動的改變對全因死亡率之影響。大專體育學刊(16) 2，250-260。
高興桂 (2012)。老年人身體活動與醫療看診次數之關係研究。中原體育學報(1)，214-224。
國家發展委員會 (2014）。中華民國人口推計 (103至150年)。取自國家發展委員會http://www.ndc.gov.tw/Content_List.aspx?n=84223C65B6F94D72
葉婷婷、王靜怡、林志峰、陳惠雅 (2010)。台灣老人身體活動能力與日常生活功能之階層相關探討。物理治療 (35)1，1-7。
劉影梅（2004）。國際身體活動量表臺灣中文版之發展與信效度驗證。
劉影梅（2006）。臺灣國際身體活動量表-自填長版使用手冊。臺北：行政院衛生署國民健康局。
羅明葵、徐昌俊 (2010)。以身體活動發展老人健康促進服務。大專體育(111)，69-74。
劉影梅 (2006)。臺灣國際身體活動量表自填長版使用手冊。臺北市：國民健康局。
高齡社會白皮書(2015)。


英文部分：
American College of sports Medicine.(2014). ACSM’s resources for the health fitness specialist (North American ed.).Philadelphia:Lippincott Williams&Wilkins.
Bauer, U. E., Briss, P. A., Goodman, R.A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. Lancet, 384(9937), 45-52. doi: 10.1016/S0140-6736(14)60648-6
Brown, S. G., & Rhodes, R. E. (2006). Relationships among dog ownership and leisure-time walking in Western Canadian adults. Am J Prev Med, 30(2), 131-136.
Brown, W. J., Burton, N. W., Sahlqvist, S., Heesch, K. C., McCarthy, K. B., Ng, N., & van Uffelen, J. G. (2013). Physical activity in three regional communities in Queensland. Aust J Rural Health, 21(2), 112-120. doi: 10.1111/ajr.12015
Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep, 100(2), 126-131.
Centers for Disease Control and Prevention.(2007).The state of aging and health in america 2007. Retrieved 8/20, 2015, from http://www.cdc.gov/aging/pdf/saha_2007.pdf
Cerin, E., Barnett, A., Cheung, M.C., Sit, C. H. P., Macfarlane, D.J., Chan, W. M. (2012). Reliability and validity of the IPAQ-L in a sample of Hong Kong urban older adults: does neighborhood of residence matter? J Aging Phys Act. 20(4), 402-420.
Cerin, E., & Leslie, E. (2008). How socio-economic status contributes to participation in leisure-time physical activity. Social science & medicine, 66(12), 2596-2609.
Cerin, E., Macfarlane, D., Sit, C. H. P., Ho, S. Y., Johnston, J. M., Chou, K. L., ... & Ho, K. S. (2013). Effects of built environment on walking among Hong Kong older adults. Hong Kong medical journal, 19(3), S39-S41.
Cerin, E., Sit, C. H., Barnett, A., Cheung, M. C., & Chan, W. M. (2013). Walking for recreation and perceptions of the neighborhood environment in older Chinese urban dwellers. Journal of urban health, 90(1), 56-66.
Chodzko-Zajko,W.J.,Proctor,D.N.,Fiatarone Singh,M.A.,Minson,C.T.,Nigg,C.R.,Salem,G.J.,et al. (2009). Exercise and physical activity for older adults.Medicine&Science in Sports&Exercise,41,1510-1530.
Christian, H. E., Westgarth, C., Bauman, A., Richards, E. A., Rhodes, R. E., Evenson, K. R., . . . Thorpe, R. J., Jr. (2013). Dog ownership and physical activity: a review of the evidence. J Phys Act Health, 10(5), 750-759.
Coleman, K. J., Rosenberg, D. E., Conway, T. L., Sallis, J. F., Saelens, B. E., Frank, L. D., & Cain, K. (2008). Physical activity, weight status, and neighborhood characteristics of dog walkers. Prev Med, 47(3), 309-312.
Cutt, H., Giles-Corti, B., & Knuiman, M. (2008a). Encouraging physical activity through dog walking: why don't some owners walk with their dog? Prev Med, 46(2), 120-126.
Cutt, H., Giles-Corti, B., Knuiman, M., Timperio, A., & Bull, F. (2008b). Understanding dog owners' increased levels of physical activity: Results from RESIDE. Am J Public Health, 98(1), 66-69. doi: 10.2105/AJPH.2006.103499
Cutt, H., Giles-Corti, B., Knuiman, M., & Burke, V. (2007). Dog ownership, health and physical activity: a critical review of the literature. Health Place, 13(1), 261-272.
Chuang ,S.Y., Chang, H.Y., Lee, M.S., Chia-Yu, Chen. R., &Pan,W.H. (2014).Skeletal muscle mass and risk of death in an elderly population. Nutrition metabolism and cardiovascular diseases 24(7), 784-791.
Dishman, R. K., Heath, G., & Lee, I. M. (2013). Physical Activity Epidemiology (2nd ed.). Champaign, IL: Human Kinetics.
Enmarker, I., Hellzén, O., Ekker, K., & Berg, A. G. (2012). Health in older cat and dog owners: The Nord-Trondelag Health Study (HUNT)-3 study. Scand J Public Health, 40(8), 718-724. doi: 10.1177/1403494812465031
Garcia, D. O., Wertheim, B. C., Manson, J. E., Chlebowski, R. T., Volpe, S. L., Howard, B. V., ... & Thomson, C. A. (2015). Relationships between dog ownership and physical activity in postmenopausal women. Preventive medicine, 70, 33-38.
Gretebeck, K. A., Radius, K., Black, D. R., Gretebeck, R. J., Ziemba, R., & Glickman, L. T. (2013). Dog ownership, functional ability, and walking in community-dwelling older adults. J Phys Act Health, 10(5), 646-655.
Frank, L., Engelke, P., & Schmid, T. (2003). Health and community design: The impact of the built environment on physical activity. Island Press.
Hardman, A. E., & Stensel, D. J. (2009). Physical activity and health: the evidence explained (2nd ed.). New York, NY: Routledge.
Hoerster, K. D., Mayer, J. A., Sallis, J. F., Pizzi, N., Talley, S., Pichon, L. C., & Butler, D. A. (2011). Dog walking: Its association with physical activity guideline adherence and its correlates. Preventive medicine, 52(1), 33-38.
Hsueh, M. C., Liao, Y., Chang, S. H. (2015). Are total and domain-specific sedentary time associated with overweight in older Taiwanese adults? Int J Environ Res Public Health. 12(10), 12697-12705. doi: 10.3390/ijerph121012697
Knight, S., & Edwards, V. (2008). In the company of wolves: the physical, social, and psychological benefits of dog ownership. J Aging Health, 20(4), 437-455. doi: 10.1177/0898264308315875
Laurier, E., Maze, R., & Lundin, J. (2006). Putting the dog back in the park: animal and human mind-in-action. Mind, Culture, and Activity, 13(1), 2-24.
Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The lancet, 380(9838), 219-229.
Lewicka, M. (2005). Ways to make people active: The role of place attachment, cultural capital, and neighborhood ties. Journal of environmental psychology,25(4), 381-395.
Liao, Y., Harada, K., Shibata, A., Ishii, K., Oka, K., Nakamura, Y., ... & Shimomitsu, T. (2012). Association of self-reported physical activity patterns and socio-demographic factors among normal-weight and overweight Japanese men. BMC public
Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C.,...Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc, 39(8), 1435-1445.
Oka, K., & Shibata, A. (2009). Dog ownership and health-related physical activity among Japanese adults. J Phys Act Health, 6(4), 412-418.
Oka, K., & Shibata, A. (2012). Prevalence and correlates of dog walking among Japanese dog owners. J Phys Act Health, 9(6), 786-793.
Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C.,...Ettinger, W. (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA, 273(5), 402-407.
Paterson, D. H., Jones, G. R., & Rice, C. L. (2007). Ageing and physical activity: evidence to develop exercise recommendations for older adults. Applied Physiology, Nutrition, and Metabolism,32(S2E), S69-S108.
Paterson, D. H., & Warburton, D. E. (2010). Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines. Int J Behav Nutr Phys Act, 7, 38. doi: 10.1186/1479-5868-7-38
Peel, E., Douglas, M., Parry, O., & Lawton, J. (2010). Type 2 diabetes and dog walking: patients' longitudinal perspectives about implementing and sustaining physical activity. Br J Gen Pract, 60(577), 570-577. doi: 10.3399/bjgp10X515061
Physical Activity Guidelines Advisory Committee. (2008). Physical Activity Guidelines Advisory Committee Report. Washington, DC: Department of Health and Human Services.
Population Reference Bureau. (2015). 2015 WORLD POPULATION DATA SHEET. Retrieved from http://www.prb.org/pdf15/2015-world-population-data-sheet_eng.pdf
Richards, E. A., Troped, P. J., & Lim, E. (2014). Assessing the intensity of dog walking and impact on overall physical activity: a pilot study using accelerometry. Open Journal of Preventive Medicine, 2014.
Saelens, B. E., Sallis, J. F., & Frank, L. D. (2003). Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures. Annals of behavioral medicine, 25(2), 80-91.
Scheibeck, R., Pallauf, M., Stellwag, C., & Seeberger, S. (2011). Elderly people in many respects benefit from interaction with dogs. Eur J Med Res, 16(12), 557-563.
Shibata, A., Oka, K., Inoue, S., Christian, H., Kitabatake, Y., & Shimomitsu, T. (2012). Physical activity of Japanese older adults who own and walk dogs. Am J Prev Med, 43(4), 429-433.
Soares, J., Epping, J., Owens, C., Brown, D. R., Lankford, T. J., Simoes, E. J., & Caspersen, C. J. (2015). Odds of getting adequate physical activity by dog walking. J Phys Act Health, 12(suppl 1), S102-S109.
Stanley, I. H., Conwell, Y., Bowen, C., & Van Orden, K. A. (2014). Pet ownership may attenuate loneliness among older adult primary care patients who live alone. Aging & mental health, 18(3), 394-399.
Taylor, A. H., Cable, N. T., Faulkner, G., Hillsdon, M., Narici, M., & Van Der Bij, A. K. (2004). Physical activity and older adults: a review of health benefits and the effectiveness of interventions. Journal of sports sciences, 22(8), 703-725.
Thorpe, R. J. Jr., Kreisle, R. A., Glickman, L. T., Simonsick, E. M., Newman, A. B., & Kritchevsky, S. (2006 a). Physical activity and pet ownership in year 3 of the Health ABC study. J Aging Phys Act, 14(2), 154-168.
Thorpe, R. J. Jr., Simonsick, E. M., Brach, J. S., Ayonayon, H., Satterfield, S., Harris, T. B.,...Kritchevsky, S. B. (2006 b). Dog ownership, walking behavior, and maintained mobility in late life. J Am Geriatr Soc, 54(9), 1419-1424.
Toohey, A. M., McCormack, G. R., Doyle-Baker, P. K., Adams, C. L., & Rock, M. J. (2013). Dog-walking and sense of community in neighborhoods: implications for promoting regular physical activity in adults 50 years and older. Health Place, 22, 75-81. doi: 10.1016/j.healthplace.2013.03.007
Tudor-Locke, C., Craig, C. L., Aoyagi, Y., Bell, R. C., Croteau, K. A., De Bourdeaudhuij, I.,...Gardner, A. W. (2011). How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act, 8, 80. doi: 10.1186/1479-5868-8-80
Van Cauwenberg, J., Clarys, P., De Bourdeaudhuij, I., Van Holle, V., Verté, D., De Witte, N., ... & Deforche, B. (2012). Physical environmental factors related to walking and cycling in older adults: the Belgian aging studies. BMC public health, 12(1), 1.
Westgarth, C., Christley, R. M., & Christian, H. E. (2014). How might we increase physical activity through dog walking?: A comprehensive review of dog walking correlates. Int J Behav Nutr Phys Act, 11, 83. doi: 10.1186/1479-5868-11-83
Wood, L., Giles-Corti, B., & Bulsara, M. (2005). The pet connection: pets as a conduit for social capital? Soc Sci Med, 61(6), 1159-1173.
World Health Organization. (2004). WHA: Global Strategy on Diet, Physical Activity and Health, Retrieved from http://www.who.int/gb/ebwha/pdf-files/WHA57//A57-R17-en.pdf.
World Health Organization. (2010). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: Author.
World Health Organization. (2012a). Global Health and Aging. Retrieved 8/20, 2015 from
http://www.who.int/ageing/publications/global_health.pdf
World Health Organization. (2012b). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: Author.
World Health Organization. (2015a). Physical activity. Retrieved 8/20, 2015, from http://www.who.int/topics/physical_activity/en/
World Health Organization. (2015b). Ageing and health. Retrieved from http://www.who.int/mediacentre/factsheets/fs404/en/
World Health Organization. (2015c). Noncommunicable diseases. Retrieved from
http://www.who.int/mediacentre/factsheets/fs355/en/