臺灣博碩士論文加值系統

隨著國人的平均餘命的增加，長者的人口數成長快速其比例急遽增加，臺灣人口老化程度嚴重，因此，長者的健康促進為重要的議題。為了能達到成功老化，長者的體能及對老年病症候群的知識成為關鍵要素。本研究針對基隆市社區老人進行增肌減脂課程(參與者54位)及預防骨質疏鬆課程(參與者49位)，探討課程介入前後對長者的影響。本論文藉調查基隆市社區60歲以上長者之骨質疏鬆預防常識及認知，採用簡易的問卷調查以瞭解課前及課後長者對於骨質疏鬆預防常識及認知之差異。
根據增肌減脂課程前後測量比較，沒有發現長者在體能方面有顯著的成長及衰退。對於長者來說，體能沒有衰退即有正面的意義。針對長者進行增肌減脂之體適能課程應該還是值得推行之公衛方案。由於本次課程僅有8堂，建議之後增加課程廣度及深度以做進一步分析。而在本研究發現到參與者8週課程後小腿圍與手臂圍有顯著的減少，值得後續進行更長期的追蹤。
根據預防骨質疏鬆課程前後測量比較研究顯示，經過8堂預防骨質疏鬆課程後，長者們對骨質疏鬆知識衛教知識、預防骨質疏鬆治療藥物及生活習慣的分數皆有顯著提升。倘若能往後能豐富課程的多樣性並提倡適時參與篩檢相信對長者在預防骨質疏鬆症方面能得到更大的效益。

關鍵字: 長者體適能、骨質疏鬆預防、健康促進、健康介入、社區

Due to the rise in life expectancy in Taiwan, the size of elderly population has grown rapidly. Therefore, the health promotion of the elderly to keep their wellbeing is an important issue. In order to achieve successful aging, the elderly’s physical fitness and knowledge of geriatric syndrome have become important. This study aimed to explore the impact of two courses of health promotion on physical fitness and osteoporosis prevention in the elderly people in Keelung. We recruited elderly people aged 60 years and older to take the course of health promotion on physical fitness (n=54) and osteoporosis prevention (n=49), 8 weeks for each. Measures of physical function, muscle, fat, circumferences of waist, arm, and calf, and questionnaire in knowledge of osteoporosis prevention were administered before and after the course. The results show that there was no significant growth or decline in physical fitness of the participants after taking the course of physical fitness. Participants had significantly smaller circumferences of arm and calf. Regarding knowledge of osteoporosis, anti-osteoporosis treatment drugs, and lifestyle habits have been improved after 8-week course classes. In conclusion, we found that the 8-week health promotion course showed no decline in physical fitness, but statistically significantly reduced the circumferences of arm and calf, and enhanced the knowledge in osteoporosis prevention for the elderly people in community.
Keywords: Community, Geriatric syndrome, Health Promotion, Health Intervention, Osteoporosis, Physical fitness.

中文摘要 iii
Abstract iv
目 錄 v
第壹章 導論 1
第一節 實習單位特色與簡介 1
第二節 研究問題與研究目的 2
第三節 研究架構與假設 7
第四節 文獻回顧 8
第貳章 方法 15
第一節 增肌減脂課程 15
第二節 預防骨質疏鬆課程 45
第三節 統計分析 51
第參章 結果 52
第一節 增肌減脂課程 52
第二節 預防骨質疏鬆課程 55
第四章 討論與結論 62
附錄一 增肌減脂運動班 – 健康狀況聲明書 69
附錄二 增肌減脂班醫學常識測量表 71
附錄三 骨質風險評估表(前測) 73
附錄四 骨質風險評估表(後測) 75

 
表目錄
表 1. 整合性與預防及延緩失能計劃增肌減脂課程梯次、上課地點及日期 16
表 2. 整合性與預防及延緩失能計劃增肌減脂課程量測方式及量測工具 17
表3. 增肌減脂課程之課程表 20
表 4. 整合性與預防及延緩失能計劃預防骨質疏鬆課程梯次、上課地點及日期 45
表 5. 預防骨質疏鬆課程表 48
表 6. 增肌減脂課程之課程參與長者人口學特質 52
表 7. 增肌減脂課程之課程參與長者同質性檢定 53
表 8. 增肌減脂課程後身體檢測、肌肉力量及三圍測量之前後測分析表 53
表 9. 預防骨質疏鬆課程之課程參與長者人口學特質 56
表 10. 預防骨質疏鬆課程之課程參與長者健康行為特質 58
表 11. 預防骨質疏鬆課程之長者骨質疏鬆知識前後測分析表 60

圖目錄
圖 1. 長者常見的前五項慢性疾病 3
圖 2. 研究架構圖 7
圖 3. 增肌減脂課程研究方法流程圖 19
圖 4. 預防骨質疏鬆課程研究方法流程圖 47

圖 2.1.4- 1. 上肢肌肉適能 - 直臂繞圈 23
圖 2.1.4- 2. 上肢肌肉適能 - 搭肩繞圈 24
圖 2.1.4- 3. 上肢肌肉適能 - 直臂旋肩 25
圖 2.1.4- 4. 上肢肌肉適能 - 握拳張掌 26
圖 2.1.4- 5. 上肢肌肉適能 - W 夾肩胛 27
圖 2.1.4- 6. 上肢肌肉適能 - 合掌夾胸 28
圖 2.1.4- 7. 上肢肌肉適能 - 合掌前劈 29
圖 2.1.4- 8. 上肢肌肉適能 - 合掌移動 30
圖 2.1.4- 9. 上肢肌肉適能 - 手肘夾球 31
圖 2.1.4- 10. 上肢肌肉適能 - 二頭夾球 32
圖 2.1.4- 11. 上肢肌肉適能 - 舉彎夾球 33
圖 2.1.4- 12. 下肢肌肉適能 - 側抬腿 34
圖 2.1.4- 13. 下肢肌肉適能 - 墊腳跟 35
圖 2.1.4- 14. 下肢肌肉適能 - 勾腳尖 36
圖 2.1.4- 15. 下肢肌肉適能 - 膝關節放鬆 37
圖 2.1.4- 16. 下肢肌肉適能 - 腳踝屈伸 38
圖 2.1.4- 17. 下肢肌肉適能 - 直膝抬腿 39
圖 2.1.4- 18. 下肢肌肉適能 - 直膝繞圈 40
圖 2.1.4- 19. 下肢肌肉適能 - 屈膝捲腹 41
圖 2.1.4- 20. 下肢肌肉適能 - 相撲蹲 42
圖 2.1.4- 21. 下肢肌肉適能 - 矢狀面伸展 43
圖 2.1.4- 22. 下肢肌肉適能 - 膝蓋夾球 44

圖 2.2.4- 1. 預防骨質疏鬆課程實際上課情形 49
圖 2.2.4- 2. 預防骨質疏鬆課程實際上課情形 49
圖 2.2.4- 3. 預防骨質疏鬆課程實際上課情形 50
圖 2.2.4- 4. 預防骨質疏鬆課程實際上課情形 50

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