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系統識別號 U0007-2207201108201200
論文名稱(中文) 社區長者跌倒預防知識、信念及行為之研究—以健康信念模式為基礎
論文名稱(英文) The Study of Fall Prevention Knowledge, Belief, & Behavior for Community-Dwelling Elderly—Utilization of the Health Belief Model
校院名稱 臺北醫學大學
系所名稱(中) 護理學研究所
系所名稱(英) Graduate Institute of Nursing
學年度 99
學期 2
出版年 100
研究生(中文) 蕭伃伶
研究生(英文) Yu-Ling Hsiao
學號 D406095002
學位類別 博士
語文別 中文
口試日期 2011-06-22
論文頁數 164頁
口試委員 指導教授-張佳琪
共同指導教授-陳靜敏
委員-郭鐘隆
委員-陳適卿
委員-黃惠璣
中文關鍵字 預防跌倒  社區長者  類所羅門研究設計 
英文關鍵字 Fall prevention  Community-dewelling elderly  Quasi-Solomon research design 
學科別分類
中文摘要 本研究以類所羅門四組實驗研究設計,以健康信念模式為基礎架構,發展「長者跌倒預防行為模式」研究概念模式,介入為期2個月的教育與運動之防跌課程,以探討於社區長者之防跌相關適能和防跌知識、個人信念、行為的成效。
共收案474名社區長者,平均年齡為70.75(SD=7.20)歲,實驗組A(完成前後測)有147人,控制組A(完成前後測)有96人,實驗組B(僅後測)有125人,控制組B(僅後測)為106人,研究工具含基本資料表、簡易身體項目評估表和防跌知識、信念與行為問卷,前測在介入開始的前一週完成,研究介入為2個月內完成12回防跌衛教與運動課程,課程完成後一週進行後測。
結果顯示實驗介入組個案於腰圍(t=-2.07, p=.04)、屈膝起立(t=4.96, p=.000)、上肢柔軟度(χ2=62.86, p=.02)、起身行走(χ2=39.57, p=.000)與平衡(睜眼左足站立χ2=36.35, p=.002)等多項跌倒預防相關適能項目都有顯著改善;於防跌知識(t=4.42, p=.000)、障礙性覺知信念(t=2.21, p=.03)、效能覺知信念(t=2.24, p=.03)、自覺效能(FES)(t=-3.67, p=.000)與採行防跌行為(t=3.48, p=.001)上亦有顯著進步。進一步分析發現防跌行為成效受性別、教育程度、有無配偶、有無工作、有無疾病及有無吸菸等因子之影響。多元回歸分析發現研究的介入是防跌知識、個人信念和防跌行為改善的顯著預測變項,同時,社區長者防跌個人信念愈高者愈能夠採行跌倒預防行為,驗證了以健康信念模式為基礎之「長者跌倒預防行為模式」。本研究結果顯示藉由防跌教育與運動課程之執行,能有效改善社區長者跌倒之危險因素,並加強長者對預防跌倒之認知、信念及行為。期望該介入能有效降低社區長者跌倒事故之發生,進而達到老年健康促進之目標。
英文摘要 The purpose of the study was to examine the effects of fall prevention and exercises programs which were developed based on Health Belief Model on fall-related fitness, fall prevention knowledge, belief and behavior of community-dwelling elders.
A total of 474 community-dwelling elders participated in this quasi- Solomon four group design: experimental group A (with both pre-and post-tests) with 147 , control group A (with both pre-and post-tests) with 96 , experimental group B (post-test only) with 125 persons, and control group B (post-test only) with 106 subjects. The mean age of subjects was 70.75 (SD=7.20).
Measurements included demographic data, physical assessment and questionnaire of fall prevention knowledge, belief, and behavior. Pretest was performed one week before the intervention. The fall prevention and exercises programs contained 12 lecture sessions and 12 exercise sessions within two months. Posttest was carried out one week after the completion of the programs.
The results of this research showed that participants in experimental groups improve significantly on waist circumference (t=-2.07, p=.04), squat down-stand up test (t=4.96, p=.000), upper extremity flexibility (χ2=62.86, p=.02), timed up-and-go test (χ2=39.57, p=.000), and balance (χ2=36.35, p=.002). Those elders also had significantly change on fall prevention knowledge (t=4.42, p=.000), perceived barriers (t=2.21, p=.03), perceived efficacy (t=2.24, p=.03), Falls Efficacy Scale (FES) (t=-3.67, p=.000), and fall prevention behavior (t=3.48, p=.001). Furthermore, the results also showed that the effects of fall prevention behavior were also affected by various factors, including gender, educational background, marital status, occupational status, disease and smoking habits. Participated at the program was a significant predictor of fall prevention knowledge, belief and behavior based on the analyses of multiple regression. The stronger the belief of community-dwelling elderly, the more frequent they adopt fall prevention behavior. Thus, this research demonstrates the behavioral pattern of fall prevention for elders which can be explained by the Health Belief Model.
In conclusion, the implementation of fall prevention and exercises programs can efficiently reduce risk factors of fall among community-dwelling elders and further strengthen their perception, belief and behavior of fall prevention. We anticipate the program can effectively lower the possibility of fall accidence and improve elderly health, therefore, can further reach the goal of health promotion for the elderly.
論文目次 致 謝 ...................II
中文摘要 .................. III
英文摘要 ...................V
目 錄 ...................VII
圖表目次 ...................IX
第一章 緒論
第一節 研究背景.......1
第二節 研究目的.......5
第三節 研究問題.......6
第四節 研究假說.......7
第五節 名詞界定.......8
第二章 文獻查証
第一節 老人跌倒的罹患性..........13
第二節 老人跌倒的嚴重性..........24
第三節 老人跌倒的預防及介入 ......28
第四節 健康信念模式 ............39
第三章 研究方法
第一節 研究架構 .............. 44
第二節 研究設計 ...............52
第三節 研究對象 ...............53
第四節 研究工具 ...............54
第五節 研究步驟 ...............58
第六節 資料分析 ...............66
第四章 研究結果分析
第一節 社區長者人口學變項、身體與行為因素之現況描述................................67
第二節 檢視前測對介入成效的影響...73
第三節 跌倒預防教育與運動課程介入成效......84
第四節 跌倒預防教育與運動課程介入成效之影響因素…101
第五節 社區長者防跌知識、信念與行為之預測因素....123
第六節 健康信念模式之驗證........................130
第五章 討論
第一節 社區長者的跌倒罹患情形....................131
第二節 社區長者防跌教育與運動課程介入成效........132
第三節 社區長者防跌介入成效影響因子..............138
第六章 結論與建議 ............................142
參考資料
中文部份 ........................................146
英文部份 ........................................150
附錄
問卷.....................................163
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