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

10.6317/LTC.201810_22(2).0003

陳怡安(Yi-An Chen)；游曉微(Hsiao-Wei Yu)；朱德華(Teh-Hua Chu)；陳雅美(Ya-Mei Chen)

社區老人 ； 預防失能照護模組 ； 體適能 ； 生活品質 ； 運動自我效能 ； Community-dwelling older adults ； Disability prevention program ； Physical fitness ； Quality of life ； Exercise self-efficacy

長期照護雜誌

22卷2期（2018 / 10 / 01）

119 - 134

繁體中文

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.

1. Bandura, A.(1997).Self-efficacy: The exercise of control.New York:W. H. Freeman.
2. Bowling, A.,Hankins, M.,Windle, G.,Bilotta, C.,Grant, R.(2013).A short measure of quality of life in older age: The performance of the brief Older People's Quality of Life questionnaire (OPQOL-brief).Archives of Gerontology and Geriatrics,56(1),181-187.
3. Cao, Z. B.,Maeda, A.,Shima, N.,Kurata, H.,Nishizono, H.(2007).The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women.Journal of Physiological Anthropology,26(3),325-332.
4. Cozby, P.,Bates, S.(2011).Methods in behavioral research.New York:McGraw-Hill Education.
5. Cress, M. E.,Buchner, D. M.,Questad, K. A.,Esselman, P. C.,deLateur, B. J.,Schwartz, R. S.(1999).Exercise: Effects on physical functional performance in independent older adults.Journal of Gerontology,54(5),M242-M248.
6. Desharnais, R.,Bouillon, J.,Godin, G.(1986).Self-efficacy and outcome expectations as determinants of exercise adherence.Psychological Reports,59(3),1155-1159.
7. Dohrn, I. M.,Hagstromer, M.,Hellenius, M. L.,Stahle, A.(2017).Short- and long-term effects of balance training on physical activity in older adults with osteoporosis: A randomized controlled trial.Journal of Geriatric Physical Therapy,40(2),102-111.
8. European Commission. (2011). European innovation partnership on active and healthy ageing: A3. Prevention of functional decline and frailty. Retrieved from https://ec.europa.eu/eip/ageing/actiongroup/index/a3_en
9. Eyigor, S.,Karapolat, H.,Durmaz, B.(2007).Effects of a group-based exercise program on the physical performance, muscle strength and quality of life in older women.Archives of Gerontology and Geriatrics,45(3),259-271.
10. Gill, D. L.,Hammond, C. C.,Reifsteck, E. J.,Jehu, C. M.,Williams, R. A.,Adams, M. M.,Shang, Y. T.(2013).Physical activity and quality of life.Journal of Preventive Medicine & Public Health,46,S28-S34.
11. Gillespie, L. D.,Robertson, M. C.,Gillespie, W. J.,Sherrington, C.,Gates, S.,Clemson, L. M.,Lamb, S. E.(2012).Interventions for preventing falls in older people living in the community.The Cochrane Database of Systematic Reviews,9,CD007146.
12. Gillison, F. B.,Skevington, S. M.,Sato, A.,Standage, M.,Evangelidou, S.(2009).The effects of exercise interventions on quality of life in clinical and healthy populations: A meta-analysis.Social Science & Medicine,68(9),1700-1710.
13. Kanemaru, A.,Arahata, K.,Ohta, T.,Katoh, T.,Tobimatsu, H.,Horiuchi, T.(2010).The efficacy of home-based muscle training for the elderly osteoporotic women: The effects of daily muscle training on quality of life (QoL).Archives of Gerontology and Geriatrics,51(2),169-172.
14. Lee, L. L.,Arthur, A.,Avis, M.(2007).Evaluating a community-based walking intervention for hypertensive older people in Taiwan: A randomized controlled trial.Preventive Medicine,44(2),160-166.
15. Mangione, K. K.,Miller, A. H.,Naughton, I. V.(2010).Cochrane review: Improving physical function and performance with progressive resistance strength training in older adults.Physical Therapy,90(12),1711-1715.
16. McAuley, E.,Jerome, G. J.,Elavsky, S.,Marquez, D. X.,Ramsey, S. N.(2003).Predicting long-term maintenance of physical activity in older adults.Preventive Medicine,37(2),110-118.
17. McAuley, E.,Lox, C.,Duncan, T. E.(1993).Long-term maintenance of exercise, self-efficacy, and physiological change in older adults.Journal of Gerontology,48(4),218-224.
18. Mielenz, T. J.,Kubiak-Rizzone, K. L.,Alvarez, K. J.,Hlavacek, P. R.,Freburger, J. K.,Giuliani, C.,Callahan, L. F.(2013).Association of self-efficacy and outcome expectations with physical activity in adults with arthritis.Arthritis,2013,621396.
19. 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.International Journal of Behavioral Nutrition and Physical Activity,7,38.
20. Resnick, B.(1998).Efficacy beliefs in geriatric rehabilitation.Journal of Gerontological Nursing,24(7),34-44.
21. Resnick, B.,Palmer, M. H.,Jenkins, L. S.,Spellbring, A. M.(2000).Path analysis of efficacy expectations and exercise behaviour in older adults.Journal of Advanced Nursing,31(6),1309-1315.
22. Rubenstein, L. Z.,Josephson, K. R.,Trueblood, P. R.,Loy, S.,Harker, J. O.,Pietruszka, F. M.,Robbins, A. S.(2000).Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men.Journal of Gerontology,55A(6),M317-M321.
23. Suzuki, T.,Kim, H.,Yoshida, H.,Ishizaki, T.(2004).Randomized controlled trial of exercise intervention for the prevention of falls in community-dwelling elderly Japanese women.Journal of Bone and Mineral Metabolism,22,602-611.
24. Tamari, K.(2010).Baseline comorbidity associated with the short-term effects of exercise intervention on quality of life in the Japanese older population: An observational study.Archives of Physical Medicine and Rehabilitation,91(9),1363-1369.
25. Tomioka, M.,Sugihara, N.,Braun, K. L.(2012).Replicating the EnhanceFitness physical activity program in Hawai`i's multicultural population, 2007-2010.Preventing Chronic Disease,9,E74.
26. Wallace, J. I.,Buchner, D. M.,Grothaus, L.,Leveille, S.,Tyll, L.,LaCroix, A. Z.,Wagner, E. H.(1998).Implementation and effectiveness of a community-based health promotion program for older adults.Journal of Gerontology,53A(4),M301-M306.
27. Waters, L.,Reeves, M.,Fjeldsoe, B.,Eakin, E.(2012).Control group improvements in physical activity intervention trials and possible explanatory factors: A systematic review.Journal of Physical Activity and Health,9(6),884-895.
28. World Health Organization(2015).World report on ageing and health.
29. 內政部統計處（2017）。內政部統計月報。取自http://sowf.moi.gov.tw/stat/month/list.htm
30. 行政院經濟建設委員會(2012).中華民國 2012年至 2060 年人口推計.臺北:作者.
31. 南投縣基督教青年會（2015）。老人福利服務。取自 http://www.nantou-ymca.org.tw/index.php
32. 衛生福利部（2017）。預防及延緩失能照護計畫。取自 http://www.mohw.gov.tw/CHT/DONAHC/Index.aspx
33. 衛生福利部（2016）。長期照顧十年計畫 2.0（核定本）。取自 http://www.mohw.gov.tw/CHT/LTC/Index.aspx

1. 劉紋妙,黃心樹,張籃茵,徐永年(2020)。下肢運動改善中高齡者的功能性體適能、基本生理指標、運動自我效能、睡眠品質及心理健康。護理雜誌，67(2)，33-44。