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題名:運動介入對高齡者身心影響之研究
作者:蘇蕙芬
作者(外文):Huey-Fen Su
校院名稱:國立高雄師範大學
系所名稱:成人教育研究所
指導教授:王政彥
學位類別:博士
出版日期:2013
主題關鍵詞:高齡者運動功能性體適能基本資料庫評估量表elderlyexercisefunctional fitnessMDS
原始連結:連回原系統網址new window
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論文摘要內容:
  高齡化的另一個值得正視的現象之一為老人安養的問題。隨著家庭結構的窄化,愈來愈多的老人必須依靠長期照顧及安養機構的照顧,機構的照護品質關係著住在其中老人的身心健康。因此,針對目前社會發展的趨勢,本研究關注住在長期照顧或安養機構中高齡者的身心健康,希望能提供相關單位在制定高齡者的政策時,能注重運動對高齡者身心的效益,提升高齡者的健康體適能;另一方面,以基本資料庫量表(MDS)評估運動介入的影響,在國內仍屬罕見,希望本研究能提供學術單位參考價值,促進醫療與運動跨領域的結合,為本研究之動機。研究目的:本研究欲探究運動介入對於高齡者身心影響之差異,並深入分析運動介入對不同衰弱程度高齡者身心影響之差異,同時亦探究無運動介入,不同衰弱程度高齡者身心之變化。研究方法:本研究以居住榮民之家之高齡榮民142人,平均年齡84.56歲,皆為男性為研究對象,將其分為實驗組與控制,再依其手握力及走路速度分為衰弱組與非衰弱組,並針對實驗組之受試者施以連續三個月的規律運動介入課程,並於運動介入前後,藉由功能性體適能評估,以及MDS量表,來評估高齡者身心影響之差異;控制組則無進行任何介入活動。資料分析:本研究以SPSS 18.0軟體針對資料進行獨立樣本單因子共變數分析、相依樣本t檢定、獨立樣本t檢定、描述性統計分析,本研究統計分析均採α=.05的顯著水準。研究結果:(一)運動介入可以提升高齡者功能性體適能之表現,並降低心理與社會幸福感之風險;(二)運動介入可以提升衰弱高齡者功能性體適能之表現,並減少心理與社會幸福感以及情緒風險之引發因子數;(三)運動介入可以提升非衰弱高齡者功能性體適能之表現,並降低心理與社會幸福感之風險及減少認知風險之引發因子數;(四)運動介入對不同衰弱程度高齡者影響之差異,在坐椅體前彎測驗及認知風險之引發因子數二項有顯著性差異;(五)無運動介入對非衰弱高齡者之影響較大,在五公尺行走測驗及認知風險之引發因子數的退步幅度皆大於衰弱高齡者。依據上述結果,提出以下結論:(一)不論高齡者衰弱與否,運動介入對其生理及心理層面都有其助益;(二)運動介入對不同衰弱程度高齡者身心之影響程度有差異;(三)非衰弱高齡者若無從事規律運動,身心退化的幅度會大於衰弱高齡者。從本研究結果得知高齡者之身心機能,可因運動介入而改善,亦會因忽視廢用而產生急劇之衰退現象。因此,本研究建議後續研究可以增長研究期程,增加運動介入頻率之外,長期照護機構,應該重視高齡住民從事規律運動的重要性,理當配置長期聘用之運動指導人員,而非短暫之計劃介入,以達到提升體能,健全心智之目標。
Abstract
Introduction: One problem with an aging population is elderly care. As family members decrease, there are more and more senior citizens who need long-term care and healthcare provided by gerontological institute. The physical and mental health condition of senior citizens depends highly on the quality of healthcare provided by the gerontological institute. As a consequence, this study focused on the health condition of senior citizens who were located in long-term care or gerontological institutes. It is suggested that the authorities concerned should address policies that focused on the benefits of exercise for overall health of senior citizens. On the other hand, a research on the impact of exercise intervention using MDS-NH scales retrieving from database remains uncommon. Findings from this study could benefit an interdisciplinary research between medical care and exercise. Purpose: The purposes of this study were to explore the impact of the exercise intervention on the physical and mental health condition of senior citizen; and to investigate the health condition of those who did not take exercise and were in different levels of frailty. Methods: The participants of this study were 142 elder veterans, who were male and had a mean age of 84.56 years old. They were assigned into experimental and control groups. Then, they were also assigned into frailty and non-frailty groups based on their grip strength and walking speed. Following that, an exercise intervention for three months was applied to those in experimental group. Before and after exercise intervention, a test was applied to evaluate the participants’ health condition through functional physical fitness and MDS-NH evaluation scale. Control group did not be treated with any intervention. Data analysis: The data were analyzed with one-way ANCOVA, independent-sample covariance analysis, paired-sample t tests and descriptive statistics from SPSS 18.0. This study significant level were α=.05. Results: (1) the intervention of exercise can significantly improve the functional physical fitness and decrease the psychosocial happiness risk of senior citizens; (2) the exercise intervention can significantly improve the functional physical fitness, and decrease the psychosocial happiness and mode risk triggers of frail senior citizens; (3) the exercise intervention can significantly improve the functional physical fitness, and decrease the psychosocial happiness risk and cognitive risk triggers; (4) the impact of the intervention was significantly moderated by the level of physical frailty in sit and reach test and cognitive risk triggers; (5) the influence of without the exercise intervention on non-frail elderly is more significant than frail elderly on 5-meter walk and cognitive risk triggers. Conclusion: (1) the exercise intervention improve elderly physical and mental health; (2) the effects of exercise intervention are different on different frail levels elderly; (3) without exercise intervention, the non-frail elderly physical and mental health are more significant deterioration than frail elderly. The results showed that the health condition could be improved through exercise intervention. A non-participation in exercise could also lead to their acute health deterioration. This study suggested that future research may examine the effect of the intervention of physical exercise with a longer time period. Beside increasing the intensity of exercise, long-term care or gerontological institutes should employ long-term exercise tutors to arrange long-term and regular exercise plans to increase senior citizen’s physical and psychological well-being.
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