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題名:建成環境與高齡者身體活動及憂鬱症狀之關聯研究
作者:黃暖晴
作者(外文):Nuan-ChingHuang
校院名稱:國立成功大學
系所名稱:都市計劃學系
指導教授:孔憲法
胡淑貞
學位類別:博士
出版日期:2018
主題關鍵詞:建成環境都市化高齡者身體活動憂鬱症狀多層次分析Built EnvironmentUrbanizationOlder AdultsPhysical ActivityDepressive SymptomsMultilevel Analysis
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世界衛生組織(WHO)於2002年提出「活躍老化」的概念,並於2007年提出「高齡友善城市指引」,採正向積極的方式來協助建構適合老年人生活的環境,以達到追求活躍老化的目標。其中,建成環境與人類行為的研究發展已久,其主要目的是在提升生活品質、改善系統效率或降低環境衝擊。近年來,建成環境對健康的影響逐漸受到重視。面對高齡化社會的來臨,建成環境與高齡者健康之相關研究也顯著受到重視。然而,台灣在這方面的研究極少。
為瞭解台灣地區建成環境與高齡者健康之關係,本研究提出四項研究議題:1.鄉鎮市區之都市化程度分析。2.建成環境與都市化及高齡化之現況檢視。3.建成環境與高齡者身體活動之關聯探討。4.建成環境與高齡者憂鬱症狀之關聯探討。研究方法分成三個階段:首先,透過2010年住宅及人口普查資料,以集群分析法進行鄉鎮市區都市化程度之分析。再透過2006年國土利用調查,以GIS疊圖分析來獲得各鄉鎮市區之建成環境資料。最後,再進一步將鄉鎮市區之都市化程度、建成環境與國民健康訪問調查資料進行串聯,以探討建成環境與高齡者身體活動及憂鬱症狀之關聯。分析方法,除了描述性分析及雙變數分析外,主要使用階層線性迴歸模型(HLM)進行多層次資料分析。
本研究中之鄉鎮市區都市化程度共分成五個層級。整體而言,公共設施用地人均面積在城鄉及高齡化地區間有顯著差異,而遊憩用地在城鄉及高齡化地區間則無顯著差異。在建成環境與高齡者身體活動間的關聯部分,區位層級之建成環境與有無運動無顯著關聯,但與身體活動是否達建議量則有顯著關聯,尤其是公園綠地廣場是與其相關的。然而進一步控制個人層級變項後,則無顯著關係出現。在建成環境與高齡者憂鬱症狀之關聯部分,學校及醫療保健人均面積較高的地區,高齡者的憂鬱症狀分數顯著較低。若是以有無憂鬱症來分析,則文化設施、遊樂場所及體育場所人均面積較高地區,其高齡者顯著地有較高的憂鬱症。
WHO proposed the concept of active aging in 2002 and introduced a guidebook for an age-friendly city in 2007. This provides a positive approach to help construct a suitable living environment for the elderly, in order to achieve the goal of active aging. However, there is limited research in Taiwan. Hence, this study proposes four research topics: (1) to analyze the urbanization level of townships in Taiwan. (2) to illustrate the status of built environment relating to the urbanization and aging status. (3) to examine the relationship between built environment and physical activity among older adults. (4) to compare the impact of built environment on depressive symptoms among older adults.
This study merged urbanization level of townships, built environment and 2009 National Health Investigation Survey (NHIS) database to analyze the relationship between built environment and physical activity and depressive symptoms in older adults. Statistical methods for this research included descriptive analysis, bivariate analysis, and multi-level analysis, mostly hierarchical linear model.
The analysis identified townships into five urbanization levels. When measuring physical activity as achieving recommended amount, built environment “park, green space” was significantly related to physical activity in older adults. However, after controlling for the risk factors of individual level, this relationships showed no difference in any urbanization level. As to depressive symptoms, school and medical land use per capita area were significantly related to CESD scores. When CESD scores were divided into yes/no type, “culture facility”, “entertainment place” and “stadium” were significantly associated with the depressive symptoms of older adults.
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