在日常景觀中療癒：農村環境與高齡者活動和健康之關係

Abstract

療癒景觀(therapeutic landscape)是一種個人所認為能提供身心理健康的環境，並被廣泛應用在環境與健康領域。而當今研究與政策上，開始強調易達性高的日常療癒景觀，如公園綠地、社區活動中心等，可透過在日常環境中的活動行為達到促進健康效益。隨高齡化趨勢，因行動能力下降且活動範圍縮減的高齡者，政府以營造日常療育景觀的方式作為提升高齡健康重要策略之一。過去高齡日常療癒景觀研究多位於都市環境，但農村環境具有特殊的人文自然環境，使農村地區高齡者得以產生和都市環境不同的活動行為模式與健康福祉。同時亦有研究指出，不同特性的高齡者會產生不同的景觀偏好與空間行為。綜合上述，本研究欲瞭解農村日常療癒景觀對高齡者活動與健康效益之影響，後續可建置農村社區高齡日常療癒地圖，並作為未來社區規劃建設之參考。研究目的有三：(1) 透過GPS穿戴式裝置，瞭解農村高齡者日常生活之活動熱點、離家距離等空間行為。(2) 藉由活動熱點與高齡者訪談，鑑別農村高齡者日常療癒景觀組成內容及其意涵。(3) 分析農村高齡者在日常療癒景觀的空間行為、身體活動、健康之關係。 環境與行為和健康研究常使用空間行為(spatial behavior)概念，探究人類在不同地理環境下的行為選擇原因與空間移動，同時討論與健康的關係。過去研究多採用問卷訪談，受限於時間與技術，無法了解使用者長期的活動行為。近年的穿戴式裝置可即時收集使用者位置資訊與生理數據。本研究採用蓋德科技900系列老人定位手錶以15分鐘為一單位，收集桃園廣福社區與溪海社區共31位超過65歲的高齡者一週位置資訊、心率與計步。並透過半結構訪談確認高齡日常療癒地點與填寫問卷收集個人特性、生理心理與社會健康等資料。後利用ArcGIS Pro 10.0軟體進行空間分析，以內容分析歸納高齡者日常療癒景觀組成並使用變異數分析、皮爾森相關分析了解變項間的關係。 研究結果顯示農村高齡日常療癒景觀空間行為，平均療癒景觀點位為兩個，日常療癒景觀距離約為1.6公里，其中社區活動中心對農村高齡來說是重要的療癒景觀。而農村高齡日常療癒景觀組成以活動為主，社會、物理為輔，代表高齡重視活動機會，再者發現不同療癒景觀組成會形成不一樣的空間行為。此外，研究發現年齡與教育程度對高齡空間行為存在部分差異，且空間行為、身體活動與健康有部分相關。

Therapeutic landscape is a concept referring to environments that individuals perceive as providing physical and mental health benefits. It is widely applied in the field of environment and health. In current research and policies, there is an increasing emphasis on easily accessible therapeutic landscapes in daily life, such as parks and community centers. People can achieve health benefits by engaging in activities within their everyday environments. However, senior population often experiences reduced mobility and a limited range of activities. Therefore, creating therapeutic landscapes in daily life has become an important strategy for promoting the health of older adults. Previous research on therapeutic landscapes for older adults has predominantly focused on urban environments. However, rural environments possess unique cultural and natural landscapes, as well as different landscape design and transportation convenience compared to urban areas. This allows older adults in rural areas to engage in activity patterns and experience health benefits that differ from those in urban environments. Additionally, studies have indicated that older adults with different characteristics may have distinct landscape preferences and spatial behaviors. Taking these factors into consideration, this study aims to understand the influence of therapeutic landscapes in rural areas on the activities and health benefits of older adults. Subsequently, a rural community therapeutic landscape map can be developed as a reference for future community planning and construction. The study has three objectives: (1) using GPS wearable devices to understand the spatial behaviors of older adults in rural areas, including activity hotspots and distance from home; (2) identifying the components and implications of therapeutic landscapes in daily life for rural older adults through activity hotspots and interviews with older adults; and (3) analyzing the relationships among spatial behaviors, physical activity, and health outcomes of older adults in rural therapeutic landscapes. The field of environmental behavior and health research often employs the concept of spatial behavior to explore the reasons behind human behavioral choices and movements in different geographic environments, as well as their relationship with health. Previous studies have mostly relied on questionnaire interviews, which are limited in their ability to capture long-term activity behaviors. In recent years, wearable devices have enabled real-time collection of user location information and physiological data. In this study, the GAITUO Technology GT900 series elder positioning watches were used to collect one week of location information, heart rate, and step count data from 31 older adults aged over 65 in the Guangfu and Xihai communities of Taoyuan. Semi-structured interviews were conducted to confirm daily therapeutic locations for older adults, and questionnaires were used to collect personal characteristics, physiological and psychological health, and social health data. Spatial analysis was conducted using ArcGIS Pro 10.0 software, and content analysis was used to deduce the components of daily therapeutic landscapes for older adults. Variance analysis, Pearson correlation analysis were employed to understand the relationships among variables. The research results revealed that in rural areas, older adults have an average of two therapeutic landscape hotspots, and the average distance to daily therapeutic landscapes is approximately 1.6 kilometers. Community activity centers are identified as important therapeutic landscapes for older adults in rural areas. The components of rural daily therapeutic landscapes primarily consist of activities, with some social and physical support elements. This indicates that older adults prioritize opportunities for engagement in activities. Furthermore, it was found that different compositions of therapeutic landscapes lead to different spatial behaviors. Additionally, the study discovered that age and education level have some influence on spatial behaviors among older adults. Moreover, spatial behaviors, physical activity, and health outcomes were found to be partially interconnected.