高齡者參與活躍老化方案之成效探討

Abstract

研究背景與目的： 全世界人口老化日趨嚴重，我國自1993年正式成為高齡化國家，行政院經建會更推估台灣將在2018年邁入「高齡社會」。為落實活躍老化觀念及實踐理念，中華民國老人福利推動聯盟於102年協助督導辦理「樂齡健康活力中心」計畫。本研究即是以102年7月至104年6月參與「台南樂齡健康活力中心」之會員為研究對象，有效樣本159人；主要探討高齡者參與樂齡方案的特質，其次評估高齡者參與樂齡方案後，在健康層面及參與層面之前、後差異，最後分析影響樂齡方案成效之相關因素。 研究方法： 以描述性統計、相依樣本T檢定、卡方檢定以及分層分析進行探討。 研究結果： 1.參與樂齡方案高齡者之特質：平均年齡71.14歲、女性、有偶、與其他人同住、初中(職)或高中(職)畢業、對於經濟狀況感到滿意、自評健康佳、平均罹患疾病數2.08項、無衰弱、認知功能正常、無憂鬱狀況、過去一週做運動的時間達90分鐘以上、體能測試正常、每週1-2次的社會互動頻率、課程參與狀況以低介入程度為主。2.在參與樂齡方案後，身體狀況(老年衰弱、體能測試、運動時間)進步、憂鬱狀況改善、認知功能改善以及社會互動頻率增加，其中30秒椅子坐立與運動時間達到顯著差異(p<0.05)。3.課程介入程度與身體狀況(老年衰弱、體能測試、運動時間)、憂鬱狀況、認知功能及社會互動頻率有顯著相關(p<0.05)，此外，老年衰弱與原始老年衰弱狀況有顯著相關(p<0.05)，憂鬱狀況、認知功能及社會互動頻率則與原始憂鬱狀況達顯著相關(p<0.05)。控制原始老年衰弱狀況、原始憂鬱狀況後，課程介入程度越高，身體狀況(老年衰弱、體能測試、運動時間)、憂鬱狀況、認知功能、社會互動頻率進步程度越高，且達顯著差異(p<0.05)。 結論與建議： 樂齡方案為我國活躍老化方案之推動典範，而初步的分析結果亦顯現此方案之正面成效，若能藉由課程的介入，持續維持高齡者健康並延緩失能時間與程度，可大幅降低老化對我國經濟、社會帶來的負擔。而本計畫由於開辦初期資料收集缺乏系統化以及評估品質尚未完善建立，導致多筆資料建立不完整，可納入之樣本數流失，進而影響實證研究可涉及內容之廣泛性，若可於各面向(軟體、硬體)皆有完善及穩定的基礎後，再進行會員招募，無論於方案成效或是資料庫的建立等，勢必可發揮本計畫的最大效益。建議本研究結果可作為實務實習單位、政府以及民間團體未來制定相關方案與政策時的參考。

The population of elderly increased rapidly around the world. Taiwan has become an aging society in 1993. Council for Economic Planning and Development estimates that Taiwan will become an aged society in 2018. In order to practice the concept of active aging, Federation for the Welfare of the Elderly started a program called “Aging and Healthy Center” since 2013. The study collected participants’ data who attended the program on July 2013 to June 2015 in this program. There were 159 people included in the analysis. Data analysis methods included descriptive statistics, pair t test, Chi-square test and stratified analysis. The purposes of this study are to describe participant’s characteristics, to examine the effectiveness of this active aging intervention program, and to explore related factors that influence the effects of active aging program. The results showed that the characteristics of the participants, including average age 71.14, female, currently married, living with others, junior or high school graduate, satisfied with their economic status, well self-rated health status, suffered from one to several kinds of diseases (average=2.08), non-frail, normal cognitive function, no depression, exercise more than ninety minutes in the past week, normal in physical fitness test, one to two times social interactive per week, and lower degree of class involvement. After attending active aging program, all of the physical conditions (frailty, physical fitness test, frequency of exercise), depressive symptoms, cognitive function and social interactive frequency were improved. There was a significant improvement for chair stand test and frequency of exercise. The result showed a significant difference between class involvement degree and physical conditions (frailty, physical fitness test, frequency of exercise), depressive symptoms, cognitive function, and frequency of social interactive. In addition, there was significant difference between frailty and original frailty status. Depression, cognitive function and social interactive frequency were significant difference with original depression status. After controlling the original frailty status or original depression status, the higher class involvement degree, the more improvement of physical conditions (frailty, physical fitness test, frequency of exercise), depressive symptoms and social interactive frequency. The result of the program showed a positive effectiveness of active aging program. We believe that we can maintain the health of the elderly and delay the time or the degree of disability by using this active aging program. It is a significant way to reduce the burden of aging in our country. Some concrete suggestions are proposed based on the above conclusions as a reference for internships, government, and future researches of making active aging programs and health policies. Multiple data were incomplete and the number of samples were decreased due to the systematic data collection and the quality control of assessment had not well-established at the beginning of the program which affects the quality of research. We should implement the program with a stable and complete foundation to build a complete database to maximize the benefits of this plan.