健走運動與社會心理介入對退休中老年人心理幸福感與生命統整性之影響與性別差異

Abstract

健走運動與社會心理介入對退休中老年人心理幸福感與生命統整性之影響與性別差異 台灣地區65 歲以上的老年人口比例快數增加，其中有相當比例的老人沒有規律 的運動；身體沒有保持規律活動是與嚴重疾病的發生機率有關連，例如心血管疾病、 癌症與糖尿病，特別是在老年人族群；除此之外研究顯示規律的身體運動是可以促進 老人執行日常生活的功能。 本研究為整合型計畫「健走運動對於促進中老年人健康的影響」之子計畫4。本 子計畫是針對健走運動與社會心理介入對於身體活動量、生命統整性與幸福感之實驗 研究，並探討其性別差異；第一年研究目的包括:(1)建構具有信效度的評量工具。(2) 探討台灣地區退休中老年人健走運動、身體活動量、生命統整性與幸福感的現況。(3) 探討台灣地區退休中老年人之健走行為、身體活動量、生命統整性與幸福感的性別差 異。(4)探討台灣地區退休中老年人對於實行健走行為與社會參與的障礙因素與需求， 這些障礙因素與需求是否有性別不平等之處。 第二年是探討介入成效，包括(5)相較於沒有規律運動組，有規律健走行為組，能 提昇其身體活動量、生命統整性與幸福感。(6)相較於沒有規律運動組，有規律健走行 為與社會心理介入組，能提昇其身體活動量、生命統整性與幸福感。(7)探討有規律健 走行為組、有規律健走行為與社會參與組，其對身體活動量、生命統整性與幸福感介 入效果的影響是否有性別差異。 本研究步驟是先蒐集在運動（健走）、健康（平均餘命）、生命統整性、與幸福感 等相關測量與性別差異相關文獻，並增加實施健走的障礙因素之題項，再邀請專家就 華人文化與台灣人運動習慣，修正不適合的測量（專家效度與內容效度）。之後在大 台北健康社區以方便取樣方式選取250 位以上的中老年人，以橫斷式研究調查，並建 構測量工具的信度（內部一致性信度與綜合信度）、效度（建構效度）；以及分析研究 對象在生命統整性、心理幸福感與性別在中老年人實行健走行為的關係，以及分析造 成個人從事健走運動的社會心理障礙因素為何。 第一年後段與第二年是進行介入實驗，預計收180 位中老年人，分成三組，每組 60 人。依據第一年調查研究結果，一方面依據中老年人需求加強社會心理及健走運動 介入課程設計，課程介入時程預計為至少12 週；另一方面是到社區尋求參與對象， 以及簽署同意書。在主持人前往社區進行研究同意書前，本研究將向人體試驗委員會 提出IRB 審查，通過後才執行研究。

Gender differences and influence of walking exercise and a psychosocial intervention on psychological well-being and sense of coherence amongst retried senior citizens The population of adults over the age of 65 is rapidly growing in Taiwan. A large percentage of this population is not regularly involved in physical activity. Physical inactivity is associated with an increased risk of developing serious health problems such as cardiovascular diseases, cancer and diabetes. This is especially relevant for the elderly. Furthermore, it has been shown that regular physical activity improves older adults' ability to perform their daily activities. This is project 4 of integrated proposal of walking exercise on promoting health of senior citizens. This project aims at evaluating the influences of walking exercise and a psychosocial intervention on physical activity, psychological well-being and sense of coherence and examining its gender differences. The objectives of 1st year are (1) establish reliable and valid measurement tools; (2)investigate current situations of walking exercise, physical activity, sense of coherence, and psychological well-being; (3)examine the gender differences of walking exercise, physical activity, sense of coherence, and psychological well-being;(4)probe reasons of not practicing exercise among senior citizens and its gender inequity. The 2nd year objectives focus on effectiveness of intervention; (5) compared to irregular walking exercise group, regular exercise group show higher physical activity, sense of coherence, and psychological well-being. (6) compared to irregular walking exercise group, regular exercise with psycho-social intervention group show higher physical activity, sense of coherence, and psychological well-being. (7) examine gender differences between irregular exercise group, regular exercise group, and regular exercise with psychosocial treatment groups. The first study procedure is to collect literature and synthesize reasons of not exercising among senior citizens. Based on literature, measurement items will be collected, checked and revised by professors in Taiwan (content validity). The questionnaires will then be distributed to 250 senior citizens in City of Taipei. Data will be used to establish internal and composite reliability, and construct validity. Data will also be used to investigate current situations and correlations of walking exercise, physical activity, sense of coherence, and psychological well-being; and barriers of physical activity. The second part of this project will conduct a quasi-experiment on 180 senior citizens who divided into three groups. Based on results from cross-sectional survey, interventions regarding walking exercise and psychosocial intervention will be revised to meet needs of senior citizens. The intervention will last 12 weeks. Participants will be recruited from locals after giving study purposes and participants will be asked to sign informed consents. This project will obtain approval from Institute Human Subject Committee before recruiting participants.