| 摘要: | 台灣已於1993年成為高齡化社會，2018年轉為高齡社會，人口迅速老齡化、社會老年人醫療保健面臨的挑戰，因此除了長期健康護理外，預防健康及次健康老人族群健康行為不當也為重要問題。學者證實缺乏健康識能的人，是健康狀況不佳的高風險人群，健康識能是指「一個人獲得，處理和理解做出適當健康決定所需的基本健康訊息和服務的能力程度」，健康意識低下，不只是健康狀況不佳的高風險人群，也與高昂的醫療成本和費用相關。本研究利用衛福部國民健康署2019年新版長者功能評估量表(Integrated Care for Older People，ICOPE)作為問卷評估工具。選擇的對象為65歲以上老年族群，問卷分三部份，第一部份為知情同意書，第二部份為基本資料、第三部份為長者功能評估量表。其中第三部份長者功能評估量表，進行影響65歲以上老年族群健康識能之認知功能、行動功能、營養不良、視力障礙、聽力障礙、憂鬱、用藥、生活目標問卷評估，採用描述性統計量化研究，並針對認知功能、行動功能、營養不良、視力障礙、聽力障礙、憂鬱、用藥、生活目標及初評後須進行之社會性照護與支持，所衍伸高齡族群需求之各議題網絡(運動、居家安全與防跌、營養、失智及友善環境、慢性病管理、醫療保健、交通、社會參與、福利與補助)使用UCINET進行社會網絡分析。
本研究發現影響高齡族群健康識能相關因子中性別、年齡、族群、教育程度、先前職業、居住狀況、主要照顧者等健康識能現況及差異，皆為健康識能評估重要因子。UCINET進行社會網絡分析各議題中，發現依網絡分析程度中心性，對高齡族群前三重要議題為，居家安全與防跌(知識獲取)、運動議題(資訊來源)、高齡營養(知識獲取)。再者以慢性疾病管理(知識獲取)、醫療保健(尋求協助)、慢性疾病管理(尋求協助)，則較少受關注。另發現現有資源議題網絡及執行組織單位與老人族群實際重視及運用之網絡議題及組織單位不盡相同，期為未來推動相關政策參考依據。
;Taiwan has become an aging society in 1993 and turned into an aging society in 2018. The rapid aging of the population and the challenges facing healthcare for the elderly are present in society. Therefore, in addition to long-term healthcare, the prevention of inappropriate health behaviors in healthy and sub-healthy elderly populations is also an important issue. Scholars have confirmed that people who lack health literacy are at high risk for poor health. Health literacy is defined as "the degree of a person′s ability to acquire, process, and understand basic health information and services needed to make appropriate health decisions", and that low and insufficient health literacy is a high risk for poor health, and is also associated with high healthcare costs and fees. This study utilized the new 2019 version of the Integrated Care for Older People (ICOPE) of the National Health Service of the Ministry of Health and Welfare as a questionnaire assessment tool. The target population was the elderly over 65 years old, and the questionnaire was divided into three parts: the first part was the informed consent form, the second part was the basic information, and the third part was ICOPE. ICOPE is a questionnaire to assess cognitive function, motor function, malnutrition, visual impairment, hearing impairment, depression, medication use, and life goals that affect the health of the elderly aged 65 or above, which is a descriptive statistical quantitative study. Social network analysis was conducted using UCINET to analyze the network of issues (exercise, home safety and fall prevention, nutrition, dementia and friendly environment, chronic disease management, health care, transportation, social participation, and welfare and subsidies) that were derived from the needs of the elderly community in terms of social care and support after the initial assessment.
The study found that gender, age, ethnicity, education level, previous occupation, living status, and primary caregiver were all important factors in assessing the health literacy of the elderly population. The top three issues for the elderly population according to the centrality of the issues analyzed by UCINET were home safety and fall prevention (knowledge acquisition), physical activity, and health. (knowledge acquisition), exercise (information source), and nutrition (knowledge acquisition). Chronic disease management (knowledge acquisition), healthcare (help-seeking), and chronic disease management (help-seeking) received less attention. It is also found that the existing resource issue networks and executive organization units are not the same as those actually valued and utilized by the elderly community, which is expected to serve as a reference for the promotion of related policies in the future. |
