近年來，由於社會快速的高齡化，老人健康問題日益突顯，尤其老年人跌倒後所發生的後遺症，更是國內外老人學研究中很受矚目的焦點，但目前國內甚少對於此議題作介入方面之研究，故本研究欲探討國外行之有年的預防跌倒介入策略是否能適用於國內老人，研究內容針對台北地區城市25位老人與鄉村16位老人進行一週之教育課程及五週之運動課程，並於介入前後測量其自變項「社會人口學特徵變項」、中介變項「運動行為社會支持體系、預防跌倒知識、預防跌倒健康信念、預防跌倒自我效能、預防跌倒運動」以及依變項「預防跌倒行為、身體功能」，以瞭解本研究之介入效果，並可做為日後研究之參考，其結果可歸納如下：

一、研究對象之居住地不同、教育程度不同、過去一年是否曾跌倒、過去一年是否因跌倒而受傷，對其「預防跌倒知識」有顯著影響；研究對象之視物清楚度不同，對其「預防跌倒運動」有顯著影響。
二、研究對象之使用手杖與否，將顯著影響其「預防跌倒行為」；年齡不同、使用手杖與否，將顯著影響其「身體功能」。
三、對城市組與鄉村組之老人而言，教育介入對其「預防跌倒知識」皆有顯著效果，對城市組老人「預防跌倒健康信念」有顯著效果。
四、鄉村組老人於介入後其「身體功能」有顯著效果，但城市組則無。
五、針對中介變項對依變項之預測力分析，結果顯示：「預防跌倒自我效能」能顯著影響「預防跌倒行為」；而五個中介變項皆不是影響「身體功能」的重要因素。

雖然台灣城鄉老人由於教育程度的差異而導致預防跌倒知識之介入效果受到影響，但兩組仍有顯著進步。研究推論：除了台灣城市老人之預防跌倒健康信念有顯著介入效果之外，大體上城鄉老人之其他變項介入效果類似，也就是說台灣城市與鄉村之老人兩組之預防跌倒有相似的效果。

Since the greatly increase of the population of the elders recently, the importance of the elderly health is getting more evident. The elderly falls and the subsequent sequelae have been the main subject of the gerontics for years in the world. However, the intervention event has not been widely studied in Taiwan. The lack of the intervention for the elderly falls in Taiwan motivates us to propose this study. The intervention has been applied to a sample of 41 elders in Taipei county, 25 urban elders and 16 rural elders, with 1 week class study and 5 weeks exercise in order to quantitatively study the effects of one independent variable (social demographic factors), five mediator variables (social support system of the exercise behavior, knowledge of the fall prevention, health belief of the fall prevention, self-efficacy of the fall prevention, and exercise of the fall prevention), and two dependent variables (behavior of the fall prevention and physical function) . This intervention is a precursor of the fall prevention for elders and coordinates the future study on this field. The questionnaire measurements are performed before and after the intervention. The mains results are summarized as follows.

1. According to the differences of the habitation, education level, experience of the falls in the past one year, and possibility of the injury due to falls, the influence of the knowledge of the fall prevention turns out to be significant. The eye-sight of the subjects strongly influences the exercise of the fall prevention.
2. The usage of the walking assistant strongly influences the behavior of the fall prevention. The age and the usage of the walking assistant are important factors for the physical function; the effect is significant.
3. The effect of the intervention to the knowledge of the fall prevention is significant to the urban and rural subjects. The health belief of the fall prevention is greatly improved only in the urban subjects.
4. The intervention of the physical function has been significantly improved in the rural subjects; no trend has been found in urban subjects.
5. The effect of the intervention to the outcome measures (two dependent variables) is quantified according to the mediator variables. This study infers that (a) the self-efficacy of the fall prevention strongly influences the behavior of the fall prevention and (b) five mediator variables are not important factors to affect the physical function.

Though the intervention to the knowledge of the fall prevention has been disturbed by the difference of the education level between urban and rural elders, the improvement of the fall prevention for urban and rural elders has been significant. An important result of our research on the intervention to the fall prevention is that the fall prevention is influenced only by the health belief. In short, independent variables other than the health belief have similar intervention effects between the urban and rural elders in Taiwan.

中文部分

內政部（2002）：臺閩地區人口統計。內政部。
內政部（2003）：臺閩地區人口統計。內政部。
王瑞霞、邱啟潤（1996）：老年人體能活動參與及其相關因素的探討。高雄醫學科學雜誌，12（6），348-358。
王文科（2001）：教育研究法。台北：五南圖書出版有限公司。
方進隆（1991）：養成規律運動習慣的行為改變法。中華體育，5（1），9-15。
行政院衛生署（1997）：衛生白皮書—跨世紀衛生建設。行政院衛生署。
行政院經濟建設委員會人力規劃處（2002）：中華民國臺灣地區民國91年至140年人口推計。行政院經濟建設委員會。
呂志尚（1996）：以行銷策略模式來推廣社區太極拳運動。國民體育季刊，25（1），124-132。
吳淑瓊（1993）：老人長期照護研究。行政院衛生署。計畫編號：DOH82-TD-086。
李惠蘭（1999）：鄉村老年人太極拳運動教導的身心健康評估。長庚大學護理學研究所碩士論文。
邱淑媞、王榮德（1994）：您可以拒絕的遺憾-談老人意外事故之現況與預防。健康世界，108（228），28-34。
邱淑媞、曹昭懿、王榮德（1993）：1974-90年間臺灣地區老年人口意外災害死亡率及潛在生命損失之分析。中華衛誌，12（4），405-420。
林玉子著，曾思瑜譯（1997）：經營一輩子的家。胡氏圖書出版社。
林世昌（2000）：不同太極拳齡中老年人健康狀況比較研究。國立臺灣師範大學體育系研究所碩士論文。
林玲雯（2001）：鄉村社區鄰里人力互助健康照顧制度之行動研究—以台北縣雙溪鄉中老年人為對象。國立臺灣師範大學衛生教育研究所碩士論文。
林佩欣、曾旭民、鄭寶釵、黃美涓、鄭復旦（1999）：太極拳對老年人感覺運動功能的影響。中華物療誌，24（4），231-241。
卓俊辰（1994）：增進健康體適能的運動方法。取自提升學生體能專案報告書附錄三：體育教師體能教育研習手冊。國立臺灣師範大學體育研究與發展中心。
高迪理（1991）：社會支持體系中之概念探討。社區發展，54，24-32。
徐亞瑛、蔡文哲譯（1994）：老年護理學。台北：華杏出版社。
徐慧娟（1994）：跌倒對老人生活健康品質的影響。國立臺灣大學公共衛生研究所碩士論文。
陳嘉基（1998）：高齡者意外跌倒構成因素分析與防滑材料探討。長期照護，2（2），48-65。
陳嘉基、張嘉祥（1996）：建築空間地坪滑倒意外研究—意外事故、墬落與跌倒死亡率之統計分析。第九屆建築研究成果發表會論文集，逢甲大學，361-364。
陳淑惠（1998）：老人需求問題面面觀-夕陽無限好，祇是近黃昏！。現代保險，119，20-23。
陳清惠、歐嘉美、李選譯（1990）：老年護理學。台北：華杏出版股份有限公司。
陳茂柏（1991）：台灣地區高齡者在住宅中之居住行為調查研究～以南部地區為例。成大建研所碩士論文。
張哲誌、周騰達（1994）：老人跌倒的預防（上）。基層醫學，9（9），170-174。
張淑紅、黃璉華、李源德（1996）：個別衛生教育介入對高脂血個案知識、健康信念、自我效能、行為的影響。中華公共衛生雜誌，15（3），188-196。
黃子庭、廖秀珠（1993）：臺北市北投區社區居家老人跌倒的情形及其相關因素之探討。公共衛生，20（3），234-246。
黃春太（1999）：城鄉地區老人的社會支持體系及健康狀況之比較研究。國立臺灣師範大學衛生教育學系碩士論文。
許毅貞（1993）：鹿港地區65至74歲社區老人之老人態度、社會支持、健康狀態與憂鬱程度之關係研究。國立臺灣師範大學衛生教育研究所碩士論文。
郭有華（1996）：從老年人下肢運動能力的衰退看健身運動功能作用初探。天津體院學報，19（4），37。
蔡碧女、陳定雄（2001）：運動與老化之防止。國立臺灣體育學院學報第八期，137-157。
鄭惠美（2001）：應用自我導向學習策略培養社區志工--以臺北縣雙溪鄉社區健康營造中心為例。護理雜誌，48（1），43-48。
蕭冰如（1998）：社區老年人健康促進衛生教育介入之探討。私立長庚大學護理學研究所碩士論文。
雙溪鄉公所（2000）：雙溪之美。台北縣雙溪鄉公所發行。

英文部分

Abreu, N., Hutchins, J., Maston, J., Polizzi, N., & Seymour, C.J. (1998). Effect of group versus home visit safety education and prevention strategies for falling in community-dwelling elderly persons. Home Health Care Management & Practice, 10(4), 57-63.
Alexander, N.B., Edelberg, H.K. (2002). Assessing mobility and preventing falls in older patients. Patient Care, 2,18-29.
American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention (2001): Guideline for the prevention of falls in older persons. J. Am. Geriatr. Soc., 49, 664-672.
Aniansson, A., Zetterberg, C., Hedberg, M., Henrilsson, K.G. (1984). Imparied muscle function with aging. Clin. Orthop., 191, 193-201.
Arfken, C.L., Lach H.W., Birge S.J., & Miller, J.P. (1994). The Prevalence and Correlates of Fear of Falling in Elderly Persons Living in the Community. American Journal of Public Health, 84(4), 565-570.
Bandura, A. (1986). Social foundations of thought and action, New Jersey: Prentice Hall.
Bandura, A. (1997). Self-efficacy: the exercise of control. New York: Freeman.
Brown, A.P. (1999). Reducing falls in elderly people: A review of exercise interventions. Physiotherapy Theory and Practice, 15, 59-68.
Buchner, D.M., Cress, M.E., de Lateur, B.J., et al. (1997). The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J. Gerontol. A Biol. Sci. Med. Sci., 52, M218-225.
Butler, N.R., Tideiksaar, R. (1989). Falling in old age: Its prevention and treatment ,22. Springer, New York.
Campbell, A.J., Robertson, M.C., Gardner, M.M., Norton, R.N., Tilyard, M.W., Buchner, D.M. (1997). Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. British Medical Journal, 315, 1065-1068.
Christmas, C., Andersen, R.A. (2000). Exercise and older patients. guidelines for clinicians. J. Am. Geriatr. Soc., 48, 318-324.
Choi, N.G. & Wodarski, J.S. (1996). The relationship between social support and health status of elderly people: does social support slow down physical and functional deterioration? Social Work Research, 20(1), 52-64.
Commodore, D.I. (1995). Falls in the elderly population: a Look at incidence, risks, healthcare costs, and preventive strategies. Rehabilitation Nursing, 2(20), 84-89.
Czaja, S.J., Hammond, K., & Drury, C.C. (1984). A major research project about accidents and aging (executive summary). BOSTI, Buffalo, N.Y.
Deery, H.A., Day, L.M., Fildes, B.N. (2000). An impact evaluation of a falls prevention program among older people. Accident Analysis and Prevention, 32, 427-433.
Dunn, J.E., Rudberg, M.A., Furner, S.E., Cassel, C.K. (1992). Mortality, disability, and falls in older persons: the role of underlying disease and disability. Am. J. Public Health, 82, 395-400.
Duncan, P.W., Weiner, D.K., Chadler, J., & Studenski, S. (1990). Functional reach: a new clinical measure of balance. Journal of Gerontology: Medical Sciences, 45(6), M192-M197.
Era, P., Heikkinen, E. (1985). Postural sway during standing and unexpected disturbance of balance in random samples of men of different ages. J. Gerontol., 40, 287-295.
Evans, W.J. (1999): Exercise training guidelines for the elderly. Med. Sci. Sports Exerc., 31, 12-17.
Feder, G., Cryer, C., Donovan, S., Carter, Y. (2000). Guidelines for the prevention of in people over 65. BMJ, 321, 1007-1011.
Ferrini & Ferrini (1993). Health in the later years. Madison, WI: Brrwn & Benchmark, 167-199.
Fife, D. (1985). Northeastern Ohio trauma study Ⅲ：incidence of fractures. Annals of Emergency Medicine,14(3), 244-248.
Gill, T.M., DiPietro, L., Krumholz, H.M. (2000). Role of exercise stress testing and safety monitoring for older persons starting an exercise program. JAMA, 284, 342-349.
Gillespie, L.D., Gillespie, W.J., Cumming, R., Lamb, S.E., Rowe, B.H. (1997). Interventions to reduce the incidence of falling in the elderly. Cochrane Library, 4, 1-29.
Gottsdanker, R. (1982). Age and simple Reaction Time. J. Gerontol., 37, 342-348.
Grisso, J.A., Schwarz, D.F., Wolfson, V., Polansky, M., La Pann, K. (1992). The impact of falls in an inner-city elderly African-American population. J. Am. Geriatr. Soc., 40, 673-678.
Hogan, D.B. (2001). A Randomized controlled trial of a community-based consultation service to prevent falls. Canadian Medical Association Journal, 165(5), 537.
Hornbrook, C.H., Stevens, V.J., Wingfield, D.J., et al. (1994). Preventing falls among community-dwelling older persons: results from a randomized trial. The Gerontologist, 34(1), 16-23.
Hu, M.H., & Woollacott, M.H. (1994). Multisensory training of standing balance in older adults: Postural stability and one-leg stance balance. J. Gerontol., 49, M52-M61.
JCMvH, JPMD, EvR, LpdeW, PMV, and HFJMC (2000). Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: Randomised controlled trial. British Medical Journal, 321, Issue 7267, 994.
Judge, J.O., Lindsey, C., Underwood, M., et al. (1993). Balance improvements in older women: effects of exercise training. Phys. Ther., 73, 254-262.
Katie, E.M., Susie, D., and Archie, Y. (2002). Aerobic training in the ‘oldest old’: the effect of 24 weeks of training. Age and Ageing, 31, 255-260.
Kempton, A., van Beurden, E., Sladden, T., Garner, E., & Beard J. (2000). Older people can stay on their feet: final results of a community-based falls prevention programme. Health Promotion International, 15(1), 27-33.
Kutner, N.J., et al. (1997). Self-report benefits of Tai Chi pratice by older adults. J Gerontology: Psychological Sciences, 52B(5), 242-246
Lai, J.S., Lan, C. Wong, M.K., et al. (1995). Two-year trends in cardiorespitory function among older Tai Chi Chuan pratitioners and sedentary subjects. J. Am. Geriatr. Soc., 43, 1222-1227.
Lan, C., Lai., J.S., Wong, M.K., et al. (1996). Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan pratitioners. Arch. Phys. Med. Rehabil., 77, 612-616.
Ledin, T., et al. (1991). Effects of balance training in elderly: evaluated by clinical tests and dynamic posturography. J Vestib Res, 1, 129-138.
Lord, S.R., Caplan, G.A., Ward, J.A. (1993). Balance, reaction time, and muscle strength in exercising and nonexercising older women: a pilot study. Arch Phys Med Rehabil, 74, 837-839.
Lord, S.R., Castell, S. (1994): Physical activity program for older persons: effect on balance, strength, neuromuscular control, and reaction time. Arch. Phys. Med. Rehabil., 75, 648-652.
Lord, S.R., Clark, R.D., Webster, I.W. (1991). Postural stability and associated physiological factors in a population of aged persons. J. Gerontol.: Medical Sciences, 46, 69-76.
Lundgren-Lindquist, B., Jette, A.M. (1990). Mobility disability among elderly men and women in Sweden. Int. Disabil. Stud., 12, 1-5.
Mauri, K., Sarianna, S., Markku, A., and Harri, S. (2002). Improving cardiovascular fitness by strength or endurance training in women aged 76-78 years. A population-based, randomized controlled trial. Age and Ageing, 31, 247-254.
McGurire, D.K., et al. (2001). A 30-year follow-up of the Dallas Bed Rest and Training Study: Effect of age on cardiovascular adaptation to exercise training. Circulation, 104, 1358-1366.
Messier, S.P., Royer, T.D., Craven, T.E., et al. (2000). Long-term exercise and its effect on balance in older, osteoarthritic adults: results from the Fitness, Arthritis, and Seniors Trial (FAST). J. Am. Geriatr. Soc., 48, 131-138.
Miller, M.E., et al. (2000). Physical activity, functional limitations, and disability in older adults. J. Am. Geriatr. Soc., 48, 1264-1272.
Murphy. J., Isaacs, B. (1982). The post-fall syndrome. Gerontol., 28, 265-270.
Myers, A.H., Baker, S.P., van Natta, M.L., Abbey, H., & Robinson, E.G. (1991), Risk factors associated with falls injuries among elderly Institutionalized persons. Am. J. Epid., 133, 1179-1190.
Myers, A. H. , Young, Y. , & Langlois, J. A. (1996). Prevention of Falls in the Elderly. Bone, 18(1), 87S-101S.
Newton, R.A. (1997). The Fall Prevention Program Manual. Fall Prevention Project.
O’Loughlin, J.L., Robitaille, Y., Boivin, J.-F., & Suissa, S. (1993). Incidence of and risk factors for falls and injurious falls among the community dwelling elderly. Am. J. Epid., 137, 342-354.
Pender, N.J. (1982). Health promotion in nursing practice, Nursing Theory and Nursing Diagnosis, 55.
Pender, N.J. (1987). Health promotion in nursing pratice. East Norwalk: Appleton & Lange.
Perry, B.C. (1982). Falls among the elderly. J. Am. Geriatr. Soc., 30, 367-371.
Petridou, E., Tolma, E., Dessypris, N., and Trichopoulos ,D. (1997). A Controlled Evaluation of a Community Injury Prevention Project in Two Greek Islands. International Journal of Epidemiology, 26(1), 173-179.
Rawsky,E.(1998): Review of the literature on falls among the elderly. Joural of Nursing Scholarship, 30(1), 47-52.
Reuters Health. New York, Mar 12,2001.( Source: Gerald McGwin Jr. et al(2001). Archives of Surgery, 136,197-203.)
Rikli RE, Jones CJ(1999): Development and Validation of a Functional Fitness Test for Community-Residing Older Adults. Journal of Aging and Physical Activity, 7, 129-161.
Ryynanen, O.P., Kivela, S.L., Honkanen, R., & Laippala, P. (1992). Recurrent elderly fallers. Scand. J. Prim. Care, 10, 277-283.
Sattin RW, Lambert Huber DA, DeVito CA, et al.(1990): The incidence of fall injury events among the elderly in a defined population. Am J Epidemiol, 131, 1028-1037.
Sattin, R.W., Rodriguez, J.G., DeVito, C.A., Wingo, P.A., and the SAFE Group (1998). Home environmental hazards and the risk of fall injury events among community-dwelling older persons. Journals of the American Geriatrics Society, 46, 669-676.
Sattin, R.W. (1992). Falls among older persons—a public health perspective. Ann. Rev. Public Health,13, 489-508.
Shumway-Cook, A., Brauer, S., and Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Physical Therapy, 80(9), 896-903.
Sowden, A., Sheldon, T., Pehl, L., Eastwood, A., Glenny, A.-M., Long, A. (1996). Preventing falls and subsequent injury in older people. Effective Health Care, 2, 1-16.
Speechley, M., and Tinetti, M. (1991). Falls and injuries in frail and vigorous community elderly persons. Journal of the American Geriatrics Society, 39, 46-52.
Stokes, J., Lindsay, J. (1996). Major causes of death and hospitalizations in Canadian seniors. Chron. Dis. Can., 17(2), 63-73.
Tennstedt, S., Howland, J., Lachman, M., Peterson, E., Kasten, L., and Jette, A. (1998). A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. Journal of Gerontology: Psychological Sciences, 53B(6), 384-392.
Thompson, P.G. (1996). Preventing falls in the elderly at home: a community-based program. Medical Journal of Australia, 164, 530-532.
Tideiksaar, R. (1989). Geriatric falls: Assessing the cause, preventing recurrence. Geriatrics, 44(7), 57-61.
Tinetti, M.E. (1986). Performance-oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society, 34, 119-126.
Tinetti, M.E., Baker, D.J., McAvay, G., Claus, E., Garret, P., Gottschalk, M., Koch, M.L., Trainor, K., and Horwitz, R.I. (1994). A multifactorial intervention to reduce the risk of falling among elderly people living in the community. New England Journal of Medicine, 331, 821-827.
Tinetti, M.E., Speechley, M., Ginter, S.F. (1988). Risk factors for falls among elderly persons living in the community. N. Engl. J. Med., 319, 1701-1707.
van Veldhuizen, K., Voorham, T., and den Hertog, P. (2001). Preventing falls in the elderly living in a deprived area: Evaluation of a community intervention. Injury Control and Safety Promotion, 8(3),195-197.
Wagner, E.H. LaCroix, A.Z., Grothaus, L., et al. (1994). Preventing disability and falls in older adults: a population-based randomized trial. Am. J. Public Health, 84, 1800-1806.
Webb, C.(1989). Action research: philosophy, method and personal experiences. Journal of Advanced Nursing, 14 (5), 403-410.
Whipple, R.H., Wolfson, L.I., Amerman, P.M. (1987). The relationship of knee and ankle weakness to falls in nursing home residents—an isokinetic study. J. Am. Geriatr. Soc., 35, 13-20.
Wolf, S.L., Barnhart, H.X., and Kutner, N.G., et al. (1996). Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J. Am. Geriatr. Soc., 44, 489-497.
Wolfson, L., Whipple, R., Derby, C., et al. (1996). Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J. Am. Geriatr., 44, 498-506.