簡易檢索 / 詳目顯示

研究生: 蘇昭瑜
Chao-Yu Su
論文名稱: 中老年婦女骨質疏鬆症預防計畫介入之成效
The effects of the osteoporosis prevention program on middle-aged and elderly women
指導教授: 郭鐘隆
Guo, Jong-Long
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2007
畢業學年度: 95
語文別: 英文
論文頁數: 30
中文關鍵詞: 中老年婦女骨質疏鬆症預防計畫
英文關鍵詞: middle-aged and elderly women, osteoporosis prevention program
論文種類: 學術論文
相關次數: 點閱:162下載:46
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 第四屆婦女國際會議指出2030年發展中國家的老年人口將會大幅增加,且一半以上的老年人口是在亞洲地區。包括台灣在內的亞洲地區其骨質疏鬆症發生率將會逐年的上升,因此對於中老年婦女有關骨質疏鬆症的預防介入極為重要。
    本研究是以社會認知理論、健康信念模式和社會支持理論為依據,內容著重於高鈣食物和負重運動課程,以提升中老年婦女自我照顧的行為能力,分為研究一和研究二兩部分來探討,研究一為探討骨質疏鬆症介入計畫對中老年婦女在骨質疏鬆症知識、健康信念、自我效能、社會支持、高鈣飲食行為、負重運動行為及骨質密度之影響;研究二則探討骨質疏鬆症計畫分別於鄉村地區和城市地區實行,其介入成效是否有差異。此研究對象主要為40歲以上之中老年婦女,共有113位婦女參與,分別為鄉村對照組(38人)、鄉村實驗組I (34人)和城市實驗組II (41人)。實驗組I和實驗組II參與為期八週(2小時/週)之骨質疏鬆症課程,於課程前填寫「骨質疏鬆症預防行為」前測問卷和測量跟骨骨密度,於八週課程結束後填寫後測問卷,跟骨骨質密度則在十二個星期後測量。
    骨質疏鬆症預防計畫介入其結果為:1.鄉村實驗組I骨質疏鬆症之知識、健康信念、自我效能、社會支持、高鈣食物攝取行為、從事負重運動行為及骨質密度皆顯著較鄉村對照組好。2.鄉村實驗組I和城市實驗組II之成效差異,除了社會支持得分鄉村實驗組I較城市實驗組II高,其他變項兩組間並無顯著差異。
    本研究能有效提升中老年婦女在骨質疏鬆症的知識、健康信念、自我效能、社會支持、高鈣食物攝取行為、從事負重運動行為和骨質密度;且不管是在鄉村或是在城市實行此計畫,皆有正向的成效。故可藉由此研究作為未來有關中老年婦女骨質疏鬆症介入計畫之參考,發展符合中老年婦女特性與需求且可行之保健預防計畫,除了能預防及改善骨質疏鬆症外,亦可減輕婦女因罹患骨質疏鬆症所耗費的社會資源。

    According to the Fourth World Conference on Women, it is estimated that the growth of elderly population will largely take place in developing countries, over half of it in Asia by the year 2030. As a result, osteoporosis will rise in Asia, including Taiwan. Therefore, it is important to develop a prevention program regarding osteoporosis for middle-aged and elderly women.
    This study was guided by Social Cognitive Theory, Health Belief Model and Social Support Theory. The program contents were mainly focused on calcium-rich foods and weight-bearing exercise that would increase behaviors for better self-care on middle-aged and elderly women. This program consisted of Study 1 and Study 2. Study 1 was to assess the effects of knowledge, health belief, self-efficacy, social support, calcium-rich foods intake, weight-bearing exercise, and bone mass density (BMD) of the osteoporosis prevention program on middle-aged and elderly women between experimental and control groups at rural site. Study 2 was to assess the effects of the osteoporosis prevention program between rural and urban sites. Recruited participants were total 113 middle-aged and elderly women that were aged 40 and above. Eventually, program recruited three groups, including Control group in rural site (38 women), Treatment I group in rural site (34 women), and Treatment II group in urban site (41 women). The Treatment I and the Treatment II groups intervened in the eight-week osteoporosis prevention program (two hour/week). Two groups completed the pre-test osteoporosis prevention behaviors questionnaires and assessed heel BMD followed by the osteoporosis prevention program. Eight weeks later, they completed the post-test questionnaires, and heel BMD was assessed after twelve weeks.
    The results were as follows: 1. The Treatment I group for knowledge, health belief, self-efficacy, social support, calcium-rich foods intake, weight-bearing exercise, and BMD significant was better than the Control group. 2. The effects between the Treatment I and the Treatment II groups were not significant, except the social support score was higher in the Treatment I group than in the Treatment II group.
    This study could effectively increase osteoporosis-related knowledge, health belief, self-efficacy, social support, calcium-rich foods intake, weight-bearing exercise, and BMD; and demonstrate positive effects on both rural and urban sites. Therefore, this program may provide a basis for future osteoporosis prevention programs on middle-aged and elderly women, and may assist in developing practical health prevention programs that conform to the requirements of middle-aged and elderly women. It not only can prevent and improve osteoporosis, but also can reduce social resources that osteoporosis consumed.

    Contents Introduction ……………………………………………………… 1 Methods …………………………………………………………… 5 2.1 Study Design …………………………………………… 5 2.2 Program Development ………………………………… 6 2.3 Measurement …………………………………………… 7 2.4 Statistical Analysis ……………………………………… 9 Results ……………………………………………………………… 10 3.1 Study 1 (Control group versus Treatment I group)…10 3.2 Study 2 (Treatment I group versus Treatment II group) ……………………………………………………………… 16 Discussion …………………………………………………………… 21 4.1 Discussion ……………………………………………… 21 4.2 Limitations ……………………………………………… 25 4.3 Recommendations ……………………………………… 25 References …………………………………………………………… 27 Table Contents Table 1 Summary of osteoporosis prevention programs …… 3 Table 2 Course component for the eight-week osteoporosis prevention program ………………………………………… 7 Table 3 Demographic characteristics of three groups …… 12 Table 4 Compared knowledge, health belief, self-efficacy, social support, weekly consumption of calcium-rich foods, weekly amount of weight-bearing exercise and BMD within the Treatment I and Control groups ……………………………………………………………13 Table 5 Result analysis of Control group vs. Treatment I group …………………………………………………………… 14 Table 6 Compared knowledge, health belief, self-efficacy, social support, weekly consumption of calcium-rich foods, weekly amount of weight-bearing exercise and BMD within the Treatment I and Treatment II groups …………………………………………………………… 18 Table 7 Result analysis of Treatment I group vs. Treatment II group ……………………………………………………… 19

    References
    Ali, N. S. (1996). Predictors of osteoporosis prevention among college women. American Journal of Health Behavior, 20(6), 379-388.
    Ali, N.S. & Twibell, R.K. (1995). Health promotion and osteoporosis prevention among postmenopausal women. Preventive Medicine, 24(5), 528-534.
    Amato, P. R. (1993). Urban-rural differences in helping friends and family members. Social Psychology Quarterly, 56(4), 249-262.
    Borer, K. T. (2005). Physical activity in the prevention and amelioration of osteoporosis in women : interaction of mechanical, hormonal and dietary factors. Sports Medicine, 35(9), 779-830.
    Cheong, J. M. K., Johnson, M.A., Lewis, R.D., Fischer, J.G. & Johnson, J.T. (2003). Reduction in modifiable osteoporosis-related risk factors among adults in the older Americans nutrition program. Family Economics and Nutrition Review, 15(1), 83-91.
    Curry, L. C., Hogstel, M. O., Davis, G.C. & Frable, P.J. (2002). Population-based osteoporosis education for older women. Public Health Nursing, 19(6), 460-469.
    Department of Health Executive Yuan, R.O.C. (2003). Retrieved 0505,2006, from www.doh.gov.tw
    Eaton, C., Reynes, J., Assaf, A., Feldman, H. Lasater, T. & Carleton, R. (1993). Predicting physical activity change in men and women in two New England communities. American Journal of Preventive Medicine, 9(4), 209-219.
    Han, W. H., Chang, C. & Chi, W.L. (2003). Association between lifestyle and hipbone mineral density in women participating in health Checkups. Taiwan Journal of Public Health 22(1), 17-26.
    Lin, T. Y. (1995). Dilemma and hope for the urban elderly in Taiwan: A futrue perspective. Chinese Journal of Mental Health, 8(2), 7-15
    National Osteoporosis Foundation (2003). Retrieved 0505,2006, from http://www.nof.org
    Nies, M., Vollman, M & Cook, T. (1998). Facilitators, barriers, and strategies for exercise in European American women in the community. Public Health Nursing., 15(4), 263-272.
    Peterson, B. A., Klesges, R. C., Kaufman, E. M., Cooper, T. V. & Vukadinovich, C.M. (2000). The effects of an educational intervention on calcium intake and bone mineral content in young women with low calcium intake. American Journal of Health Promotion, 14(3), 149-156.
    Piaseu, N., Belza, B. & Mitchell, P. (2001). Testing the effectiveness of an osteoporosis educational program for nursing students in Thailand. Arthritis Care and Researh, 45, 246-251.
    Piaseu, N., Schepp, K. & Belza, B. (2002). Causal analysis of exercise and calcium intake behaviors for osteoporosis prevention among young women in Thailand. Health Care for Women International, 23, 364-376.
    Resnick, B. & Nigg, C. (2003). Testing a theoretical model of exercise behavior for older adults. Nursing Research, 52(2), 80-88.
    Resnick, B., Orwig, D., Magaziner, J. & Wynne, C. (2002). The effect of social support on exercise behavior in older adults. Clinical Nursing Research, 11(1), 52-70.
    Rollnick, S., Mason, P. & Butler, C. (1999). Health behavior change: A guide for practitioners. New York: Churchill Livingstone.
    Rubin, S.M. & Cummings, S.R. (1992). Results of bone densitometry affect women’s decisions about taking measures to prevent fractures. Annals of Internal Medicine, 116, 990-995.
    Sallis, J. F., Grossman, R.M., Pinski, R.B., Patterson, T.L. & Nader, P.R. (1987). The development of scales to measure social support for diet and exercise behaviors. Preventive Medicine, 16, 826-836.
    Sedlak, C. A., Doheny, M.O. & Jones, S.L. (2000). Osteoporosis education programs: changing knowledge and behaviors. Public Health Nursing, 17(5), 398-402.
    Sternfeld, B., Ainsworth, B. & Quesenberry, C. (1999). Physical activity patterns in a diverse population of women. Preventive Medicine, 28(3), 313-323.
    Stuifbergen, A.K. & Becker H.A. (1994). Predictors of health promoting lifestyle in persons with disabilities. Research in Nursing & Health, 7, 3-13.
    Tsai, K. S. (1997). Osteoporosis fracture rate, bone mineral density, and bone metabolism in Taiwan. Journal of Formosa Medicine Association, 96(10), 802-805.
    Tseng, I. L., Lee, S. H. & Lee, M. C. (1995). Comparative studies on the
    health status between the elderly in rural and urban area. Chung
    Shan Medical Journal, 6(1), 65-87
    Turner, L. W., Hunt, S.B., DiBrezzo, R. & Jones, C. (2004). Design and implementation of an osteoporosis prevention program using the Health Belief Model. American Journal of Health Studies, 19(2), 115-121.
    Tussing, L. & Chapman-Novakofski, K. (2005). Osteoporosis prevention education: Behavior theories and calcium intake. The American Dietetic Association, 105(1), 92-97.
    United Nations (1998). Commission on the Status of Women. Retrieved 0328, 2007, from http://www.un.org/documents/ecosoc/cn6/1998/ecn61998-4.htm
    Winzenberg, T., Oldenburg, B., Frendin, S., De Wit, L., Riley, M. & Jones, G. (2006). The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial [NCT00273260]. BMC Public Health, 6(12).
    Yang, N. P., Lin, T., Wang, C.S. & Chou, P.S. (2004). Correlation of osteoporosis screening by quantitative ultrasound of calcaneus and osteoporosis self-assessment tool for Asians in Taiwanese. Journal of the Formosan Medical Association, 103(2), 130-136.
    Yu, S. & Huang, Y. (2003). Knowledge of, attitudes toward, and activity
    to prevent osteoporosis among middle-aged and elderly women.
    The Journal of Nursing Research, 11(1), 65-72.

    QR CODE