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系統識別號 U0026-2007201722485400
論文名稱(中文) 臺灣中老年人工作轉換與運動量之變化:8年追蹤研究
論文名稱(英文) Work Transitions and Changes in Physical Activity among Middle-aged and Older Adults in Taiwan: an Eight-year Follow-up Study
校院名稱 成功大學
系所名稱(中) 公共衛生研究所
系所名稱(英) Graduate Institute of Public Health
學年度 105
學期 2
出版年 106
研究生(中文) 鄭涵勻
研究生(英文) Han-Yun Cheng
學號 T86041031
學位類別 碩士
語文別 中文
論文頁數 97頁
口試委員 指導教授-胡淑貞
召集委員-林麗娟
口試委員-翁慧卿
中文關鍵字 工作轉換  運動量  中老年人  長期追蹤研究 
英文關鍵字 work transitions and changes  physical activity  middle-aged and old adults  longitudinal study 
學科別分類
中文摘要 研究背景
WHO指出,中老年人積極從事運動有助於維持健康延緩老化,然而,持續工作會影響其運動時間和運動量。過去有關工作轉換對運動量的研究中,國外多以運動代謝當量進行估計,而國內並未有工作轉換對運動量的相關研究。因此,本研究目的為:1.呼應歐盟活躍老化指標(AAI),瞭解臺灣中老年工作轉換與運動量盛行率 2.探討中老年工作轉換對當波與後續進行運動量間變化。

研究方法
本研究使用臺灣中老年身心社會生活狀況長期追蹤調查(TLSA)資料庫,選取1999、2003和2007三波調查資料,以1999年55歲~74歲族群固定樣本進行長期追蹤研究。排除55-74歲、住機構、問卷代答、ADL≧1、1999年工作記錄無回應及1999年運動記錄無回應者後,最終研究樣本為2376人。本研究結果變項為每周累計運動量,由「每周運動次數」和「每次運動時間」相乘後得出,屬連續性變項。自變項以1999年和2003年工作轉換狀況進行分組,分為「一直有工作」、「有到無工作」、「無到有工作」及「一直無工作」等四組。控制變項包含人口學變項(性別、年齡、教育和伴侶)、健康狀態(自覺健康、慢性病數、憂鬱分數)、健康行為(抽菸、飲酒、運動)。統計分析採用迴歸分析與Mixed-effect model (random)探討工作轉換對當波及後續運動量變化之影響。

研究結果
本研究樣本2376人中,男性比例為52.48%,基線平均年齡為63.09±5.82 歲,49.7%教育程度為識字國小程度,78.1%有伴侶,68.4%無工作。在工作轉換上,一直有工作組393人(16.5%)、有到無工作組357人(15.0%)、無到有工作組59人(2.5%)和一直無工作組1567人(66.0%),由於「無到有工作」人數較少,故不列入後續分析。第一部分為分析當波運動量變化,在放入所有控制變項模型中,相較於一直有工作組,有到無工作組每周累計運動量顯著增加50.31分(p<0.001),一直無工作組每周減少6.91分但無顯著。在分層分析部分,不同的工作轉換組別有不一樣的影響效果,例如:有到無工作組,不論男女或是否達規律運動標準630皆會顯著增加每周累計運動量(p<0.01),但在基線年齡僅有55-64歲有顯著增加每周累計運動量。第二部分是分析後續運動量變化,相較於一直有工作組,有到無工作組每周累計運動量顯著減少39.14分(p<0.01),一直無工作組每周也減少28.08分(p<0.001)。分層分析部分,男性有到無工作組(b=-56.35,p<0.001)或一直無工作組(b=-27.91,p<0.05)都顯著減少運動量,基線年齡55-64歲(b=-30.24,p<0.01)和65-74歲的有到無工作組(b=-62.59,p<0.001)、未達運動量標準630(b=-29.31,p<0.01)與達標準630(b=-62.14,p<0.001)的有到無工作組之分層樣本皆會顯著減少每周累計運動量。

研究結論
本研究結果顯示臺灣中老年人的工作轉換確實會影響其運動量的變化。相較於一直有工作組,從有工作轉換至無工作組,每周累計運動量會在當波出現增加,而在後續呈現下降趨勢;而且,相較於一直有工作者,一直無工作者每周累計運動量較高且趨向穩定。分層分析結果發現性別、年齡、及過去運動量是否達標等因素皆會影響其工作轉換後的運動量。建議政府相關單位可針對不同族群與對象設計退休前後三年的體能活動指引,並訂定完善法令增加職場運動設施,以促進民眾之健康。
英文摘要 The purpose of this longitudinal study is to examine the effect of work transitions and changes in physical activity among middle-aged and old adults in Taiwan. This study used the nationally representative dataset “Taiwan Longitudinal Study on Aging (TLSA)” and analyzed three waves of the database (1999, 2003 and 2007). A total of 2,317 samples aged between 55-74 years was recruited in 1999. Work transitions and changes status in 1999 and 2003 were divided into four groups: (1) continuing employed, (2) leaving work, (3) returning to work, (4) continuing unemployed. Physical activity was measured by cumulative minutes per week by two questions. The covariates included demographics, health behaviors, depression, self-reported health status, and chronic diseases. Multinomial linear regression and mixed-effect model (random) were used to examine the effect of work transitions and changes on subsequent physical activity. After controlling confounders, the first part is to analyze the change of the amount of physical activity in the concurrent period of the survey, compared with continuing employed group, leaving work group significantly increased 50.31 minutes per week, continuing unemployed group decreased 6.91 minutes but no significance. The second part is to analyze the change of the amount of physical activity in the subsequent survey, compared with continuing employed group, leaving work group decreased 39.14 minutes per week, continuing unemployed group decreased 28.08 minutes. Both were significant. The results showed that while the working status of the elderly changed from with work to without work, the amount of physical activity per week increased first and then decreased afterward. The cumulative physical activity in continuing unemployed group was higher than continuing employed and the amount of physical activity tends to be stable.
論文目次 中文摘要Ⅰ
Extended AbstractⅢ
誌謝Ⅶ
圖目錄 X
表目錄 XI
第壹章 前言 1
第一節 研究重要性 1
第二節 研究目的 5
第三節 研究假設 5
第貳章 文獻回顧 6
第一節 運動行為對中老年身心健康之影響 6
第二節 中老年人運動量之概況 10
第三節 影響運動行為之因素 17
第四節 工作轉換與運動量行為 20
第參章 研究方法 26
第一節 資料來源 26
第二節 研究對象 27
第三節 研究設計 28
第四節 研究架構 29
第五節 研究變項定義 30
第六節 統計分析 37
第肆章 研究結果 40
第一節 各變項之三波描述性分析 40
第二節 各變項與工作轉換之雙變數分析 44
第三節 工作轉換對當波(1999~2003)運動量變化分析 50
第四節 工作轉換對後續(2003~2007)追蹤運動量變化分析 63
第伍章 討論 74
第一節 本研究發現 74
第二節 對研究結果的解釋與討論 77
第三節 研究優勢與限制 86
第四節 結論與建議 88
參考文獻 90
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