系統識別號 U0026-2108201306322500
論文名稱(中文) 社會互動為高齡者外出頻率與健康間關係之中介因素
論文名稱(英文) Social interaction as mediator between out-of-home trips and health among older adults
校院名稱 成功大學
系所名稱(中) 體育健康與休閒研究所
系所名稱(英) Institute of Physical Education, Health & Leisure Studies
學年度 101
學期 2
出版年 102
研究生(中文) 陳慧真
研究生(英文) Hui-Chen Chen
學號 RB6991038
學位類別 碩士
語文別 英文
論文頁數 30頁
口試委員 口試委員-張珩
中文關鍵字 社會互動  活動參與  高齡者  外出行為 
英文關鍵字 Social interaction  participation  outdoor behavior  elderly 
中文摘要 外出活動參與對於提升高齡者健康來說,是個重要議題。根據調查發現,不常外出的高齡者,比較容易有慢性病及自覺健康比較差。然而,近來部份研究發現外出活動中的社會互動,也是影響高齡者健康的重要因素之一。此外,各類的活動,因為活動型態的屬性,所能提供的社會互動應該也有所不同,故社會互動在不同種類的活動裡,所能提供的健康效益應該也會有所不同。因此,本研究將比較社會互動在不同外出活動中的健康效益是否有所差異。
本研究共招募台南市13個都市社區,65歲以上的高齡者為對象,以問卷調查及進行體適能評估的方式進行。問卷調查包含外出進行休閒性身體活動(Leisure-time physical activity, LTPA)和生活性的機能活動(instrumental activity of daily life, IADL)的頻率、自覺健康量表(SF12)及社會互動。社會互動問卷是參考相關問卷發展出相關題項,進行專家效度及信效度分析,篩選題項後使用。統計分析使用結構方程模式(Structural equation modeling)檢視變項間的相關性,另採用Sobel test及Bootstrapping方式檢驗中介效果。
英文摘要 Participation in outdoor activity is an important issue in promoting the health of the elderly. Homebound older adults tend to have more chronic diseases and poor subjective health status than do non-homebound adults. Elderly people engaged in outdoor activities more than once a week would prevent physical disability. Recently several studies found that social interaction may help to increase participation in outdoor activities and maintain health in older adults. Few studies have discussed the relationship between health and social interaction in various purposes of participation. The objective of the present study was to explore the effect of social interaction on the relationship between participation in different outdoor activities and health.
Cross-sectional data were drawn from elderly residents of 13 neighborhoods in southern Taiwan. They were asked to take functional fitness tests and complete a self-reported questionnaires onsite which were social interaction, frequency of outdoor activities and self-reported health. Data on health assessments were obtained by objective (senior functional fitness test) and subjective measures (SF12 survey). Structural equation model was introduced to examine the association between outdoor activities, social interaction, and health. By using the Sobel test and bootstrapping procedure to test the mediation effect of social interaction.
According to our research, social interaction was found to be associated with health status in different outdoor activities. Social interactions partially mediate the association between leisure-time physical activity and health, whereas social interaction acts as a full mediator between instrumental activities of daily living and health. Social interactions exhibiting a meditational effect depended on the purposes of participation in outdoor activities.
Social interaction is therefore a critical factor that encourages older adults to participate in outdoor activities to promote health. Although frequent outdoor activity has been considered as a facilitator in promoting health, social interaction appears to mediate the correlation between participation in outdoor activities and health in the elderly.
論文目次 Introduction...1
Statistical analysis...10
Descriptive and univariate analysis...11
Structural equation model...12
Mediation effect in the structural models...15
參考文獻 Aida, J., Kondo, K., Kawachi, I., Subramanian, S., Ichida, Y., Hirai, H., . . . Tsakos, G. (2013). Does social capital affect the incidence of functional disability in older Japanese? A prospective population-based cohort study. Journal of Epidemiology and Community Health, 67(1), 42-47.
Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.
Bollen, K.A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20(1), 15-140.
Buchman, A.S., Boyle, P.A., Wilson, R.S., Fleischman, D.A., Leurgans, S., & Bennett, D.A. (2009). Association between late-life social activity and motor decline in older adults. Archives of Internal Medicine, 169(12), 1139.
Burton, N.W., Khan, A., & Brown, W.J. (2012). How, where and with whom? Physical activity context preferences of three adult groups at risk of inactivity. British Journal of Sports Medicine, 46, 1125-1131.
Chang, Y.H., Chen, R.C.Y., Wahlqvist, M.L., & Lee, M.S. (2012). Frequent shopping
by men and women increases survival in the older Taiwanese population. Journal of Epidemiology and Community Health, 66(7), e20-e20.
Cherry, K.E., Walker, E.J., Brown, J.S., Volaufova, J., LaMotte, L.R., Welsh, D.A., . . . Wood, R.H. (2013). Social engagement and health in younger, older, and oldest-old adults in the Louisiana healthy aging study. Journal of Applied Gerontology, 32(1), 51-75.
Chow, H.-W., Chen, H.-C., & Lin, L.L. (2013). Association between out-of-home trips and seniors' functional fitness. Geriatrics & Gerontology International, (Accepted).
Cohen-Mansfield, J., Shmotkin, D., & Hazan, H. (2012). Homebound older persons: prevalence, characteristics, and longitudinal predictors. Archives of Gerontology and Geriatrics, 54(1), 55-60.
Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7(3), 269-297.
Cornwell, B., Laumann, E.O., & Schumm, L.P. (2008). The social connectedness of older adults: a national profile. American Sociological Review, 73(2), 185-203.
Davis, M.G., Fox, K.R., Hillsdon, M., Coulson, J.C., Sharp, D.J., Stathi, A., & Thompson, J.L. (2011). Getting out and about in older adults the nature of daily
trips and their association with objectively assessed physical activity. International Journal of Behavioral Nutrition and Physical Activity, 8, 116-125.
Department of statistics. (2009). Report of the senior citizen condition survey 2009, Republic of China. Taipei: Ministry of the Interior, Taiwan Retrieved from sowf.moi.gov.tw/stat/Survey/98old.doc.
Escobar-Bravo, M.-Á., Puga-González, D., & Martín-Baranera, M. (2012). Protective effects of social networks on disability among older adults in Spain. Archives of Gerontology and Geriatrics, 54(1), 109-116.
Fornell, C., & Larcker, D.F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 39-50.
Forsén, L., Bjørnelv, G.M.W., Bentzen, H., Søgaard, A.J., & Graff-Iversen, S. (2012). Functional ability, physical activity and self-rated health in old age a cross sectional population-based study in Norway. Open Public Health Journal, 5, 40-51.
Hayes, A.F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408-420.
James, B.D., Boyle, P.A., Buchman, A.S., & Bennett, D.A. (2011). Relation of late-life
social activity with incident disability among community-dwelling older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 66(4), 467-473.
Kaczynski, A.T., & Glover, T.D. (2012). Talking the talk, walking the walk: examining the effect of neighbourhood walkability and social connectedness on physical activity. Journal of Public Health, 34(3), 382-389.
Kerr, J., Rosenberg, D., & Frank, L. (2012). The Role of the Built Environment in Healthy Aging Community Design, Physical Activity, and Health among Older Adults. Journal of Planning Literature, 27(1), 43-60.
Lawton, M.P., Brody, E.M., & ACSW. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3 Part 1), 179-186.
Lee, C.-T., Yeh, C.-J., Lee, M.-C., Lin, H.-S., Chen, V.C.-H., Hsieh, M.-H., . . . Lai, T.-J. (2012). Social support and mobility limitation as modifiable predictors of improvement in depressive symptoms in the elderly: Results of a national longitudinal study. Archives of Gerontology and Geriatrics, 55(3), 530-538. doi: http://dx.doi.org/10.1016/j.archger.2012.03.002
Lewis, K.H., Gillman, M.W., Greaney, M.L., Puleo, E., Bennett, G.G., & Emmons,K.M. (2012). Relationships between Social Resources and Healthful Behaviors across the Age Spectrum. Journal of Aging Research. doi: dx.doi.org/10.1155/2012/501072
Müller-Riemenschneider, F., Reinhold, T., Nocon, M., & Willich, S.N. (2008). Long-term effectiveness of interventions promoting physical activity: a systematic review. Preventive Medicine, 47(4), 354-368.
Maier, H., & Klumb, P.L. (2005). Social participation and survival at older ages: is the effect driven by activity content or context? European Journal of Ageing, 2(1), 31-39.
McMurdo, M.E.T., Argo, I., Crombie, I.K., Feng, Z., Sniehotta, F.F., Vadiveloo, T., . . . Donnan, P.T. (2012). Social, Environmental and Psychological Factors Associated with Objective Physical Activity Levels in the Over 65s. PloS One, 7(2), e31878.
Mohnen, S.M., Völker, B., Flap, H., Subramanian, S., & Groenewegen, P.P. (2013). You have to be there to enjoy it? Neighbourhood social capital and health. The European Journal of Public Health, 23(1), 33-39.
Murayama, H., Yoshie, S., Sugawara, I., Wakui, T., & Arami, R. (2012). Contextual effect of neighborhood environment on homebound elderly in a Japanese
community. Archives of Gerontology and Geriatrics, 54(1), 67-71.
Nathan, A., Pereira, G., Foster, S., Hooper, P., Saarloos, D., & Giles-Corti, B. (2012). Access to commercial destinations within the neighbourhood and walking among Australian older adults. International Journal of Behavioral Nutrition and Physical Activity, 9(33), 133-141.
Netz, Y., Goldsmith, R., Shimony, T., Arnon, M., & Zeev, A. (2013). Loneliness is associated with an increased risk of sedentary life in older Israelis. Aging & Mental Health, 17(1), 40-47.
Nguyen, H.M., & Cihlar, V. (2013). Differences in physical fitness and subjectively rated physical health in Vietnamese and German older adults. Journal of Cross-cultural Gerontology, 28, 181-194.
Norstrand, J.A., Glicksman, A., Lubben, J., & Kleban, M. (2012). The Role of the Social Environment on Physical and Mental Health of Older Adults. Journal of Housing For the Elderly, 26(1-3), 290-307.
Nyqvist, F., Pape, B., Pellfolk, T., Forsman, A.K., & Wahlbeck, K. (2013). Structural and Cognitive Aspects of Social Capital and All-Cause Mortality: A Meta-Analysis of Cohort Studies. Social Indicators Research, 1-22.
Paterson, D.H., Jones, G.R., & Rice, C.L. (2007). Ageing and physical activity:
evidence to develop exercise recommendations for older adults Canadian Public Health Association, 98(S2), S69-108. doi: doi:10.1139/H07-111
Perissinotto, C.M., Cenzer, I.S., & Covinsky, K.E. (2012). Loneliness in Older Persons :A Predictor of Functional Decline and Death. Archives of Internal Medicine, 172(14), 1078-1084.
Pieter-Paul, V., & Tampubolon, G. (2012). Individual social capital, neighbourhood deprivation, and self-rated health in England. Social Science & Medicine, 75, 349e357.
Qiu, W.Q., Dean, M., Liu, T., George, L., Gann, M., Cohen, J., & Bruce, M.L. (2010). Physical and mental health of homebound older adults: an overlooked population. Journal of the American Geriatrics Society 58(12), 2423-2428.
Resnick, B., & Nahm, E.S. (2001). Reliability and validity testing of the revised 12-item Short-Form Health Survey in older adults. Journal of Nursing Measurement, 9(2), 151-161.
Richard, L., Gauvin, L., Kestens, Y., Shatenstein, B., Payette, H., Daniel, M., . . . Mercille, G. (2013). Neighborhood Resources and Social Participation Among Older Adults: Results From the VoisiNuage Study. Journal of Aging and Health, 25(2), 296-318.
Rikli, R.E., & Jones, C.J. (2001). Senior fitness test manual: Champaign, IL : Human Kinetics.
Rosso, A.L., Auchincloss, A.H., & Michael, Y.L. (2011). The urban built environment and mobility in older adults: A comprehensive review. Journal of Aging Research. doi: 10.4061/2011/816106
Rowe, J.W., & Kahn, R.L. (1997). Successful aging. The Gerontologist, 37(4), 433-440.
Schultz-Larsena, K., Rahmanfardc, N., & Holstc, C. (2012). Physical activity and the disablement process:A 14-year follow-up study of older non-disabled women and men. Archives of Gerontology and Geriatrics, 55(1), 25-30. doi: 10.1016/j.archger.2011.06.024
Schumacker, R.E., & Lomax, R.G. (2004). A beginner's guide to structural equation modeling (2 ed.). NJ: Lawrence Erlbaum: Mahwah.
Seeman, T.E., & Berkman, L.F. (1988). Structural characteristics of social networks and their relationship with social support in the elderly: who provides support. Social Science & Medicine, 26(7), 737-749.
Shimada, H., Ishizaki, T., Kato, M., Morimoto, A., Tamate, A., Uchiyama, Y., & Yasumura, S. (2010). How often and how far do frail elderly people need to go
outdoors to maintain functional capacity? Archives of Gerontology and Geriatrics, 50(2), 140-146.
Snih, S.A., Peek, K.M., Sawyer, P., Markides, K.S., Allman, R.M., & Ottenbacher, K.J. (2012). Life‐Space mobility in Mexican Americans aged 75 and older. Journal of the American Geriatrics Society, 60(3), 532-537.
Sobel, M.E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13(1982), 290-312.
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797-5801.
Toepoel, V. (2013). Ageing, Leisure, and Social Connectedness: How could Leisure Help Reduce Social Isolation of Older People? Social Indicators Research, 113(1), 1-18.
Van Cauwenberg, J., De Bourdeaudhuij, I., De Meester, F., Van Dyck, D., Salmon, J., Clarys, P., & Deforche, B. (2011). Relationship between the physical environment and physical activity in older adults: a systematic review. Health & Place, 17(2), 458-469.
Vogel, T., Brechat, P.H., Leprêtre, P.M., Kaltenbach, G., Berthel, M., & Lonsdorfer, J.
(2009). Health benefits of physical activity in older patients: a review. International Journal of Clinical Practice, 63(2), 303-320.
Warburton, D.E.R., Nicol, C.W., & Bredin, S.S.D. (2006). Health benefits of physical activity: the evidence. Canadian Medical Association Journal, 174(6), 801-809.
Ware, J.E., Kosinski, M., & Keller, S.D. (1998). SF 12: How to score the SF12 physical and mental health summary scale (third ed.). Lincolin: RI: QualityMetric Incoporated.
William, J.D., Weidong, X., & Gholamreza, T. (1994). A Confirmatory Factor Analysis of the End-User Computing Satisfaction Instrument. MIS Quarterly, 18(4), 453-461.
Yen, I., Michael, Y., & Perdue, L. (2009). Neighborhood Environment in Studies of Health of Older Adults: A Systematic Review. American Journal of Preventive Medicine, 37(5), 455-463.
Zunzunegui, M.V., Rodriguez-Laso, A., Otero, A., Pluijm, S.M.F., Nikula, S., Blumstein, T., . . . Deeg, D.J.H. (2005). Disability and social ties: comparative findings of the CLESA study. European Journal of Ageing, 2(1), 40-47.
  • 同意授權校內瀏覽/列印電子全文服務,於2017-08-28起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2017-08-28起公開。

  • 如您有疑問,請聯絡圖書館