Development, Application, and Evaluation of the Senior Elastic Band Exercise Program for Elderly Residents in Long Term Care Facilities (3/3)

計畫編號:NSC99-2628-B037-066-MY3執行機構:高雄醫學大學護理學系研究期間:101/08-102/07老化過程往往會造成身體功能下降並提高慢性病罹患率，進而導致不等程度之功能性依賴。對老 年族群，尤其是長期照顧機構老年住民，之健康促進或健康維持對降低醫療資源耗損而言極為重要。 改變靜態生活方式則是促進殘弱老人體適能及延緩健康衰退之重要良方。多項研究證實，身體活動或 運動可延展獨立功能之維持時間、減少失能、並促進老人之生活品質。本研究計畫主要目的為：（1） 發展並評值銀髮彈力帶健身操於長期照顧機構老人應用之安全性與合適性；（2）測試長期銀髮彈力帶 健身操運動對長期照顧機構老人功能性體適能及睡眠品質之影響；及（3）了解機構老人對長期從事 銀髮彈力帶健身操之遵從性及長期效益。 本研究採三年期、縱貫性、三角交叉檢視之設計。第一年研究目的旨於透由德菲爾專家調查彙整 12 位專家的意見和一群約15-20 位長期照顧機構老人之前驅性試驗，發展出一套既安全又適合機構老 年長輩從事的銀髮彈力帶健身操運動方案。第二年研究將藉由類實驗性、不相等控制組設計來評量六 個月銀髮彈力帶健身操在機構老人功能性體適能（心肺血管功能、身體柔軟度、肌力/肌耐力及平衡感） 和睡眠品質之應用成效。藉由方便取樣方式，在高雄縣市選取四家長期照顧機構，共約120 位機構老 年住民，取得研究群組，再依研究機構地點以隨機分配方式分成兩組：銀髮彈力帶健身操實驗組及等 待控制組。實驗組將接受訓練合格並領有「銀髮彈力帶健身操指導士」證書之指導士帶領，每星期三 次、每次四十分鐘之運動方案課程，持續六個月；等待控制組則維持機構中原有的活動安排。所有的 研究對象將接受一次前測及二次後測，間隔三個月。在最後第三年研究中，運動方案將改以VCD 方 式引導長輩繼續操練銀髮彈力帶健身操九個月，並接受另外三次之後測，間隔三個月，以瞭解長輩對 銀髮彈力帶健身操練習的遵從性及其長期效益。 SPSS 統計分析軟體17.0 版將用於研究結果之分析。在量性資料方面，將以描述性統計（如，頻 率、百分比、平均值及標準差）和推論性統計（如，獨立樣本t 檢定、混合設計雙因子變異數分析、 單因子重覆測量變異數分析及共變數分析）檢驗之。在專家學者及老人建議之質性資料上，則以批判 性、統整性之內容分析方式進行。 期許本研究所發展之銀髮彈力帶健身操未來可納入長期照顧機構中規律性之活動安排，以促進老 年長輩之健康並豐富長輩於機構中之生活。 Aging process typically results in a decline in physical functioning and an increase in the incidence of chronic health problems that could lead to various levels of functional dependency. Health promotion and/or health maintenance of elders, especially those elderly residents in long term care facilities, is essential in reducing healthcare expenditures. Avoiding the sedentary life style is one way to enhance the physical fitness of elders and delay the health deterioration of nature aging imposes on this transitional frail elderly population. Scientific evidence indicates that physical activity and exercise offer opportunities to add years of active independent living, reduce disability, and improve the quality of life for elders. The goals of this research project are: 1) to develop and evaluate the safety and feasibility of the Senior Elastic Band (SEB) exercise program for elderly residents in long term care facilities, 2) to evaluate the long-term effects of the SEB on physical functional fitness and sleep quality of elderly residents in long term care facilities, and 3) to investigate the compliance of elderly residents with long-term SEB exercises. A three-year, longitudinal, triangulation research method will be used. The study purpose of the first year is to develop a safe and appropriate SEB program for the elderly residents in long term care facilities using Delphi survey with a panel of 12 experts and pilot-testing on a group of 15-20 elderly residents in long term care facilities. In the second year of the study, a quasi-experimental, non-equivalent control group design will be used to evaluate the effects of the SEB exercise program on the physical functional fitness (cardiovascular-respiratory function, body flexibility, muscle power/muscle endurance, and balance) and sleep quality of elderly residents in long term care facilities. Through the convenience sampling strategy, a total of four long term care facilities with approximately 120 elders in Kaohsiung will be recruited and randomly assigned based on the resided facilities to a SEB experimental group or a waiting-list control group. The subjects in the experimental group will receive the SEB interventions lead by the certified instructors, three times per week, 40 minutes per practice for six months; the subjects in the waiting-list control group will remain regular daily activities in the facilities. All subjects will receive one pre-test and two post-tests three months apart during the study. In the third year, the elderly participants will continue practicing the SEB guided by a VCD for another nine months, and the compliance of the participants toward regular SEB exercise and its long-term effects on the physical functional fitness and sleep quality outcomes will be tested with additional three post-tests, three months apart. The Statistical Package for the Social Sciences (SPSS) Version 17.0 will be used to analyze the results. Quantitative data will be analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent-sample t test; mixed-design, two-way analysis of variance; one-way repeated measures analysis of variance; and analysis of covariance). The qualitative responses of the experts and participants will be critically analyzed and summarized using content analysis. The developed SEB program could be used as a physical activity in the long term care facilities to add the variety of the program schedule, enhance the program participation rate, and promote the well-being of the elderly residents in long term care facilities