[[alternative]]The relationship between health promotion behavior and health status of elderly in Taiwan: The direct and buffering effects of social engagement.

[[abstract]]研究背景：面臨老化海嘯侵襲的台灣，老年人的健康問題迫切重視。而長年累積的生活型態及其社會參與情形皆是影響健康狀況的重要因素。其中，社會參與功能對於健康狀況同時具有直接與緩衝效果，因此本研究欲了解社會參與在老年人健康促進行為與健康狀況間所扮演的緩衝關係為何。 研究目的：本研究旨在探討65歲以上之老年人健康促進行為、社會參與分別與健康狀況之間的關係，並進一步了解社會參與對於健康促進行為及健康狀況兩者間的緩衝效應。 研究方法：以 2009年國民健康訪問調查問卷(National Health Interview Survey, NHIS)之資料數據進行分析，研究對象為台灣地區65歲以上老年人，完整樣本數共2,904位。使用SPSS20.0 for Windows中文統計套裝軟體，以平均數、標準差及百分比分析樣本特性；再以階層線性迴歸分析控制人口學變項及罹患慢性疾病數後，老年人健康促進行為、社會參與、交互作用項與健康狀況之關係。 研究結果：分析結果顯示老年人健康促進行為及社會參與對自覺健康狀態、活動能力、心理健康三項健康狀況測量指標皆呈顯著正相關(p<.001)。經繪製調節效果圖發現，社會參與確實具有直接及緩衝效果，直接效果部分，高度活動參與之老年人，活動能力較佳；人際互動頻率高之老年人，心理健康狀態較好。整體趨勢所呈現之緩衝效應，高度活動參與之老年人，健康促進行為對活動能力的影響小於低度活動參與的老年人；高度人際互動的老年人，其健康促進行為對心理健康的影響小於低度人際互動的老年人。另外，人口學變項及罹患慢性疾病數這些因素當中，受正規教育及月收入較高者之老年人三項健康測量指標皆較好，而罹患慢性疾病數越多，健康狀況越差。 結論：社會參與及健康促進行為確實是影響老年人身心健康狀況之重要因素，社會參與亦同時具有直接效果及緩衝效果，因此，建議政府及衛生單位根據不同程度社會參與之老人制定合適地健康促進方針，並針對未受正規教育、月收入較低的老年人予以協助，以及改善罹患慢性疾病的情形，讓老年人能夠獨立自主、降低依賴程度，繼續參與社會並健康的生活。[[abstract]]Background: Taiwan is facing the challenge of Silver Tsunami, and elderly’s health may be the urgent problem. Lifestyle and social engagement are the important factors which can both affect elderly’s health status , among them, the fuction of social engagement have direct and buffering effect to health status. Thus, we try to examine social engagement how to buffer the relationship between health promotion behavior and heath status of elderly. Objectives: The aim of this study is to investigate each relationship between health promotion behavior, social engagement and health status of elderly who is ≧65 years old, and further to understand the buffering effect of social engagement between health promotion behavior and heath status. Methods: The data of this study is retrieved from National Health Interview Survey in Taiwan in 2009. The subjects are 2,904 elderly who are ≧65 years old in Taiwan. This data were analysed by SPSS20.0 for Windows, and the descriptive statistic and hierarchical linear regression analysis were used. Results: The results show the elderly’s health promotion behavior and social engagement both have the positive correlation significantly with three health status measured indicators (self- reported health, mobility, and mental health)(p<.001).And the figures show social engagement have direct and buffering effect. The part of the direct effects, when the higher degree of activity participation, the better elderly’s mobility. And, the higher degree of personal interaction, the better elderly’s mental health. Futhermore, the part of the buffering effects, while the elderly who had higher degree of activity participation , their health promotion behavior to mobility’s effect smaller than the elderly who had lower degree of activity participation. And the elderly who had higher degree of personal interaction , their health promotion behavior to mental health’s effect smaller than the elderly who had lower degree of personal interaction. In addition, the elderly who had formal education and higher income had higher score of health status measured indicators, but the elderly who suffering more chronic diseases lead to worse health status. Conclusion: Overall, social engagement and health promotion behavior are both indeed important factors, which are affect the elderly’s health status.The government and the Ministry of Health and Welfare should pay more attention of the elderly who have informal education, are lower income, suffering more chronic diseases, and devoted to help them to live independently, continue to participate social activity, and lead a healthier life