Dissertations / Theses on the topic 'Quality of Life. Aged. Housing for the Elderly'

Ageing has become a significant research area in the last few decades. The most important reason that makes ageing issue significant is the increasing rate of the older indviduals within the population all around the world. Statistical data on ageing both in Turkey and in the world reveals that, in the near future, the number of population over 65 will increase dramatically. It can be asserted that there will be an urgent need of specifically designed accommodation for this portion of the population. Hence, this thesis intends to search for and practice a design solution for the elderly housing. One of the instruments that supported the formulation of such a solution is the subject of &lsquo<br>universal design&rsquo<br>. Within the scope of this study, the principles of universal design and its relationship with ageing are defined, examined and evaluated. It is accepted that living environment has effect on the enhancement of the individual&rsquo<br>s quality of life. For this reason, the relationship between person and environment is briefly discussed in congruence with principles of universal design and provision of quality of life. Accessibility, safety, privacy, autonomy and independence are the common concerns of universal design and provision of a higher quality of life. With review of the definitions of specific elderly housing types, another approach for this study is to make a case study of the existing architectural solutions for the elderly housing. This helped to understand architectural approaches to the relationship between ageing and environment in the world. In the light of the findings, an architectural project, presenting a habitable environment for the elderly, is proposed. For the project, the concept of &ldquo<br>assisted living&rdquo<br>as a new category for elderly housing, is chosen.

Människor lever längre och den äldre generationen är också generellt mer aktiva än tidigare. Det medför att behovet av anpassade bostäder som klarar dessa krav också ökar. Ett exempel på ett sådant boende är trygghetsboende. Det finns regler och krav för hur ett trygghetsboende ska utformas. Det innebär dock inte att boendet automatiskt uppnår syftet det är menat för, alltså ett boende som kan öka livskvaliteten, skapa gemenskap, kännas tryggt och där äldre kan trivas. Syftet med arbetet är att skapa ett trygghetsboende som bidrar till ökad livskvalité och som upplevs trivsamt och tryggt. Målet är att identifiera vilka faktorer som bidrar till detta för att sedan exemplifiera dem i ett gestaltningsförslag. En kvalitativ metod i form av fallstudie med intervjuer genomfördes för att kunna uppnå mål och syfte. Centralt läge och tillgängligt utformad inom- och utomhusmiljö var faktorer som bidrog till trivsel och trygghet medan självständighet, god hälsa, social samvaro och närhet till vänner och familj höjde livskvalitén. Faktorer som bidrar till ökad livskvalité och till vad som är trivsamt och tryggt är väldigt subjektivt. Alla människor är olika och ett tryggt boende kan innebära många skilda ting. Faktorerna som framträdde i resultatet stämmer dock väl överens med vetenskapliga studier som gjorts inom området. Det gör att arbetets resultat kan tillämpas som stöd vid nybyggnation eller ombyggnation av en befintlig byggnad till ett trygghetsboende.<br>People live longer and the older generation is also generally more active than before. This also increases the need for custom housing that meets these demands. An example of such accommodation is secure housing (trygghetsboende). There are rules and requirements for the design of a secure housing, but it does not automatically mean that the accommodation reaches the purpose it is intended for, an accommodation that can enhance the quality of life, contribute to togetherness, feel safe and an accommodation to enjoy. The purpose of this study is to create a secure housing that contributes to an increased quality of life and is experienced pleasantly and safely. The goal is to identify which factors that contribute to this, and then exemplify it in a design proposal. A qualitative method in the form of a case study with interviews was conducted to answer the goal and purpose behind this study. Central location and accessible designed indoor environment and outdoor environment were factors that contributed to well-being and security while independence, good health, social cohesion and proximity to friends and family raised the quality of life. Factors that contribute to increased quality of life and to what is comfortable and safe are very subjective. All people are different and safe living can mean many different things. However, the factors that emerged in the results are consistent with scientific studies made in the area. This means that the results of this work can be used as support for new construction or conversion to a secure housing.

Esta é uma investigação descritiva que utilizou a integração dos métodos quantitativos e qualitativos, cuja análise foi realizada sob a perspectiva da qualidade de vida da Organização Mundial da Saúde (OMS) e da teoria da auto-eficácia de Bandura. Foi desenvolvida junto a 125 idosos participantes de um centro de lazer em Porto Alegre (Brasil), no qual realizam atividades físicas e sociais, com o objetivo de compreender a construção dos comportamentos promotores de saúde dessas pessoas. Na primeira etapa, foi aplicado um formulário contendo questões demográficas, socioeconômicas e de autopercepção da saúde e o questionário de avaliação de qualidade de vida – WHOQOL-bref. Para analisar esses dados, foram utilizadas a estatística descritiva e a analítica. A idade média foi 69,4 anos (DP ± 6,4), predominando o sexo feminino (90,4%), a escolaridade de ensino médio (37,6%) e as atividades no lar (79,2%). Metade recebia até cinco salários mínimos mensais, 64,8% morava acompanhado, 52% realizava atividade física e social há 5 anos ou mais, 96% consultou com profissional da área da saúde no ano anterior, 80% referiu autopercepção positiva da saúde atual. As médias dos domínios do WHOQOL-bref foram: físico 72,37 (± 14,25), psicológico 73,50 (± 10,48), relações sociais 79,40 (± 12,98), meio ambiente 74,85 (± 11,62) e global 78,30 (± 13,85), havendo correlação positiva, estatisticamente significativa, entre os quatro domínios com o domínio global. Na análise de regressão linear múltipla, o domínio físico foi o maior preditor de qualidade de vida (β = 0,39), seguido pelos domínios meio ambiente (β = 0,19) e relações sociais (β = 0,17). Na análise de variância (ANOVA), a variável autopercepção atual da saúde apresentou significância estatística com quatro domínios do WHOQOL-bref. Para conhecer as atividades promotoras de saúde e identificar os fatores que influenciaram esses indivíduos idosos a adotar e manter comportamentos que consideram saudáveis, foram entrevistados 11 que alcançaram escores com um desvio-padrão igual ou acima da média do grupo (≥ 85,18). Na análise das entrevistas, surgiram três categorias: comportamentos promotores de saúde (prática de atividade física, cuidados com a nutrição e convivência familiar/social), adoção dos comportamentos promotores de saúde (influências na infância/juventude e na maturidade) e manutenção dos comportamentos promotores de saúde (atitudes e atributos pessoais positivos, expectativa de viver melhor e mais tempo). A investigação evidenciou que esses indivíduos mantêm comportamentos promotores de saúde similares aos recomendados pelos profissionais e pelas organizações de saúde. Além disso, supõe-se que a adoção e a manutenção de tais comportamentos foram determinadas pelo senso positivo de auto-eficácia desses indivíduos e porque eles desenvolveram estratégias para facilitar a manutenção.<br>This is a descriptive investigation that has used the integration of quantitative and qualitative methods, in which the analysis was done based on World Health Organization´s (WHO) quality of life perspective and Bandura´s self-efficacy theory. It was developed with 125 older adults who participate in a leisure center in Porto Alegre (Brazil), where they perform physical and social activities, attempting to understand the construction of their promoting health behaviors. In the first stage, it was applied a form with demographic, socioeconomic and health self-perception questions as well as the evaluation of quality of life questionnaire – WHOQOL-bref. To data analysis, it was used the descriptive and analitical statistics. The group mean age was 69,4 years old (SD ± 6,4), with majority of female (90,4%), high schooling (37,6%) and household chores (79,2%). Half of them received an income of up to five monthly minimum wages, 64,8% lived with someone, 52% used to do physical and social activities for 5 years or longer, 96% met a health professional during the last yea and 80% expressed current positive health selfperception. The means of WHOQOL-bref domains were: physical 72,37 (± 14,25), psychological 73,50 (± 10,48), social relations 79,40 (± 12,98), environment 74,85 (± 11,62) and overall 78,30 (± 13,85), showing positive correlation, statisticly significative, between the four domains with the overall domain. In the multiple linear regression analysis, the physical domain was the main predictor of quality of life (β = 0,39), followed by environment domain (β = 0,19) and social relations (β = 0,17). In the variance analysis (ANOVA), the current health self-perception variable showed statistic significance with four WHOQOL-bref´s domains. In order to know the promoting health activities and identify the factors that influenced older adults to adopt and maintain behaviors that they consider healthy, 11 older adults who got scores with one standard deviation equal or over the group mean (≥ 85,18) were interviewed. From the interviews´ analysis, emerged three categories: promoting health behaviors (practice of physical activity, attention to nutrition and family/social acquaintanceship), adoption of promoting health behaviors (influences on childwood/youth and maturity) and maintenance of promoting health behaviors (positive personal attitudes and attributes, expectation to live better and longer). The investigation evidenced that these individuals sustain promoting health behaviors alike the recommended ones by health professionals and organizations. It is believed that the adoption and the maintenance of those behaviors were determined by their positive sense of self-efficacy and by developing strategies to make easier the maintenance.<br>Este es una investigación descriptiva que utilizó la integración de los métodos cuantitativos y cualitativos, cuyo análisis fue realizada bajo la perspectiva de calidad de vida de la Organización Mundial de la Salud (OMS) y de la teoría de la autoeficacia de Bandura. La investigación fue desarrollada junto con 125 adultos mayores participantes de un centro de ocio en la ciudad de Porto Alegre (Brasil), en el cual practican actividades físicas y sociales, con la finalidad de comprender la formación de sus conductas promotoras de salud. En la primera parte, fueron aplicados un formulario con preguntas demográficas, socioeconómicas y de autopercepción de la salud y el cuestionario de evaluación de la calidad de vida: WHOQOLbref. Las estadísticas descriptiva y analítica fueron utilizadas para el análisis de los datos. El promedio de edad fue de 69,4 años (DS ± 6,4), con predominio del sexo femenino (90,4%), con enseñanza secundaria (37,6%) y con actividades domésticas (79,2%). La mitad recibía hasta cinco salarios mínimos al mes, el 64,8% vivía acompañado, el 52% realizaba actividades físicas y sociales había 5 años o más, el 96% había tenido una cita con un profesional de salud el año anterio y el ochenta por ciento refirió una autopercepción positiva de su salud actual. Los promedios de los dominios del WHOQOL-bref fueron: físico 72,37 (± 14,25), psicológico 73,50 (± 10,48), relaciones sociales 79,40 (± 12,98), medio ambiente 74,85 (± 11,62) y global 78,30 (± 13,85). Hubo correlación positiva, estadísticamente significativa, entre los cuatro dominios y el dominio global, y en el análisis de regresión lineal múltiple el dominio físico fue el principal predictor de calidad de vida (β = 0,39), seguido por los dominios medio ambiente (β = 0,19) y relaciones sociales (β = 0,17). En el análisis de varianza (ANOVA), la variable autopercepción actual de la salud presentó significación estadística con cuatro dominios del WHOQOL-bref. Para conocer las actividades promotoras de salud e identificar los factores que influenciaron esos adultos mayores a adoptar y mantener conductas que consideran sanas, fueron entrevistadas 11 que alcanzaron puntuaciones con desviación estándarigual ou superior al promedio del grupo (≥ 85,18). En el análisis de las entrevistas, surgieron tres categorías: conductas promotoras de salud (práctica de actividades físicas, atención a la nutrición y convivencia familiar/social), adopción de las conductas promotoras de salud (influencias en la infancia/juventud y en la madurez) y mantenimiento de las conductas promotoras de salud (actitudes y atributos personales positivos, expectativa de vivir mejor y por más tiempo). La investigación evidenció que esos individuos mantienen conductas promotoras de salud similares a las recomendadas por profesionales y organizaciones de salud. Además, se supone que la adopción y el mantenimiento de dichas conductas fueran determinados por el sentido positivo de autoeficacia de esos individuos y porque elles desarrollaron estrategias para facilitar el mantenimiento.

Le thème du vieillissement de la population française est bien connu. Les effets sont plus importants qu’on le pense souvent. L’habitat, les pratiques urbaines, les services et commerces doivent être adaptés. Le géographe aborde le thème par la relation des usagers aux territoires en faisant appel aux outils scientifiques donnés par la psychologie environnementale et aux indications de la médecine.Ce travail répond à une demande professionnelle d’ICADE, un des principaux promoteurs immobiliers du pays. L’auteur met en œuvre des méthodes très concrètes : cartes mentales, GPS, qui permettent de saisir le mieux possible les besoins des usagers. Plusieurs expérimentations ont été conduites, à différentes échelles, sur divers terrains (Lyon et Rhône-Alpes, Région parisienne, Nice). La troisième partie de l’ouvrage est une réflexion sur la gouvernance la plus efficiente qui devrait présider à la mise en œuvre de pôles gérontologiques et de réseaux de santé<br>The aging of the French population is a well- known topic but its effects are more important than is usually thought. The dwelling, the urban living habits, the services and amenities have to be adapted to seniors.The geographer tackles the problem through the relation of elder people to their living territory by using scientific tools provided by environmental psychology, and by referring to medical data.This research work has been made at the professional request of ICADE, one of the leading estate developers in France. The author applies very concrete methods, such as the use of mental maps and GPS trackers, so as to grasp the needs of seniors as accurately as possible. Several experiments have been conducted, at different scales and in different surroundings -Lyon and the Rhône-Alpes region, the Paris region, and also the city of Nice. The third part of the study consists in reflecting on the governance that would be the most efficient to implement the “gerontopôles” (structures associating geriatrics, medical and social care and gerontology)

Orientador: Lilian Tereza Lavras Costallat<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas<br>Made available in DSpace on 2018-08-09T15:22:14Z (GMT). No. of bitstreams: 1 Ikuta_YujiMagalhaes_M.pdf: 2118011 bytes, checksum: 86beb5958678905d3cab2ecc98328466 (MD5) Previous issue date: 2007<br>Resumo: O envelhecimento populacional é um fenômeno de amplitude mundial. A ONU considera o período de 1975 a 2025 como a ¿era do envelhecimento¿. As quedas constituem grave problema de saúde pública com conseqüências para a saúde do idoso, como hospitalização e morte. Assim, torna-se imprescindível o cuidado à pessoa idosa na atenção básica que é a porta do sistema de saúde. Este estudo teve como objetivos determinar a prevalência de quedas e caracterizar os fatores de risco domiciliares e o perfil sócio-demográfico dos idosos. Foi realizado um estudo transversal analítico com uma amostra de 2.080 idosos com idade igual ou superior a 60 anos, adscritos às Unidades de Saúde da Família do município de Amparo, São Paulo. Foram excluídos os idosos acamados e com déficit cognitivo. A coleta de dados foi efetuada mediante a aplicação de questionário, durante a visita domiciliar, com variáveis sócio-demográficas, história de quedas e fatores de risco domiciliares. Os dados foram distribuídos, analisados e comparados com os testes Qui-quadrado, Mann-Whitney e Odds ratio. Adotou-se como nível de significância p<0,05 com IC de 95%. Dos idosos incluídos, 26,88% referiram quedas, sendo que 60,46% relataram uma queda e 39,53% mais de uma queda. As variáveis sócio-demográficas associadas, estatisticamente, com quedas foram o convívio com não familiares com 2 vezes maior chance para quedas, seguido de analfabetismo com uma probabilidade 1,81 vez maior, sexo feminino com risco 1,74 vez aumentado, faixa etária acima de 70 anos com 1,58 vez maior risco, morar sozinho com uma chance 1,44 vez superior, estado civil não casado com 1,37 vez maior risco, renda de 0 a menos de 3 salários mínimos com uma probabilidade 1,34 vez maior e IMC abaixo de 30 (p=0,0317). Com relação à história de quedas, 81,40% sofreram de 1 a 3 quedas, o período de maior ocorrência foi de dia (82,52%). O idoso apresenta uma probabilidade 4,5 vezes maior para cair quando está andando e 1,63 vez maior chance para cair no próprio domicílio, principalmente no quintal. O número de fatores de risco no domicílio não apresentou relação significativa com a prevalência de quedas. Os fatores de risco domiciliares com significativa associação estatística com a ocorrência de quedas foram os brinquedos espalhados no chão, com chance 1,57 vez maior para quedas nos domicílios que os apresentam, sapatos, revistas e objetos espalhados no chão com uma probabilidade de quedas 1,43 vez aumentada. Os idosos que apresentam fatores de risco domiciliares possuem uma chance 2,2 vezes maior de cair quando comparados àqueles que não nenhum fator de risco. Portanto, sabendo que a ocorrência de quedas resulta em diversas conseqüências á saúde do idoso com comprometimento de sua qualidade de vida e capacidade funcional, ressalta-se a importância da realização de políticas públicas com maior incentivo a Estratégia Saúde da Família para atuar na prevenção, tratamento e recuperação do idoso com história de queda e no manejo dos fatores de risco para a manutenção da autonomia e independência, em todas dimensões de sua saúde, em sua família e em sua comunidade<br>Abstract: community and to determine home hazards associated to fall and to describe the social-demographic profile of studied seniors. The developed research was transverse analytical type, involving 2080 elderly (with 60 years or more) living in a community in the Family¿s Units Health of the municipal district of Amparo (SP). The bedridden seniors and elderly with cognitive deficit were excluded. The data were collected by the application of an interview protocol, containing social-demographic variables, history of falls and risk factors for fall in the home. The data were distributed, analyzed and compared with the tests Qui-square, Mann-Whitney and Odds ratio. It was adopted as level of significance 5% or p <0,05 with IC of 95%. Among the studied seniors, 26,88% referred falls. In the midst with falls, 60,46% related one fall and 39,53% more than one fall. Statistical association existed between the occurrence of falls and the variables: conviviality with no family in the home with 2 times larger chance for falls, following by illiteracy with a probability 1,81 time larger, feminine sex with risk 1,74 time increased, age group above 70 years with 1,58 time larger risk, to live alone with a chance 1,44 time superior, no married marital status with 1,37 time larger risk, low wage (less than 3 minimum wages) with a probability 1,34 time larger and IMC below 30 (p=0,0317). Regarding the history of falls, 81,40% suffered from 1 to 3 falls, the period of larger occurrence was in the daytime (82,52%). Elderly presents a probability 4,5 times larger to fall when he is walking and 1,63 time larger chance to fall in the own home, mainly in the back yard. The number of environmental risk factors for falls in the home didn't present significant relationship with the prevalence of falls. The home risk factors with significant statistical association with the occurrence of falls were the dispersed toys in the ground, with a chance 1,57 time larger for falls and shoes, magazines and other dispersed objects in the ground of the home with a probability of falls 1,43 time increased. Elderly that present home risk factors have a chance 2,2 times larger of falling when compared to those that have no factor of home environmental risk. Therefore, the occurrence of falls results in several consequences for the senior's health with compromising of his life quality and functional capacity. The importance of the accomplishment of public politics is emphasized with larger incentive to the Primary Care, to act in the prevention, treatment and the senior's fall victim recovery and in the handling of the risk factors for the maintenance of the autonomy and independence, in all dimensions of his health, in his family and community<br>Mestrado<br>Clinica Medica<br>Clinica Medica

El propósito de esta tesis ha sido investigar el estado de salud bucal de las personas mayores institucionalizadas en Barcelona y los cuidados que ellos reciben para promover y mantener su salud bucal. Por otro lado, evaluar la evolución de las desigualdades socioeconómicas en el uso de los servicios dentales en Chile, donde se garantizó la atención de salud bucal a algunos grupos poblacionales. Ello con la finalidad de proponer el esquema de garantías de algunas atenciones de salud bucal como una estrategia para mejorar, en el largo plazo, el impacto de la salud bucal en la calidad de vida de las personas mayores. Los resultados muestran que las personas mayores institucionalizadas en Barcelona presentan una mala salud bucal y una mala calidad de vida en relación a su salud bucal (Artículo 1). Aunque este colectivo recibe los cuidados diarios de salud bucal protocolizados, hay características de las instituciones y de las personas cuidadoras de mayores, que impiden optimizar la realización de estas actividades (Artículo 2). Por otro lado, las desigualdades socioeconómicas en el uso de los servicios odontológicos en Chile disminuyeron significativamente luego de la implementación del esquema de garantías de atención dental (Artículo 3). Se enfatiza la importancia de fomentar estrategias para apoyar y promover la salud bucal de las personas mayores institucionalizadas, cuyo estado de salud general disminuye su capacidad de autocuidado. Además se destaca que los aspectos estructurales como el aseguramiento y cobertura de las atenciones dentales favorecen un uso más equitativo de los servicios odontológicos. El esquema de garantizar la atención de salud bucal a grupos más vulnerables, como es el colectivo de personas mayores institucionalizadas, pudiera ser una estrategia adecuada para España donde actualmente la población carece de cobertura de atención dental.<br>The purpose of this thesis was to describe the oral health status of institutionalized elderly in Barcelona and the oral-health care they receive to promote and to maintain their oral health. On the other hand, another goal was to assess the evolution of socioeconomic inequalities in the use of dental services in Chile, a country that guaranteed the oral health care to some people. This in order to propose the scheme ensuring some oral health care as a strategy to improve, in the long term, the impact of oral health on the quality of life of older people . The results show that institutionalized elderly in Barcelona have poor oral health and poor quality of life in relation to their oral health (Paper 1). Although this group receives daily oral health care, there are features of institutions and caregivers, hindering optimize the performance of these activities (Paper 2). On the other hand, socioeconomic inequalities in the use of dental services significantly decreased after the implementation of the guarantees for dental care in Chile (Paper 3). It emphasizes the importance of developing strategies to support and promote a better oral health among institutionalized elderly, whose overall health decreases their ability to self-care. Also noteworthy is that the structural aspects such as insurance and dental care coverage contribute to a more equitable use of dental services. The scheme ensuring oral health care and services to vulnerable groups, such as the institutionalized elderly collective, could be an appropriate policy for Spain where the population currently lacks of dental care coverage.

碩士<br>國立台北護理學院<br>醫護教育研究所<br>93<br>The purpose of this research was to evaluate the quality of life for patients with spondylolisthesis, and to evaluate the degree of effects of each of possible related factors, including gender, age, education, career, religion, severity and duration of this disease, degree of painful sensation, and the limitation of function of daily life. This study was conducted in a cross-sectional manner to patients of spondylolisthesis in a medical center in North Taiwan. Patient with disease severity of Meyerding’s grade 1 or above and was subject to surgical treatment was included in this study. The number of patients included was 150 in total. Data collection was through structural questionnaire and visiting for each patient. Parameters evaluated in this study include degree of painful sensation, disability, and degree of quality of life through following methods: Visual Analog Scale (VAS), Barthel Index, and questionnaire about degree of quality of life in order. Statistical methods include dependent t-test, ANOVA, Chi-square test, and stepwise regression analysis. Following are some important conclusions: 1.The quality of life of study population was median in general. Among the parameters evaluated in quality of life “social relationship aspect” scores best and “psychological aspect” scores the least. 2.Relationship between patients’ demographic data and their disease characters: Significance of relationship was noted between following items: between “age”, “marriage status” and “location of spondylolisthesis”; between “occupation”, “education”, “religion” and “painfulness due to disease”. 3.Relationship between patients’ demographic data and their quality of life:Quality of life in terms of physiological aspect is better in patient who keeps his job than that of patient who dose not posses a job. Quality of life in terms of physiological aspect is better in patients with a faith than that of patients who are atheists. 4.Relationship between disease character and quality of life: The lesser the pain, the better the quality of life in terms of both physiological and psychological aspects. The lesser the limitation of daily activity, the better the quality of life in terms of physiological aspect. 5.Relationship between demographic data, disease character and quality of life: “Painfulness due to disease” is an important predictive factor to quality of life in terms of either physiological, psychological, and environmental aspects. In addition, limitation in daily activity is an important predictive factorto quality of life in terms of physiological activity.

碩士<br>國立陽明大學<br>衛生福利研究所<br>107<br>Background: World Health Organization indicated that oral disease is a serious public health issue on 2003, and it cause considerable impact on individuals and society. Chewing dysfunction might not cause immediately life-threatening situation or critical body injuries, but it will cause painfully discomfort and influence the dietary intake and digestive condition on individuals. And furthermore, oral dysfunction will even has negative impact on appearance, metal condition, physical condition, and interpersonal relationship and then influence the healthy quality of life. This study aim to understand the current condition of oral health related quality of life among Taiwanese elders and to analyze the related factors (sociodemographic factors, health factors, health behaviors and use of dental services )by using the nationally representative investigation “Taiwan Longitudinal Study on Aging”. Method: A cross-sectional study was conducted by using the data from “2011 Taiwan Longitudinal Study on Aging” of Health Promotion Administration, Ministry of Health and Welfare, which included 3,727 middle and old aged participants in Taiwan. The association between independent and dependent variables was tested by using statistical methods, which included descriptive statistics, Chi-square test, multiple regression, and multiple logistic regression. Result: The participants were mostly male (49.4%), aged between 60-64 years old (24.2%), who was married (66.2%) and was Minnan (70.6%), lived in northern Taiwan (29.9%) and didn’t live in the nursing home(99.0%). The education level was mostly under elementary school. And the average OHIP scores was 3.49. The multiple regression and multiple logistic regression showed that participants with education level higher than high school and university and who exercise 6-8 times a week had significantly better oral health related quality of life. Participants who reported pain in health factor, whose Nagi scale reported non-disable, who reported smoking (whether currently quit or not) in health behavior had significantly worse oral health related quality of life. And, participants who saw the dentist in past a year, who had more frequency of seeing the dentist in past a month and who had dentures had worse oral health related quality of life. Conclusion and Recommendation: This study showed the related factors of oral health related quality of life among middle and old aged elders. In order to improve the quality of life, we suggest to implement health education on changeable health behavior (smoking and exercising) on disable elders and elders who had dentures.

碩士<br>中華科技大學<br>健康科技研究所<br>107<br>This research discuss the impact of experiencing organic farming with animals’ stool fertilizer on life quality of middle age and old age citizens. And we expect to elevate life quality and both body and metal health of them. In order to survey, Wenshan District Health Center offers organic farming experience activity every week for 3 months to 32 citizens among middle age to old age. And apply WHO questionnaire of life quality (WHOQOL-BREF) to them before and after the activity. This questionnaire includes 28 questions from 4 categories: physiological health (7), mental health (6), social relationship (4), environment (9), and general life quality and health (2). Document was classified by Likert scale, which implies better life quality with higher score. 32 questionnaires were valid (100%) and analyzed with repeated measures paired t test (p<0.05). Results revealed that: post-test score is higher than pre-test score with statistical significance in 13 questions. In which general life quality showed the most significant difference (p<0.001). Environmental health, entertainment in environment category, and mobility of physiological health held second place (p<0.01). “Pain disturb daily activities”, and “Energetic enough for daily life” in general life quality and physiological health categories showed significant difference as well (p<0.05); Along with “Ability to concentrate” in mental health, and “Safety in daily life”, “Enough wealth”, “Life information”, “transportation”, and “food at wish” (p<0.05). This research revealed the fact that with this organic farming experience activity; participants are not only able to experiment but to get the chance to mobilize themselves with self-affirmation and emotional release. Moreover, this program elevates general life quality and health condition of citizens among middle age to old age.

碩士<br>國立中正大學<br>教學專業發展數位學習碩士在職專班<br>102<br>This study aims to investigate the relationship between the middle-aged and the elderly who participate in elderly learning and the quality of their life. Based on the results of this study, recommendations were provided to government organization agencies 、 related education organizations and the middle-aged and the elderly. This study was done with questionnaires by surveying the middle-aged and the elderly in HsinChu county and HsinChu city who participate in elderly learning. 350 questionnaires were sent out, and 350 were returned, after excluding respondents consistent incomplete or invalid respondents 14 copies of the questionnaire,the total number of valid questionnaire was 336, with a return rate of 96%. The conclusions of this study were: 1. The willing of the middle-aged and the elderly in HsinChu to participate in elderly learning are medium to high degree, average participation over 3 times per week, total hours of participation is 16 hours per month. 2. The quality of life of the middle-aged and the elderly in Hsinchu is fairly high, at all levels, with an overall average score of 3.3 points, "environmental interaction" the highest level of quality of life, with an average score of up to 3.84 points. 3. The women in Hsinchu who aged 61-65 years old, highly educated, living with a spouse, a moderately prosperous economic conditions ,good health, with religious have a higher proportion of participation in elderly learning. 4. The women in Hsinchu who aged below 55 years old, high level of education, living with a spouse, a moderately prosperous economic conditions, good health, religious, and longer participation in elderly learning have higher quality of life. 5. For the middle-aged and the elderly, there are correlation between participation in learning and quality of life, meaning that the higher willingness and frequencies to learn ,the better quality of life they have. 6. The learning participation of elderly can effectively predict the level of quality of life, which "participation effect" have most predictive power for the quality of life. According to the research findings, this study provides the following recommendations for government agencies, educational institutions of elderly, the middle-aged and the elderly themselves and future research: Recommendations for government agencies 1. Concerned senior education, promotion of education policy for senior citizens. 2. Marketing elderly seniors involved in learning effectiveness, stimulate elderly willingness to participate in learning . 3. Provision budget, grants related units and educational institutions for the relevant curriculum activities to attract the middle-aged and the elderly to participate in learning. 4. Set up a dedicated agency responsible for promoting and marketing the middle-aged and the elderly and education activities, and the establishment of advisory services to enhance public understanding of education policy and program for the middle-aged and the elderly. 5. Combining the resources of civil society, integration of resources and division of labor between the public and private sectors in order to strengthen the educational content for senior citizens to play elder education maximum efficiency. 6. Rational allocation of educational resources, improve the learning environment equipment, in order to narrow the gap between urban and rural areas, so that every elderly person entitled to equality of educational services. 7. Provide better social services, such as: education grants or tour buses, to encourage the active participation of vulnerable elderly seniors learning, enhance quality of life. 8. People concept of health promotion, establish good habits and create a healthy living environment, in order to achieve healthy aging and successful aging goals. 9. Continue to cooperate with colleges to investigate the effectiveness of the seniors learning ,providing reference to government and educational institutions. Recommendations for educational institutions of elderly 1. Proper planning of learning programs, attracting elderly people to join the learning. 2. Enhance the training of elderly teachers, improve quality of elderly learning. 3. Provide multiple learning channels, assisting the middle-aged and the elderly in remote areas involved in elderly learning. 4. Strengthen advocacy elderly learning, initiative to provide consulting services to assist the middle-aged and the elderlyto further understand about elderly learning. 5. Combine resources of community to development characteristic curriculum of the center; Use elderly human resources to develop new feature of community. Recommendations for the middle-aged and the elderly themselves 1. Enthusiastically participate in elderly learning to enrich life in old age. 2. Development of personal interests and expertise to maintain quality of life in old age. 3. Good psychological adjustment, be positive to face aging. 4. Enhance social interaction, sharing joys of life, passing life experience. 5. Develop good habits, maintain a healthy body function. Recommendations for future research 1. In research area: proposes to expand the study area for more research evidence to convince the elderly to participate seniors learn. 2. In research target group: It is recommended to collect more different area and different living conditions of the middle-aged and the elderly in order to improve the external validity of the study. 3. In research variables: recommendations of the study can be extended to explore other relevant factors, in particular the participation of seniors learning settings related In the study variables: recommendations of the study can be extended to explore other relevant factors, in particular the participation of seniors learning settings related variables, in order to enhance the value of the quality of life research. 4. In research methods: based on quantification and supplemented by interviews, observations, etc., in order to obtain more detailed and factual findings. 5. In research tools: font size, wording simple to understand, not too lengthy; minimize open-end question and not too many questions.

研究背景：便秘被過往的研究確認為世界各地老年人的一個常見健康問題，尤其是居住在安老院的長者。香港一項人口普查亦指出便秘也是香港老年人的一個常見健康問題。便秘對長者的生理、心理和社會功能等各方面都產生不良影響。此外，醫療體制亦因處理便秘及其衍生的健康問題而面對沉重的負擔。目前所採用的常規方案是生活模式改變及使用軟便劑，但兩者均未能有效地紓緩便秘的徵狀。由於香港老齡人口持續增長，便秘將會是一個具有潛在持續性的老年健康問題，故尋找一個能有效地紓緩便秘徵狀的方案甚為迫切。耳穴療法是一項普及的中醫療法，亦屬於互補療法。過往在中國進行的研究顯示，耳穴療法能有效地治療便秘，惟此等療效尚未被確實。耳穴療法應是一個對處理便秘具有潛在療效的治療方案。現時，香港尚未有研究評價耳穴療法對處理便秘的療效。<br>研究目的：本研究旨在評價耳穴療法的互補療效，對安老院內的長者便秘徵狀及便秘相關的健康生活品質的干預效果。<br>研究方法：本研究是一個採取混合研究法的臨床研究。先進行化研究，評價耳穴療法對安老院內長者的便秘徵狀及便秘相關的健康生活品質的互補療效；接著進行質化研究，探討面談者對接受耳穴療法的經驗及感受。量化研究是一個隨機對照及雙盲的研究。安老院內的院友被取錄為參與者後，便隨機地獲分配一個研究組別。本研究共有三個研究組別，每名組員分別接受一個預定的干預措施，包括磁珠耳貼療法 (干預組)，王不留行籽耳貼療法 (對照A組) 及耳貼療法 (對照B組)，干預措施是在七個選定的耳穴上進行耳穴療法，共維持十天。研究指標包括便秘徵狀及便秘相關的健康生活品質。此等研究指標分別在干預前 (基線資料)、十天後 (干預措施結束) 和二十天後 (干預措施結束後十天) 進行資料蒐集。統計推斷方法是採用廣義估計方程模型檢驗組間和組內在便秘徵狀及便秘相關的健康生活品質之差異。質化研究的面談者必須是完成整個研究過程的干預組組員，並在量化檢驗的便秘徵狀指標中取得最高分及最低分的各四位組員。透過個別面談，探討面談者對接受耳穴療法以處理便秘的經驗及感受。<br>研究結果：本研究共有99名參與者。祇有90名參與者接受干預措施 (干預組=31；對照A組=28；對照B組=31)，其中的81名參與者完成整個療程 (干預組=29；對照A組=25；對照B組=27)。本研究結果顯示耳穴療法在十天 (p=0.016)及二十天 (p=0.016) 的研究時期內，便秘相關的健康生活品質中的滿意度在干預組及對照A組間有顯著的差異 (十天及二十天均是p=0.016)。然而，本研究證實磁珠耳貼療法能顯著地紓緩便秘徵狀 (十天：p=0.013；二十天：p<0.001)，提升與便秘相關的健康生活品質 (十天：p=0.005；二十天：p<0.001)，並於三個研究組別中取得最大的療效。此外，質化研究結果顯示，耳穴療法確是一項安全及具認受性的療法，適用於安老院內的院友，可作為處理便秘的治療方案。<br>研究結論：本研究是香港首個通過隨機對照的臨床研究，以評價耳穴療法對處理便秘的互補療效。研究結果顯示磁珠耳貼療法對安老院內的院友具有正向的臨床價值：磁珠耳貼療法能紓緩便秘徵狀及提升便秘相關的健康生活品質；安老院內的院友認為耳穴療法是一項安全及具認受性的療法；對住在安老院內年長的中國人而言，耳穴療法是一項與其文化相關的照護方式。本研究就處理安老院內院友的便秘問題為護理專業提供了有關耳穴療法的新知，並作為日後於護理實務及護理研究方面的參考和方向。<br>Background: Constipation has been identified in previous studies as a worldwide health problem among elderly people, especially those living in residential care homes (RCHs). Similarly, constipation is also reported as a common health problem among elderly people in Hong Kong in a local population survey. Constipation adversely affects the biopsychosocial well-being of elderly people. In addition, heavy burden has been imposed on the health care system in dealing with constipation and its related health problems. Constipation is currently managed by laxatives and lifestyle modification. However, constipation is not effectively relieved by these two management strategies. In Hong Kong, the aging population is seen to have an increasing trend. Constipation will then be a potentially expanding health problem among elderly people. All these data indicate an urgent need for effective alternatives to manage this health problem. Auriculotherapy is one popular treatment modality in Chinese medicine, which is also a form of complementary therapy. Previous studies conducted in Mainland China reported promising results in managing constipation with auriculotherapy, although its effectiveness was not affirmed. Auriculotherapy appears to be a promising management strategy for constipation. Until now, no study has been conducted in Hong Kong to evaluate the effectiveness of auriculotherapy in managing constipation.<br>Aim: The current study aims to evaluate the complementary effects of auriculotherapy in relieving constipation symptoms and in promoting disease-specific health-related quality of life (HRQOL) among elderly RCH residents.<br>Methods: The present study is a clinical trial that adopts the mixed-method design. A randomized placebo-controlled trial was first conducted to evaluate the complementary effects of auriculotherapy in relieving symptoms of constipation and in promoting disease-specific HRQOL in elderly RCH residents. After the completion of the randomized placebo-controlled trial, the qualitative approach was conducted to explore the participants’ experience and perceptions on the use and complementary effects of auriculotherapy with magnetic pellets in managing constipation. The randomized placebo-controlled trial was a double-blind study. The participants were recruited from elderly RCH residents and then randomly assigned to one of the three study groups. The participants received the assigned intervention, namely, auriculotherapy using auricular plaster with magnetic pellet (experimental group), auriculotherapy using auricular plaster with Semen Vaccariae (placebo-controlled group A), or auriculotherapy using only auricular plaster (placebo-controlled group B). Auriculotherapy was applied onto seven selected auricular acupoints for 10 days. Two outcome variables, namely, constipation symptoms and disease-specific HRQOL, were measured before the implementation of intervention (baseline), on Day 10 (at the completion of the intervention), and on Day 20 (at the 10th-day follow-up after the intervention). The generalized estimating equation model was adopted to evaluate the between-group and within-group differences in the complementary effects of auriculotherapy on constipation symptoms and disease-specific HRQOL. In the qualitative approach, the informants were recruited from participants of the experimental group who had successfully completed the study with mean scores in constipation symptoms at the top- or bottom-four ranking. The informants were individually interviewed to explore their experience and perceptions on the use and complementary effects of auriculotherapy in managing constipation.<br>Results: Ninety-nine participants were recruited in the study. Ninety participants received the intervention as assigned, and eventually, 81 participants completed the intervention. When the interaction effects of time and group were simultaneously considered, statistical significant differences were only found in the satisfaction subscale of the disease-specific HRQOL between the experimental group and placebo-controlled group A on both Day 10 (p=0.016) and Day 20 (p=0.016). For the experimental group, significant time effects were found in constipation symptoms (Day 10：p=0.013; Day 20：p<0.001) and disease-specific HRQOL (Day 10：p=0.005; Day 20：p<0.001) after receiving auriculotherapy. Most importantly, the participants who received auriculotherapy with magnetic pellets showed the greatest improvement in constipation symptoms and disease-specific HRQOL after the intervention compared with the two placebo-controlled groups. The qualitative findings further revealed that auriculotherapy is a safe, well-accepted therapy in managing constipation among elderly RCH residents.<br>Conclusion: The current study is the first known randomized placebo-controlled trial that evaluates the complementary effects of auriculotherapy in managing constipation in Hong Kong. The current findings indicate positive clinical value of auriculotherapy with magnetic pellets in managing constipation in elderly RCH residents. Auriculotherapy with magnetic pellets was found to provide favourable therapeutic effects in relieving constipation symptoms and in promoting disease-specific HRQOL among elderly RCH residents. This therapy is also considered by elderly people as a safe and acceptable therapy with minimal side effects. In addition, auriculotherapy is considered as a culturally relevant care modality for Chinese elderly RCH residents. The current study contributes new knowledge to nursing for future reference and directions in both nursing practice and nursing research with regard to the complementary effects of auriculotherapy in managing constipation among elderly RCH residents.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Detailed summary in vernacular field only.<br>Li, Mei Kuen.<br>Thesis (Ph.D.)--Chinese University of Hong Kong, 2012.<br>Includes bibliographical references (leaves 273-305).<br>Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.<br>Abstract and appendixes also in Chinese.<br>Chapter CHAPTER 1 --- INTRODUCTION<br>Introduction --- p.1<br>Background of the study --- p.2<br>Aim and significances of the study --- p.6<br>Overview of the thesis --- p.6<br>Chapter CHAPTER 2 --- LITERATURE REVIEW<br>Introduction --- p.8<br>Constipation: Potentially expanding health problem in elderly population --- p.9<br>Prevalence of constipation --- p.9<br>Definition of constipation --- p.11<br>Physiology and pathophysiology of defecation --- p.13<br>Effects of constipation --- p.15<br>Adverse individual health consequences --- p.15<br>Economic burden in health care system --- p.18<br>Contributory factors for constipation --- p.20<br>Roles of nurses in managing constipation in current practice --- p.22<br>Cautious use of laxatives --- p.24<br>Lifestyle modification --- p.24<br>Promoting dietary fiber intake --- p.25<br>Encouraging oral fluid intake --- p.26<br>Promoting physical activity --- p.26<br>Integration of complementary therapy into nursing practice in managing constipation --- p.28<br>Auriculotherapy --- p.30<br>Historical overview of auriculotherapy --- p.30<br>Conceptual framework of auriculotherapy --- p.31<br>Approaches of auriculotherapy --- p.36<br>Mechanism of auriculotherapy --- p.37<br>Clinical applications of auriculotherapy in managing constipation --- p.39<br>Complementary effects of auriculotherapy in managing constipation: Review of previous studies --- p.41<br>Subject characteristics --- p.41<br>Intervention protocol --- p.45<br>Therapeutic outcome criteria and effectiveness --- p.50<br>Strengths and limitations of the reviewed studies --- p.56<br>Recommendations for future studies --- p.59<br>Significances of the current study --- p.60<br>Summary --- p.61<br>Chapter CHAPTER 3 --- METHODS<br>Introduction --- p.63<br>Overview of study design --- p.65<br>Mixed-method study design --- p.66<br>Quantitative approach --- p.66<br>Qualitative approach --- p.68<br>Research aim and objectives --- p.68<br>Research aim --- p.68<br>Research objectives --- p.68<br>Null hypotheses --- p.69<br>Operational definitions --- p.71<br>Rationale of the study design --- p.73<br>Rationale for adopting the mixed-method design --- p.73<br>Rationale for adopting the randomized controlled trial design --- p.75<br>Rationale for adopting double-blindness --- p.75<br>Rationale for adopting random assignment --- p.76<br>Rationale for adopting a pretest and repeated post-test design --- p.78<br>Rationale for recruiting placebo-controlled groups --- p.79<br>Quantitative approach --- p.81<br>Sample --- p.81<br>Accessible population --- p.81<br>Sampling method and selection of participants --- p.82<br>Sample size determination --- p.85<br>Experimental intervention --- p.87<br>Content of the experimental intervention --- p.87<br>Integrity of experimental intervention --- p.92<br>Qualification of the intervener --- p.92<br>Consistency of implementation of intervention --- p.93<br>Compliance of the participants to study instructions --- p.84<br>Data collection --- p.95<br>Study Instruments and records --- p.95<br>Patient Assessment of Constipation Symptom Questionnaire (Cantonese Chinese for Hong Kong) (PAC-SYM) --- p.96<br>Patient Assessment of Constipation Quality of Life Questionnaire (Cantonese Chinese for Hong Kong) (PAC-QOL) --- p.97<br>Abbreviated Mental Test (Hong Kong version; AMT) --- p.98<br>Physical Activity Questionnaire (Hong Kong version; PAQ) --- p.98<br>Screening for eligibility of the participant --- p.99<br>Demographic and Clinical Data Sheet --- p.99<br>Assessment of Clinical Syndrome of Constipation --- p.99<br>Assessment of oral intake of Fruits and Vegetables (AFV) --- p.100<br>Bowel Movement Record (BMR) --- p.100<br>Drug Administration Record (DAR) --- p.101<br>Data collection procedure --- p.101<br>Qualitative approach --- p.104<br>Rationale for adopting criterion sampling --- p.105<br>Pilot Study --- p.106<br>Feasibility of the sampling method --- p.107<br>Feasibility of the data collection instruments and procedure --- p.107<br>Feasibility of implementation of the study intervention --- p.108<br>Characteristics of the pilot sample --- p.109<br>Sample size recalculation --- p.113<br>Appropriateness of the interview guide --- p.114<br>Recommendations for the main study --- p.115<br>Data Analysis --- p.115<br>Quantitative data --- p.115<br>Assessment of accuracy of data entry --- p.116<br>Description of sample characteristics --- p.117<br>Assessment of homogeneity of the study groups --- p.117<br>Detection of the intervention effect --- p.118<br>Justification for choosing parametric statistical tests over non-parametric statistical tests --- p.118<br>Adoption of the Generalized Estimating Equations (GEE) model --- p.119<br>Rationale for adopting the GEE model --- p.119<br>Choosing the appropriate link function and working correlation matrix --- p.121<br>Control of possible covariates in data analysis --- p.123<br>Qualitative data --- p.124<br>Ethical considerations --- p.125<br>Principle of respect for persons --- p.126<br>Principle of beneficence --- p.127<br>Principle of justice --- p.128<br>Summary --- p.129<br>Chapter CHAPTER 4 --- RESULTS<br>Introduction --- p.132<br>Recruitment and characteristics of participants --- p.133<br>Recruitment of participants --- p.133<br>Characteristics of the participants --- p.137<br>Characteristics of the study sample and homogeneity among study groups --- p.140<br>Characteristics of the study sample --- p.141<br>Homogeneity of the characteristics of participants who received and those who did not receive the intervention in the study --- p.145<br>Homogeneity of the characteristics of participants in the experimental and the placebo-controlled groups --- p.145<br>Complementary effects of auriculotherapy in managing constipation --- p.149<br>Adopting the GEE model --- p.152<br>Checking the missing data --- p.152<br>Identifying the covariates --- p.152<br>Choosing the appropriate link function --- p.153<br>Choosing the appropriate working correlation matrix --- p.160<br>Complementary effects of auriculotherapy on constipation symptoms and disease-specific HRQOL --- p.160<br>Complementary effects of auriculotherapy on constipation symptoms --- p.161<br>Constipation symptoms (PAC-SYM) --- p.161<br>Subscales of constipation symptoms --- p.165<br>Abdominal symptoms subscale --- p.165<br>Rectal symptoms subscale --- p.168<br>Stool symptoms subscale --- p.172<br>Summary of the complementary effects of auriculotherapy on constipation symptoms --- p.175<br>Complementary effects of auriculotherapy on disease-specific HRQOL --- p.177<br>Disease-specific HRQOL (PAC-QOL) --- p.177<br>Subscales of disease-specific HRQOL --- p.181<br>Physical discomfort subscale --- p.181<br>Psychosocial discomfort subscale --- p.185<br>Worries and concerns subscale --- p.186<br>Satisfaction subscale --- p.190<br>Summary of the complementary effects of auriculotherapy on disease-specific HRQOL --- p.193<br>Effect size calculation --- p.196<br>Findings revealed from study records --- p.197<br>Monitoring of the intervention dose --- p.198<br>Change of bowel movement pattern --- p.198<br>Change in drug administration --- p.200<br>Reporting of side effects associated with auriculotherapy --- p.202<br>Reporting of unexpected beneficial effects after receiving auriculotherapy --- p.202<br>Qualitative findings revealed from interview --- p.203<br>Recruitment of informants --- p.203<br>Characteristics of the informants --- p.204<br>Qualitative findings --- p.207<br>Benefits of auriculotherapy in managing constipation --- p.208<br>Minor discomforts associated with auriculotherapy --- p.210<br>Life as usual with the use of auriculotherapy --- p.210<br>Willingness to adopt and recommend auriculotherapy to others --- p.213<br>Summary of the qualitative findings --- p.214<br>Summary --- p.215<br>Chapter CHAPTER 5 --- DISCUSSION<br>Introduction --- p.217<br>Profile of participants --- p.217<br>Demographic and clinical characteristics of the participants --- p.218<br>Baselines outcome variables of the participants --- p.224<br>Clinical value of auriculotherapy with magnetic pellets in managing constipation --- p.226<br>Summary of the key findings --- p.226<br>Complementary effects in relieving constipation symptoms and in promoting disease-specific HRQOL --- p.228<br>Safe and well-accepted intervention --- p.236<br>Culturally relevant care modality --- p.239<br>Challenges associated with recruiting elderly participants --- p.241<br>Strengths and limitations of the current study --- p.246<br>Strengths of the study --- p.246<br>Limitations of the study --- p.253<br>Summary --- p.257<br>Chapter CHAPTER 6 --- CONCLUSION<br>Introduction --- p.258<br>Contribution of new knowledge to nursing --- p.258<br>Implications for nursing practice --- p.259<br>Clinical application of auriculotherapy in nursing practice --- p.261<br>Strategies to promote integration of auriculotherapy into nursing practice --- p.263<br>Implications for nursing research --- p.266<br>Recommendations for further studies --- p.268<br>Conclusion of the whole study --- p.269<br>REFERENCES (ENGLISH) --- p.273<br>REFERENCES (CHINESE) --- p.303

碩士<br>國立中正大學<br>運動與休閒教育研究所<br>102<br>The purpose of this study was to investigate the effects of Tai Chi on physical fitness and quality of life for the middle-aged and elderly with metabolic syndrome. The subjects were recruited by 123 elderly people from community who were examined with metabolic syndrome by hospital and were assigned into experimental group and control group by quasi-experimental design. The experimental group was trained Tai Chi for 12 weeks, 3 sessions a week, and 60 minutes per session. Physical fitness tests and the SF-36 was made before and after this experiment. Data was analyzed by the descriptive statistics, paired t test, one way ANOVA and canonical analysis. The results show as following： （1）The middle-aged and elderly had degenerated by the muscle endurance, grip strength, balance and questionnaire score gained less on Physical Functioning, Role- Physical, Role Emotional and Physical Health Dimension.（2）The male were better muscle strength and muscle endurance than female. The female were better flexibility than male.（3）The higher education subjects were performed better physical fitness and gained higher Bodily Pain score.（4）The subjects with employed were with higher BMI value, lower muscle endurance and scored lower Physical Functioning score than who unemployed.（5）The subjects with enough sleep was had a lower BMI value and gained higher scores on General Health and Vitality by QOL.（6）After the Tai Chi training, the cardio-respiratory fitness and balance were significant in the experimental group.（7）After the Tai Chi training, the Physical Functioning, Role-Physical, Bodily Pain and General Health were significant correlation with physical fitness.

碩士<br>亞洲大學<br>健康產業管理學系長期照護組<br>101<br>The main purpose of this study was to investigate the relationship between the spiritual health status and quality of life among the middle and aged people over 55 years old. Random sampling method was used. The subjects were selected from 10 Evergreen Academies in Taichung, Taiwan. By cross-sectional study method, we used structured questionnaire including social-demographic data, Spiritual Health Scale and WHOQOL-BREF Scale. 371 questionnaires were completed. Data was analyzed with SPSS 18.0. This study found that (1) in regards to spiritual health, the difference was prominent among education level, religious piety and self-conscious health status, (2) in regards to quality of life, the difference was prominent among marital status, education level, religious piety, self-conscious health status and economic status. (3) The correlation between spiritual health and quality of life was positively in the middle level (r=.47，p＜0.01). The correlation between spiritual scale and the four domains (mental health, psychology, environmental and social relation) of quality of life was positively in the low to middle level. (4) the multiple regression analysis showed that the higher the spiritual health, education level and self-conscious health was, the better the quality of life would be. The total variance of this model was 40.8%. We suggested to do further researches in future on how the spiritual intervention may upgrade the quality of life.

碩士<br>中臺科技大學<br>醫療暨健康產業管理系碩士班<br>105<br>OBJECTIVE： With the increase of aging population worldwide, the aging problem has raised the great concern of international community. Our government is putting a lot of effort into community care services with a view to create a self participation and health promotion environment for the elderly. The purpose of this study is to explore the health promotion activities held for the elderly in community centers and how the activities relate to the quality of life and sense of happiness of the elderly. The result of this study will be used as references in policy formation and practice of establishing senior community centers in the future. METHODS： This study adopted a cross-sectional research and sample survey method. Subjects were chosen from the elderly taking part in the activities held in community care centers. A total of 240 questionnaires were sent out and 220 effective questionnaires were received. The response rate was 92%. With regard to data analysis, SPSS 17.0 was used to perform descriptive statistics, inferential statistics, independent-sample t test and one way analysis of variance. When the value of P is smaller than 0.05, the result was considered significant and Pearson’s correlation was used to exam the relevance among the five dimensions. RESULTS： For the elderly participating in the activities held in the community care centers, healthy and happy life was their main concern. Qualitative analysis: The variance analysis of background difference and quality of life showed significant variation in living condition, perceived health status, length of participating in activities and benefit of participating in acitivies. In addition, the variance analysis of background difference and sense of happiness showed significant variation in marriage, living condition, perceived health status, length of participating activities and benefit of participating activities. Quality of life and sense of happiness had significant positive correlation. Quantitative analysis: As long as the community care centers opened, the elderly always showed up, felt satisfied in life, kept healthy physically and psychologically, had good interpersonal relationship, didn’t feel bored and learned new things. Therefore, participating in the activities of community care centers was important. CONCLUSION： The longer the elderly took part in community care centers, the more they were satisfied with their quality of life and the higher their sense of happiness would be. In other words, a positive correlation existed between the satisfaction in quality of life and sense of happiness. SUGGESTION： In practice, pay visits and show concern to the elderly without participating in the community care centers and encourage them to participate in the activities or training program for volunteers. In policy, acquire subsidy, site, equipment, etc. In academic research, invite scholars to take part in the curriculum design of community care centers. KEYWORDS：the elderly, community participation, quality of life, sense of happiness, community care center.

This dissertation is about pastoral care and counselling to elderly people to keep them visible within our faith communities. The research is a reflection and a re-telling of the lives of five elderly people who shared their stories with me. I heard them talk about ageing as an ongoing journey that is not always smooth. To grow older includes a lot of changes and a reassessment of lifestyles and goals as well as the danger of becoming invisible to others. Visibility cannot be maintained without communities of support, and care within communities of shared prophetic mission. A pastoral therapist must convey the Christian message of care by healing and caring solidarity, co-constructing new narratives of hope, and bringing back visibility to the elderly.<br>Practical Theology<br>M.Th. (Specialisation in Pastoral Therapy)

碩士<br>美和技術學院<br>健康照護研究所<br>95<br>The purpose of this research were to imvestigate the relationship between Healthy behavior, Dietary behavior and Life Quality. A cross-sectional survey with structural questionnaires were used. The perimeters measures included Demographic data, Healthy behavior, and Chinese versions of Short Form-36 (SF-36 questionnaires) in Taiwan. A total of 427 Hakka middle-aged adults and elderly were participated in this study. Data were analyzed by using SPSS for Windows Descriptive statistics , Pearson’s correlation, Independent t-test, One-way ANOVA, and Stepwise regression.Findings were as follow : The variables of ‘ Male ’ and ‘ Occupational condition at present ’ resulted in significant difference of the behavior of smoking and betel nut chewing. The obvious difference of the behavior of alcohol drinking reflects the distinctions in ‘ Male ’ and ‘ Occupational condition at present ’ ‘ Educational level ’‘ Occupational condition ’ at present, and the ‘ Personal Disposable Income per month ’.The differences between of ‘ Educational level ’ and the ‘ Personal Disposable Income per month ’ was associated with the diversity regular of exercise habits. In regard to the regular eating habits edible frequency, the frequency of eating ‘ flavor ’ was the highest. The second were place eating ‘ pickled vegetables ’ and what followed and the lowest one eating ‘ barbecued roast food ’.The frequency of eating ‘ pickled vegetables ’ is obviously higher in the group of education level above elementary degree than in the group of educational level below elementary degree. The object the this study score the average received 61.02 score in life quality aspect.‘physical component scale’ （PCS）was 72.05 score, and ‘ mental component scale’ （MCS）was somewhat lower s in this research of scored and only score 50 score. In the method of integral life quality prediction, of the method in integral life quality independent variables includ ‘Age’ ‘Personal Disposable Income permonth’ ‘chronic diseases’ ‘regulur exercise habits’ and ‘drinking habits’ had significant impact on the average score of life quality. The variables above contributed 25% in reasonable variance of whole regressive model. It is wished that the results of this research could offer a guide to improve the healthy behaviors of Hakka people, and consequently they will have a better health qulity of life in a way which can be refered for consideration in policy decision making.

OBJECTIVES: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on improved quality of life for people with dementia. This study compared the experience of people living with dementia and other mental health problems in extra care housing schemes that utilised EOP with schemes that employed an active control intervention. METHOD: Ten extra care housing schemes were cluster randomised to receive either the EOP intervention or an active control intervention for an 18-month period. Residents with dementia or other significant mental health problems (20-30 per scheme) were assessed on a number of outcome measures at baseline, six months, one year and 18 months. The primary outcome measure was quality of life. Self-reported depression was an important secondary outcome. RESULTS: The EOP-participating residents rated their quality of life more positively over time (4.0 (SE 0.6) units; 14% p < 0.001) than the active control (1.3 (SE 0.6) units; 4% p = 0.003). There was also a significant group-time interaction for depressive symptoms (p = 0.003). The EOP-participating residents reported a reduction of 25% at both six and 12 months and a 37% reduction at 18 months (all p's < 0.001). EOP residents were less likely than residents in the active control sites to move to a care home or to be admitted to a hospital inpatient bed. They were more likely to be seen by a range of community health professionals. CONCLUSION: The EOP had a positive impact on the quality of life of people with dementia in well-staffed extra care housing schemes.