不同運動改變階段老人的健康狀態與憂鬱之探討

憂鬱是老人常見的心理問題，而隨著老年人口逐年增加，老人憂鬱的比率將會上升，因此了解影響老人憂鬱的原因，發展適合的措施來預防或改善憂鬱是很重要的。本研究目的是使用跨理論模式中的五個不同運動改變階段為架構來檢視老人的運動及憂鬱情形，以及健康狀態是否影響老人之運動行為。本研究採橫斷性相關性研究法，以集叢隨機抽樣，選取台中市153位65歲及以上之居家老人為樣本，以面對面訪談方式於老人家中進行資料收集。研究結果發現：（1）研究對象之運動改變階段的分佈以動機前期最多佔35％，而動機期最少佔7％；此外，老人之運動型態以走路為主佔54.38％，其次為體操佔15.79％。(2)老人的運動行為未受到性別、年齡、婚姻狀態、以及教育程度的影響，但不同運動行為的老人其健康狀態是不同的，處於維持期老人其身體健康與整體健康是最好的，而動機期老人的身體健康則是最差的。(3)台中市老人的憂鬱比率為33％；處於動機期的老人最憂鬱，而維持期老人最不憂鬱。(4)將健康狀態控制後發現老人的憂鬱情形並未因運動改變階段而有差異。本研究結果顯示老人健康的狀況會影響到其運動行為及憂鬱情形。健康專業人員可依據老人健康狀態及運動改變階段設計出更確切的運動介人措施，進而有效改善老人的憂鬱問題。

Depression is a common mental disorder in older persons. The increase of older population will raise the percentage of older persons with depression. It is important to understand depression, therefore specific interventions could be developed to prevent or treat depression. This study was to use five exercise stages of change based on the Transtheoretical Model to examine exercise behavior and depression and to understand health status whether effected on exercise behavior of older persons. A cross-sectional correlational research design was employed. A sample of 153 older persons aged 65 and above was obtained by cluster sampling. Data were collected at subjects’ homes by one-by-one interview. The findings of the study were : (1) The majority (35%) of the participants was in the precontemplation stage and 7% was in the contemplation stage. The exercise types in which the participants engaged were walking (54.38%) and physical stretch exercise (15.79%). (2) Gender, age, marital status, and educational level were not statistically significant across the stages of change. Health status, however, was different across the stages of change. Older persons in the maintenance stage had the highest scores in physical health and overall health, while those in the contemplation stage had the lowest scores in physical health. (3) The percentage of the participants with depression was 33%. Older persons in the contemplation stage were the most depressed while those in the maintenance stage were the least depressed. (4) Depression was not statistically significant across the stages of change after health status treated as covariance. The findings of the study revealed that health status had effects on exercise behavior and depression of older persons. Health professionals could develop specific interventions according to health status and exercise stages of change of older persons. Consequently, this will decrease depression of older persons.