社區長者社會參與意圖及其相關之研究-以新北市新莊區為例

Abstract

背景：面對我國快速邁向超高齡社會，促進社區長者的社會參與已被視為延緩衰弱與提升生活品質的關鍵策略。然而，影響長者社會參與意圖的心理與情境因素仍待釐清。本研究運用健康信念模式（Health Belief Model, HBM）與自我效能理論，探討長者社會參與意圖之相關因素。 方法：採橫斷式調查設計，隨機抽取新北市新莊區 65 歲以上長者 379 位，透過結構式問卷收集人口學特徵、信康信念（自覺罹患性、嚴重性、利益性、障礙性、行動線索）、自我效能與社會參與行為意圖。以描述統計、t 檢定、單因子變異數分析、皮爾森積差相關及多元線性迴歸檢驗研究假設。 結果： 一、年齡、教育程度與慢性病狀況顯著影響健康信念與自我效能（p < .05）。 二、背景變項（性別、婚姻、居住情況、慢性病）與行為意圖呈顯著關聯；女性、已婚及非獨居長者之參與意圖較高。 三、多元迴歸顯示，自我效能（β = 0.43, p < .001）、自覺利益性（β = 0.29, p < .001）可正向預測社會參與意圖；自覺障礙性則呈負向預測（β = –0.25, p < .001）。模型共解釋行為意圖變異量 52%。 結論：提升長者對社會參與之利益認知、降低參與障礙、並強化自我效能，可有效增進其社會參與意圖。建議政府與社區單位設計貼近需求的活動情境、提供多元行動線索與交通支持，並透過同儕示範與能力培力方案，打造友善參與環境，以促進活躍老化與延緩衰弱。

Background In rapidly ageing Taiwan, social participation is considered pivotal for maintaining quality of life and delaying frailty among community dwelling older adults. Yet the psychosocial determinants of participation intention remain unclear. Guided by the Health Belief Model (HBM) and self efficacy theory, this study examined factors associated with social participation intention in elders. Methods A cross sectional survey was conducted with 379 randomly selected residents aged ≥ 65 yearsin Xinzhuang District, New Taipei City. A structured questionnaire measured sociodemographics, HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action), self efficacy, and Behavioral Intention. Descriptive statistics, t tests, one way ANOVA, Pearson correlations, and multiple linear regression were applied.Results Age, education, and chronic disease status significantly affected health beliefs and self efficacy (p < .05). Gender, marital status, living arrangement, and chronic disease were correlated with intention; women, married, and non living alone elders showed higher intention. Regression analysis indicated that self efficacy (β = 0.43, p < .001) and perceived benefits (β = 0.29, p < .001) positively predicted social participation intention, whereas perceived barriers showed a negative effect (β = –0.25, p < .001). The model explained 52 % of the variance in intention. Conclusions Enhancing perceived benefits, reducing perceived barriers, and strengthening self efficacy are key to fostering social participation among older adults. Policymakers and community planners should create accessible activities, provide diverse cues to action and transportation support, and implement peer led empowerment programmes to cultivate an age friendly environment that promotes active ageing and delays frailty.