身體活動健康促進方案介入庇護工場員工之成效探討
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2023
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隨著台灣庇護工場的發展到如今面臨不同的經營困境，包括庇護工場的定位爭議、如何協助身心障礙者轉銜、如何永續發展等。其中身心障礙者的健康是關鍵的影響因素，卻常常受到忽略，以致身體活動不足進而造成慢性疾病、提早老化、二度障礙等。因此，健康促進對身心障礙者來說是很重要的。研究顯示達到美國運動醫學學會於 2018 年訂定身體活動指南標準，每週從事 150 分鐘中等強度以上之有氧運動，有助於提升且維持良好的身體組成與功能性體適能。且任務導向的有氧運動可提高個案對訓練方案的服從度，進而達到更好的訓練效果，並從中獲得成就感幫助提升參與者的自我效能。自我效能有助於健康生活型態的維持，當個人感受到身體狀態與功能的提升，會影響其面對生活中遭遇困難的自我認知，隨之提升日常生活活動的勝任程度，最後改善整體的生活品質。本研究目的旨在探討身體活動健康促進方案對於庇護工場員工之身體組成、功能性體適能、自我效能與生活品質之成效。研究方法採用實驗研究法，以方便取樣的方式，選取一家庇護工場為實驗組，另一家庇護工場則為控制組，實驗組參與身體活動健康促進方案，透過動作類電玩遊戲，以活動任務為導向，進行為期十二週，每週三次，每次 50-60 分鐘的訓練，過程中會監測參與者的心律以確保運動強度達到中等以上，而控制組則維持原有的生活型態。結果參數包括功能性體適能（包括身體組成、肌力、心肺耐力、柔軟度、平衡能力與敏捷度）來了解身心障礙者生理層面的變化，其中身體組成包括體重、體脂率、軀幹、上肢、下肢分部位的骨骼肌率、身體質量指數和基礎代謝率，並藉由一般自我效能量表-中文版和台灣簡明版世界衛生組織生活品質問卷，進一步了解身心障礙者心理層面的變化，收集資料時間點包括：訓練前（前測）、訓練六週後（後測一）、訓練十二週後（後測二）。本研究共有 32 位參與者完成三次前後測評估（實驗組 16 位、控制組 16 位），使用 SPSS 23.0 中文版統計分析軟體進行數據分析，數據分析包含：獨立 T 檢定、卡方檢定、混合設計重複量數雙因子變異數分析，顯著水準為 p＜.05。統計分析結果發現，本研究所設計的身體活動健康促進方案對於身體組成（體重和骨骼肌率）、肌肉力量、心肺耐力、動態平衡能力和自我效能有顯著的影響。若要建立健康的生活型態，達到促進健康並提升生活品質的目的，尚需提升身心障礙者的健康知能，加入飲食的控和作息的調整，未來之研究建議以複合式健康促進方案進一步探究身心障礙者的健康議題。
With the development of sheltered workshops in Taiwan, they are now facing different operating difficulties, including how to set the positioning of sheltered workshops, how to assist people with disabilities in transitioning, and how to develop sustainably, etc. Among them, the health of people with disabilities is a key influencing factor, but it is often ignored, resulting in insufficient physical activity, which leads to chronic diseases, premature aging, and secondary disability. Therefore, health promotion is important for people with disabilities because of these unhealthy conditions. Research shows that meeting the physical activity guidelines, engaging in 150 minutes of moderate-intensity aerobic exercise per week, set by the American College of Sports Medicine in 2018 can help improve and maintain good body composition and functional fitness. And task-oriented aerobic exercise can improve the participants' compliance with the training, thereby achieving better training results and gaining accomplishment from it which increase participants' self-efficacy. Self-efficacy contributes to the maintenance of a healthy lifestyle. When an individual feels an improvement in their physical state and body functions, it will affect their selfawareness in difficulties encountered in life, and subsequently improve their competence in activities of daily living. When individuals feel the improvement of their physical state and function, it will affect their self-recognition when they encounter difficulties of life, thereby improving their competence in daily living activities, and finally improving their overall quality of life.The purpose of this study is to investigate the effect of a physical activity health promotion program on body composition, functional fitness, self-efficacy, and quality of life of workers in the sheltered workshops. This is an experimental research design study. The research selected one sheltered workshop as the experimental group (n=16) and the other sheltered workshop as the control group (n=16) by convenience sampling. The experimental group received the training of the physical activity health promotion program. The training program lasted for twelve weeks and there were three 50-60 minute training sessions in each week. And the control group maintained the original lifestyle. To understand the physiological changes in people with disabilities, we measured participants' functional fitness (including body composition, muscle strength, cardiorespiratory endurance, flexibility, balance, and agility). The outcome measurements of body composition included body weight, body fat percentage, skeletal muscle percentage of the trunk, upper/lower limbs, and body mass index, and basal metabolic rate. And by collecting the result parameters of the General Self-Efficacy Scale[GSES]-Chinese version and the WHOQOL-BREF Taiwan Version, we can further understand the changes inthe psychological level of people with disabilities. The outcome measurements were measured at the time before training, six weeks after training, and twelve weeks after training.A total of 32 participants completed the entire experiment (16 in the experimental group and 16 in the control group). SPSS 23 was used to perform the following statistical analysis to answer the research questions: independent t-test, Chi-square test, and mixed-design repeated measure two-way analysis of variance analysis. The statistical significance is defined as p＜.05. Statistical analysis results found that the physical activity health promotion program designed in this study had a significant impact on body composition (weight and skeletal muscle rate), muscle strength, cardiorespiratory endurance, dynamic balance ability and self-efficacy. To establish a healthy lifestyle, achieve the purpose of promoting health and improving the quality of life, it is necessary to improve the health knowledge of people with physical and mental disabilities, including dietary control and adjustment of work and rest. Multi-component health promotion program can be used to explore health issues for people with disabilities in future research.
With the development of sheltered workshops in Taiwan, they are now facing different operating difficulties, including how to set the positioning of sheltered workshops, how to assist people with disabilities in transitioning, and how to develop sustainably, etc. Among them, the health of people with disabilities is a key influencing factor, but it is often ignored, resulting in insufficient physical activity, which leads to chronic diseases, premature aging, and secondary disability. Therefore, health promotion is important for people with disabilities because of these unhealthy conditions. Research shows that meeting the physical activity guidelines, engaging in 150 minutes of moderate-intensity aerobic exercise per week, set by the American College of Sports Medicine in 2018 can help improve and maintain good body composition and functional fitness. And task-oriented aerobic exercise can improve the participants' compliance with the training, thereby achieving better training results and gaining accomplishment from it which increase participants' self-efficacy. Self-efficacy contributes to the maintenance of a healthy lifestyle. When an individual feels an improvement in their physical state and body functions, it will affect their selfawareness in difficulties encountered in life, and subsequently improve their competence in activities of daily living. When individuals feel the improvement of their physical state and function, it will affect their self-recognition when they encounter difficulties of life, thereby improving their competence in daily living activities, and finally improving their overall quality of life.The purpose of this study is to investigate the effect of a physical activity health promotion program on body composition, functional fitness, self-efficacy, and quality of life of workers in the sheltered workshops. This is an experimental research design study. The research selected one sheltered workshop as the experimental group (n=16) and the other sheltered workshop as the control group (n=16) by convenience sampling. The experimental group received the training of the physical activity health promotion program. The training program lasted for twelve weeks and there were three 50-60 minute training sessions in each week. And the control group maintained the original lifestyle. To understand the physiological changes in people with disabilities, we measured participants' functional fitness (including body composition, muscle strength, cardiorespiratory endurance, flexibility, balance, and agility). The outcome measurements of body composition included body weight, body fat percentage, skeletal muscle percentage of the trunk, upper/lower limbs, and body mass index, and basal metabolic rate. And by collecting the result parameters of the General Self-Efficacy Scale[GSES]-Chinese version and the WHOQOL-BREF Taiwan Version, we can further understand the changes inthe psychological level of people with disabilities. The outcome measurements were measured at the time before training, six weeks after training, and twelve weeks after training.A total of 32 participants completed the entire experiment (16 in the experimental group and 16 in the control group). SPSS 23 was used to perform the following statistical analysis to answer the research questions: independent t-test, Chi-square test, and mixed-design repeated measure two-way analysis of variance analysis. The statistical significance is defined as p＜.05. Statistical analysis results found that the physical activity health promotion program designed in this study had a significant impact on body composition (weight and skeletal muscle rate), muscle strength, cardiorespiratory endurance, dynamic balance ability and self-efficacy. To establish a healthy lifestyle, achieve the purpose of promoting health and improving the quality of life, it is necessary to improve the health knowledge of people with physical and mental disabilities, including dietary control and adjustment of work and rest. Multi-component health promotion program can be used to explore health issues for people with disabilities in future research.
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Keywords
庇護工場, 健康促進, 動作類電玩遊戲, 功能性體適能, 自我效能, 生活品質, sheltered workshops, health promotion, exergame, functional fitness, self-efficacy, quality of life