Publication:

社區中老年人運動行為之改變─運用跨理論模式介入之質性研究

儘管許多研究已顯示運動對於老年人的健康很重要，但是根據調查我國老年族群仍屬於運動不足。可見如何使坐式生活者開始從事規律性運動，是目前首要克服的課題。跨理論模式是一個常應用在健康行為改變的策略，包括改變的階段、改變的處理過程、決策的權衡和自我效能。基於每個階段有不同特性，所以在不同改變階段則需運用不同策略，才能有效的協助運動行為的建構。基於上述之動機，本研究將採取透過實地進入社區，並以影像記錄，最後以訪談的方式了解其運動階段之改變與策略介入之影響。目的：1.以跨理論模式之改變階段，描述社區老年人的運動行為改變歷程。2.運用跨理論模式之改變的處理過程，規劃適當的策略介入，協助社區老年人持續參與運動課程。3.了解影響社區老年人進入運動行為維持期之重要因素。方法：在運動參與過程中介入改變的策略方法，協助老年人繼續參與運動課程。使用訪談的研究方式嘗試瞭解其參與運動課程之行為改變歷程，而探討介入後對於其改變階段之影響。並且以實地觀察紀錄、重要關係人之訪談作為輔助性資料。結果：1.介入之改變的策略包含「意識提升」、「情感喚起」、「環境再評估」、「自我再評估」、「自我解放」、「增強管理」、「助人之人際關係」、「反制約」、「刺激控制」。2.各階段介入之改變的處理過程為：(1)使參與者從「無意圖期」提升至「意圖期」，則使用「意識提升」、「情感喚起」與「環境再評估」。(2)使參與者從「意圖期」提升至「準備期」，則使用「自我再評估」。(3)使參與者從「準備期」提升至「行動期」，則使用「自我解放」。(4)使參與者從「行動期」提升至「維持期」，則使用「增強管理」、「助人之人際關係」、「反制約」與「刺激控制」。3.本研究的5位受訪者規律的參與運動後，目前其運動階段已提升至維持期並持續6個月以上。

Cycling has become one of the options of leisure activities. Previous studies have demonstrated the impact of endurance exercise on cardiac damage in well-trained athletes. The effect of long-term endurance exercise on cardiac damage in untrained persons still remains unclear. The purpose of this study was to evaluate heart damage during different exercises in healthy people. These studies were achieved by: (1) 32 untrained healthy subjects (24 males and 8 females, 19-38 years old) who participated in 2008 The Ironcamel Cycling Tour of Taiwan. The tour covered 1114 km in 15 days. All subjects were in a free-feeding style during the tour. Fasting blood samples were collected in the early morning on day 1, 5, 10, 15 during the tour and 4 days after the tour. (2) 10 trained healthy males who participated in 2008 Dong Hwa University Triathlon Championships. All subjects completed for 750 meter swim (limited time : 30 minutes), 20 km bike (50 minutes), and 5 km road race (40 minutes). Water-drinking was not restricted for all subjects during the competition, and blood samples were collected before and after the race.

All plasma samples were analyzed for myoglobin, creatine kinase MB (CK-MB), N-terminal B-type Natriuretic Peptide (NT-proBNP) and cardiac troponin T (cTnT) concentrations. The results showed: (1) the concentration of myoglobin was significantly increased on day 5; that of CK-MB was significantly increased during the tour; and that of NT-proBNP was peaked on day 5, then was slowly reduced and returned to baseline level . (2) myoglobin, CK-MB, and NT-proBNP levels after the race were significantly higher than before. cTnT levels were detected below the minimum before and after the race. The current results suggested that biomedical markers of heart damage might be increased according to the increase in exercise intensity and time after long-term cycling tour and triathlon, but soon returned to their original levels, changes are in the standard rage. General young people who are enjoying these kinds of activities might not have the necessity to worry about big health concerns on cardiac aspects.