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研究生: 李雅雯
Lee Ya-Wen
論文名稱: 台灣地區老年人飲食品質相關因素研究
Factors Affecting Dietary Quality of the Elderly In Taiwan
指導教授: 林薇
Lin, Wei
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
論文出版年: 2002
畢業學年度: 90
語文別: 中文
論文頁數: 181
中文關鍵詞: 老年人營養知識營養態度飲食行為飲食品質
英文關鍵詞: elderly, nutrition knowledge, nutrition attitude, eating behavior, dietary quality
論文種類: 學術論文
相關次數: 點閱:894下載:189
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  • 本研究之主要目的在瞭解老年人的營養知識、營養態度、飲食行及飲食攝取之現況以及其相關因素,並探討影響老年人飲食品質的因素。研究者以「國民營養健康狀況變遷老人調查1998-1999」65歲以上老年人共1873人之資料進行分析。研究結果發現:老年人營養知識欠佳,但進食態度相當正向且不甚相信坊間流傳的保健說法及保健食品,然對傳統飲食禁忌卻極為篤信。此外有強烈的傳統飲食禁忌行為及高脂高膽固醇禁忌行為,但對醃漬發酵物及高澱粉高糖食物較不忌口,有規律食用三餐的習慣,但較不食用點心宵夜。依據研究者發展之飲食品質評估法DQS(Dietary Quality Score)評量老年人飲食狀況,發現四成老人飲食品質欠佳,其中豆類及家禽家畜類攝取頻率偏低,奶類及水果類攝取頻率更是不足;此外,雖仍有部分高油高鹽進食習慣,但已較少使用飽和脂肪含量較高的烹調用油。對飲食品質有直接影響的重要因素及其對飲食品質的影響分別為:女性有較佳的飲食品質;相對於本省閩南籍老年人,外省籍老年人有較佳的飲食品質;相對於居住於城市的老年人,山地、東部及澎湖的老年人飲食品質較差;教育程度越高者、經濟狀況越佳者、用餐時有他人陪伴者、或營養知識、進食態度愈佳者,飲食品質愈好;而高脂高膽固醇禁忌行為較強烈者、規律食用三餐及點心宵夜者飲食品質也愈佳。相關單位施行老人營養教育應以男性、澎湖、山地、東部地區、以及經濟狀況較差、低教育程度者為優先考量對象。

    The purpose of this study was to investigate the status and related factors of the elders’ nutrition knowledge, attitude, and behavior, as well as the factors affecting dietary quality. Data of Nutrition and Health Survey in Taiwan II (NAHSIT II) was used for analysis, the subjects were 1873 elderly aged over 65. The results indicated that the elders’ nutrition knowledge was poor, the nutrition attitude was fair, but they firmly believed Chinese traditional dietary taboos. Their dietary restricted behaviors related to Chinese traditional taboos and high-fat/ high-cholesterols foods were intense, but not the fermented or pickled foods, and high-starch/ high-sugar foods. The elderly ate each meal regularly, but were not used to eat snacks between meals. 40% elders’ overall dietary quality was not satisfactory based on the DQS (Dietary Quality Score) developed by researchers. The frequency of soybean products and poultry, red meat intake was low, as well as milk and fruits; although some high-fat eating habits still existed, the cooking oils used were very low in saturated fat. Major factors contributing to dietary quality of Taiwanese elderly were gender, native place, location of residence, educational level, financial status, eating-accompanying, nutrition knowledge, eating attitude, high-fat/ high-cholesterol food restriction, regular meal eating and regular snack eating. Individuals who were females, were Mainlanders (compared with Fukkien), had higher educational level, better financial status, being accompanied while eating had better dietary quality; compared with the urban elderly, those were the residents in mountain areas, the east of Taiwan, or Penghu had worse dietary quality. Based on the research results, this study suggested that to improve the dietary status of the elders, it is necessary to improve the nutrition knowledge, attitude and emphasize the importance of high fat/high cholesterol food restriction, regular meal eating, snacks eating, and eating accompany. Male, those who lived in remote areas, such as mountain areas, the east of Taiwan, and Penghu, and those who had poor financial status or lower educational level, are the first priority target group for nutrition education.

    內容目次……………………………………………………………….I 附表目次……………………………………………………………….V 附圖目次……………………………………………………………….VII 第一章 緒論…………………………………………………………1 第一節 研究動機…………………………………………….1 第二節 研究目的…………………………………………….3 第三節 研究問題…………………………………………….3 第四節 名詞界定…………………………………………….4 第二章 文獻探討…………………………………………………….6 第一節 營養與老化…………………………………………..6 壹、老化的生物學……………………………………….6 貳、老化的營養學……………………………………….7 參、營養與老化的關係………………………………….8 第二節 老年人的飲食營養狀況及影響因素………………..9 壹、 老年人的飲食營養狀況…………………………….9 貳、 老年人飲食品質的影響因素……………………….11 第三節 飲食品質評量………………………………………..21 壹、整體飲食品質評量的重要性……………………….21 貳、整體飲食品質的評量方法………………………….22 第三章 材料與方法…………………………………………………..40 第一節 研究架構……………………………………………..40 第二節 研究對象與研究變項………………………………..41 第三節 研究工具……………………………………………..47 壹、 個人基本資料問卷…………………………………....47 貳、 營養知識、態度與行為問卷…………………………47 參、 飲食問卷………………………………………………49 肆、 二十四小時飲食回憶記錄……………………………49 第四節 飲食品質評量方法…………………………………...51 壹、 飲食品質分數…………………………………………51 貳、 健康進食指數…………………………………………70 參、 飲食品質評量方法之效度檢定………………………71 第五節 資料分析……………………………………………...83 第四章 結果分析與討論……………………………………………..86 第一節 研究樣本個人背景變項分析…………………………..86 第二節 老年人營養知識、態度、飲食行為及飲食品質 之分析…………………………………………………..91 壹、 老年人營養知識現況…………………………………91 貳、 老年人營養態度現況…………………………………92 參、 老年人飲食行為現況…………………………………93 肆、 老年人飲食品質分數得分情形與食物攝取狀況……95 第三節 老年人營養知識、態度、飲食行為、及飲食品質 相關因素分析………………………………………….103 壹、個人背景變項與營養知識、態度、飲食行為、 飲食品質的相關情形…………………………………103 貳、營養知識、態度、飲食行為、及飲食品質間 的相關情形……………………………………………109 第四節 老年人飲食品質影響因素分析………………………112 壹、 變項處理及多元共線性診斷………………………..112 貳、 飲食品質營養因素分析……………………………..114 第五節 研究限制………………………………………………123 第五章 結論與建議…………………………………………………125 第一節 結論……………………………………………………125 第二節 建議……………………………………………………127 參考文獻………………………………………………………………132 壹、 中文部分…………………………………………………..132 貳、 日文部分…………………………………………………..134 參、 西文部分…………………………………………………..134 附錄……………………………………………………………………144 附錄一 各地區層中選之鄉鎮市區及村里……………………144 附錄二 「國民營養健康狀況變遷老人調查1998-1999」 問卷…………………………………………………..145 附錄三 老年人營養態度因素負荷量矩陣……………………172 附錄四 老年人飲食禁忌行為因素負荷量矩陣………………173 附錄五 各子類食物每100卡之營養素含量表………………174 附錄六 食物子類之營養素係數………………………………175 附錄七 老年人各食物項目單次攝取量………………………176 附錄八 飲食品質計分-用油種類部分之給分………………..177 附錄九 老年人飲食品質分數得分分佈………………………178 附錄十 老年人個人背景變項相關矩陣………………………179 附錄十一老年人飲食品質多元逐步迴歸分析摘要表………..180 附錄十二 老年人飲食營養訊息主要來源答題情形…………181 附表目次 表2-3.1 以食物或食物群為基礎的飲食品質評量方式……………...26 表2-3.2 老年人飲食型態相關研究…………………………………...30 表2-3.3 結合營養素與食物群的飲食品質評量方式 -飲食品質指數………………………………………………..33 表2-3.4結合營養素與食物群的飲食品質評量方式 -健康進食指數………………………………………………..34 表2-3.5 結合營養素與食物群的飲食品質評量方式 -飲食品質指數修訂版………………………………………..35 表2-3.6 結合營養素與食物群的飲食品質評量方式 -中國飲食品質指數…………………………………………..37 表2-3.7結合營養素與食物群的飲食品質評量方式 -健康飲食指標………………………………………………..38 表3-2.1 研究變項之操作型定義與計分方式或虛擬變項……………43 表3-4.1 飲食頻率計分-主食類食物之子類別及項目………………..56 表3-4.2 飲食頻率計分-蛋豆魚肉類之食物子類別及項目…………..57 表3-4.3 飲食頻率計分-奶類之食物子類別及項目…………………..57 表3-4.4 飲食頻率計分-蔬菜類之食物子類別及項目………………..57 表3-4.5 飲食頻率計分-水果類之食物子類別及項目………………..58 表3-4.6 飲食頻率計分-其他類之食物子類別及項目………………..58 表3-4.7 飲食品質計分-各食物子類最高得分之計分流程…………..59 表3-4.8 五大類食物中各食物子類之歸類…………………………...62 表3-4.9 飲食品質計分-飲食頻率部分之給分………………………..64 表3-4.10 飲食品質計分-飲食習慣部分之給分………………………68 表3-4.11 HEI之計分方法……………………………………………70 表3-4.12 DQS及HEI與營養相關血液生化值之斯皮爾曼 等級相關矩陣……………………………………………….72 表3-4.13 不同DQS得分組別之24小時飲食回憶記錄攝取 營養素單因子變異數分析摘要表………………………….75 表3-4.14 不同HEI得分組別之24小時飲食回憶記錄營養 素攝取單因子變異數分析摘要表………………………….78 表3-4.15 DQS及HEI與24小時飲食回憶記錄攝取營養素 之皮爾森積差相關矩陣…………………………………….80 表4-1.1 研究樣本個人背景變項之分佈狀況………………………...87 表4-2.1 老年人營養知識量表得分情形………………………………92 表4-2.2 老年人營養態度量表得分情形………………………………92 表4-2.3 老年人飲食禁忌行為之答題情形及得分情形………………93 表4-2.4 老年人餐點規律性之答題情形及得分情形…………………94 表4-2.5 老年人飲食品質分數之得分情形……………………………95 表4-2.6 飲食品質分數之各類食物及飲食習慣、用油種類 得分分佈……………………………………………..……….97 表4-2.7 老年人各食物子類每月攝取頻率之次數分配………………98 表4-2.8 老年人飲食習慣答題情形…………………………………..101 表4-3.1 老年人個人背景變項與營養知識、態度、飲食 行為、飲食品質之相關矩陣……………………………….104 表4-3.2 老年人營養知識、態度與飲食行為、飲食品質 之相關矩陣…………………………………………………110 表4-4.1 自變項間共線性診斷結果分佈…………………………….113 表4-4.2 老年人飲食品質之階層迴歸分析摘要表………………….115 附圖目次 圖3-1 研究架構圖…………………………………………………….40 圖3-2 飲食品質分數(DQS)建構流程圖………………………….54

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