骨質疏鬆症成為全球性老化不可避免的疾病，隨著國人營養衛生狀況改善，社會人口逐漸高齡化後骨質疏鬆症造成的脊椎及髖部骨折，將造成嚴重罹病甚至於致命的合併症。根據2005-2008年國民營養調查報告指出50歲以上男女骨質疏鬆症盛行率分別為23.9%及38.3%。依全民健保資料，65歲以上的男性每年髖部骨折個案由1996年3280例逐年增加至2002年5054例；女性則由5104例增加至8021例，平均每年增加9.5%。可見此骨質疏鬆症疾病應該被重視且應積極介入預防，減低對國人健康危害。
骨質疏鬆症疾病與年齡及老化程度有嚴重危險性，本文採用簡易問卷型式調查內含健康信念模式( Health Belief Model )廣泛導入疾病的偵測及預防；健康信念模式指出，個人將會預防疾病而採取措施，他們感受到疾病的嚴重性，深信此疾病發生將造成嚴重衝擊；而且願採取預防措施如攝取富涵鈣食物、運動行為，並除去任何阻礙的因素，主動預防。骨質疏鬆症健康知識是否有足夠性？是否將健康信念模式及健康知識轉化為預防疾病的意念與行為？骨質疏鬆症被視為慢性老年化疾病，運用健康信念模式將可預防骨質疏鬆症及減少低骨密度，而成功疾病預防模式則仰賴大眾對此疾病的健康知識。目前台灣國內尚無成熟的骨質疏鬆信念問卷量表，本文藉此研究調查南台灣50歲以上居民對骨質疏鬆症的知識，即是否有骨質疏鬆症疾病預防行為如主動接受骨質密度檢查，攝取富涵鈣食物、運動行為及預防跌倒，並作為解決健康問題的探討。
本文研究為橫斷式研究，以受試者年齡符合研究入選，為不分性別，年紀由50歲以上(含50歲)，經由研究助理於行政院衛生署所屬的某一醫療部門診收案，受試者約撥出20分鐘，可完成問卷，採不記名方式以問卷方式自我填寫如遇不識字者可由研究助理或陪伴者代為填寫完成或郵寄回函。本研究使用描述統計及推論統計加以分析。本研究亦使用多變項複迴歸(Multiple lineal regression)的方式檢測那些因素與結果的指標有統計上的關係(relations )。我們將以判定係數(coefficient of determination，R²)及F值判定模式的重要意義。
結果分析對骨密篩檢行為及費用(Y1)的檢測F值=1.313,adjR²0.013,P=0.204無顯著意義；但自覺身體狀況t=-1.99,(p<0.05)有統計意義。女性受試者其中自覺身體狀況t=-3.09,(p<0.001)有顯著意義。
(一)自變項基本屬性對預防骨鬆行為(運動、飲食)(Y2)的檢測中；女性基本屬性中自覺健康狀況t=-2.44,(P<0.05)具有統計意義。自變項基本屬性對預防跌倒措施(環境)(Y3)的檢測；基本屬性變項中女性t=1.98,(P<0.05)、不吸菸t=2.56,(P<0.05)、自覺健康狀況t=-2.43,(P<0.05)此屬性變項有統計意義。女性相對男性在自覺健康狀況此變項有預防骨鬆行為明顯改善作為。
(二)骨鬆健康信念變項對骨密篩檢行為及費用(Y1)的檢測F值=4.052,adj R²=0.163,(P<.001)有意義；其中補鈣益處t=2.17,(p<0.05)、攝鈣障礙t=5.29,(p<0.001)有統計意義。女性骨鬆健康信念變項因素易患性t=2.26,(p<0.05)及健康動機性t=3.20,(p<0.001)，而男性僅有健康動機性t=3.91,(p<0.001)有統計意義。
骨鬆健康信念對預防骨鬆行為(運動、飲食)(Y2)的檢測F值=6.482,adj R²=0.259,(P<.001)有意義；其中骨鬆健康信念變項補鈣益處t=5.15,(P<0.001)、健康動機t=4.14,(P<0.001)；此兩項有統計意義。女性骨鬆健康信念變項補鈣益處t=3.61,(p<0.001)及健康動機性t=3.59,(p<0.001)，而男性僅有補鈣益處t=2.74,(P<0.05)有統計意義。
骨鬆健康信念對預防骨鬆行為(環境)(Y3)的檢測F值5.72,adj R²=0.231,
,(P<0.001)有意義；其中骨鬆健康信念變項補鈣益處t=3.00,(P<0.001)、攝鈣障礙t=4.42,(P<0.001)變項有統計意義。女性骨鬆健康信念變項因素易患性t=1.94,(p<0.05)、補鈣益處t=1.97,(P<0.05)及健康動機性t=3.12,(p<0.001)；而男性僅有健康動機性t=2.68,(p<0.05)有統計意義。
(三)骨鬆健康知識對骨密篩檢行為及費用(Y1)的檢測女、男性無顯著差異。
骨鬆健康知識對預防骨鬆行為(運動、飲食)(Y2)的檢測男性健康知識變項t=2.06,p<0.05)，而女性並無此健康知識變項統計意義。
骨鬆健康知識變項對預防跌倒措施(環境)(Y3)的檢測女、男性無顯著差異。
研究結果顯示分析，男、女性受試者普遍骨質疏鬆的健康知識不足；並且在針對預防骨質疏鬆症行為表現明顯不佳。顯示衛教資訊及教育訓練介入措施仍有極大發揮空間作為預防疾病。而健康照護機構亦應當積極篩選出危險族群，除教育行為外，改善有老年人居住活動環境預防跌倒，皆是現階段有效的預防措施。

Osteoporosis knowledge, health beliefs, and preventive behaviors among old aged population at South Taiwan.

Purpose: To assess Osteoporosis, health beliefs and preventative behaviors of Osteoporosis (Calcium intake, physical activity, will to examine DXA, will to
Prevent fall) among old aged population.

Method; A cross-section design, convenient questionnaire consisted of items assessing osteoporosis knowledge, health beliefs and preventative behaviors practices those regarding calcium intake, physical activity, will to examine DXA, will to prevent fall among old aged population.
Total enrolled 315 persons , all aged ≧ 50 years joined this investigation without racial, religious or language restriction.
Descriptive statistics, Pearson correlation test, and multi-variable lineal regression test were used to analyze the data.

Result: Aged population believed that osteoporosis preventative behaviors existed such as calcium intake, physical activity and health motivation. But there are still huge barriers from get calcium, physical activity away from preventative behaviors.
However specific in depth knowledge regarding these risks factors were lacking. Further finding showed that osteoporosis preventative behavior(OPB)Y1,Y2,Y3。

目 錄
論文審定書 ............................................... i
誌謝.............................................. ..... .ii
中文摘要................................................iii
Abstract ...............................................v
目 錄..................................................vi
圖 次 ................................................viii
表 次 ..................................................ix
第一章 緒論...............................................1
第一節 研究背景及動機.....................................1
第二節 研究目的...........................................3
第二章 文獻查證...........................................4
第一節 骨質疏鬆症定義.....................................4
第二節 骨質疏鬆症的預防 ..................................4
第三節 骨鬆症預防跌倒措施.................................6
第四節 骨質疏鬆症健康信念.................................6
第五節 骨質疏鬆症健康知識.................................7
第六節 骨質疏鬆症引起骨折合併症及症狀困擾.................8
第三章 研究方法...........................................9
第一節 研究假設與架構.....................................9
第二節 研究對象、抽樣方法與資料收集程序...................11
第三節 研究工具問卷設計..................................12
第四節 研究變項的操作型定義..............................14
第五節 資料處理與分析方法................................16
第四章 研究分析與結果....................................18
第一節 描述性統計分析....................................18
第二節 T檢定的統計分析結果...............................21
第三節 雙變項皮爾森相關分析結果..........................24
第四節 多變項多元線性複迴歸分析..........................27
第五節 研究結果摘要......................................45
第六節 研究假設進行驗證結果..............................48
第五章 討論與建議........................................50
第一節 研究討論..........................................50
第二節 研究限制..........................................54
第三節 建議..............................................55
參考文獻.................................................56
附 錄 ..................................................62
一、 人體試驗委員會核准同意............................62
二、 骨質疏鬆問卷......................................64

圖 次
圖2-1 骨質疏鬆症健康信念面項表..........................7
圖3-1 本研究之研究架構圖................................9

表 次
表3-1 本研究內在一致性信度一覽表 13
表3-2 本研究各變項之操作型定義 14
表4-1 男女性基本資料的分析 19
表4-2 男女在年齡、教育程度上的不同 21
表4-3 本研究之依變項、自變項平均數標準差一覽表 22
表4-4 本研究男女之依變項、自變項平均數標準差一覽表 22
表4-5 相關性分析表 25
表4-6 健康信念、健康知識對[骨密篩檢行為及費用]之階層迴歸分析 28
表4-7 健康信念、健康知識對[骨密篩檢行為及費用]之階層迴歸分析(女性) 30
表4-8 健康信念、健康知識對[骨密篩檢行為及費用]之階層迴歸分析(男性) 32
表4-9 健康信念、健康知識對[預防骨鬆行為（運動、飲食）]之階層迴歸分析 34
表4-10 健康信念、健康知識對[預防骨鬆行為（運動、飲食）]之階層迴歸分析(女性) 36
表4-11 健康信念、健康知識對[預防骨鬆行為（運動、飲食）]之階層迴歸分析(男性) 38
表4-12 健康信念、健康知識對[預防骨鬆行為（環境）]之階層迴歸分析 40
表4-13 健康信念、健康知識對[預防骨鬆行為（環境）]之階層迴歸分析（女性) 42
表4-14 健康信念、健康知識對[預防跌倒行為（環境）]之階層迴歸分析(男性) 44
表4-15 驗證結果(女性) 48
表4-16 驗證結果(男性) 49

一、中文文獻：
期刊文章
1.楊榮森(2008):老年人的跌倒與骨折預防。台灣老年醫學會雜誌:Vol(3),p78-90。
2.陳玉平,劉雪琴,蔡德鴻(2005):骨質疏鬆症健康信念量表的信度和效度測定。中國臨床康復第9巻第3期。

書籍
1.骨質疏鬆症臨床治療指引：中華民國骨質疏鬆症學會100年12月第一版.
2.社會科學研究方法第9版：Earl Babbie著李美華、孔祥明等合譯
3.多元迴歸分析：余桂霖著

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1.王英偉、謝至鎠編(民國102年4月)。長者防跌妙招。上網日期：民國102年6月20日。衛生福利部國民健康署健康九九網站。
網址：http:/www.health99.doh.gov.tw
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書籍
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