in Health Promotion
MIMI M. Y. TSE, Ph.D., R.N., 1 KIM C. Y. CHOI, B.S.N., R.N.,2 and RINCY S.W. LEUNG, B.S.N., R.N.3
ABSTRACT
To meet the needs of frail older people and to promote functional longevity, providing health
education and disease prevention to the elderly is important. The present study describes the
development, implementation, and evaluation of an e-health program for older persons. The
objective of the 4-week e-health program was to improve elders’ autonomous access to and
use of health-related information in the form of physical exercise videography from a government-
sponsored Web site. The content of the program included participants’ mastery of
basic computing skills and accessing and enhancing participants’ interest in seeking healthrelated
knowledge and information via the Internet. Data were collected in weeks 1 (pretest)
and 4 (posttest) using questionnaires and open-ended questions. Thirty older people participated
in the study (9 males, 21 females, aged 65–80 years, with the mean age of 72). Participants’
mastery of basic computer operating skills increased significantly (p ? 0.05); they were
able to access health information via the Internet and had gained health-related knowledge
by week 4 posttest (p ? 0.05). The overall learning experience was positive. In conclusion, the
collaboration of community partners in sponsoring a technology-based e-health program
would be an effective way to provide health education to older people.
電子健康老年人：該技術使用
健康促進
我的軍事工業化謝，博士，註冊護士，1金賽揚財，學士學位進修，註冊護士，2和RINCY西南梁，B.S.N.，R.N.3
摘要
為了滿足需求，老年人和體弱促進長壽功能，提供健康
教育和預防疾病的老人非常重要。本研究介紹
開發，實施和評價的電子保健方案的老年人。該
目標 4週電子保健方案，以改善老年人的自主利用和
使用健康有關的信息的形式的體育鍛煉錄像從政府
贊助網站。該計劃內容包括學員精通
基本的計算機技能和獲取，提高參與者的興趣，尋求健康相關
知識和信息通過因特網。資料收集在1週（前測）
和4（後測）通過問卷調查和開放式問題。 30老年人參加
在研究中（9男21女，年齡 65-80歲，平均年齡 72）。參加者
掌握基本的電腦操作技能明顯提高（P？0.05）;他們
能夠獲得健康信息，並通過互聯網獲得的與健康有關的知識
通過 4週後測性（P？0.05）。整體的學習經驗是積極的。最後，
社區合作夥伴贊助的技術為基礎的電子健康計劃
將是一個有效的方式提供健康教育，老年人。
INTRODUCTION
TO MEET THE NEEDS of frail older people and to promote
functional longevity, it is important for
older people to receive health education for developing
healthy habits, maintaining health, and preventing
disease. The growth and implementation of
Web-enabled communication and patient services, as
well as e-health initiatives, enable patients, their families,
and their caregivers to access useful information
and resources;1 thus, the quality of services and
care can be improved. E-health is the use of Internet
technology and electronic communication to support
the delivery and management of health care services.
1–2 Internet users represent a large population
seeking information, and many are seeking healthrelated
information. Approximately 60 million adults
sought health-related information in 2000.1,3
Despite the advantages of the Internet and advances
in electronic communication, utilization of
the Internet among older adults in Chinese societies
is relatively low; only 2% of adults aged 65 or older
in Hong Kong and 0.8% of adults aged 60 or older
in mainland China are Internet users.4 One of the
reasons may be the low literacy level among older
people in Hong Kong and China; also, they have
limited access to computers, making them a difficult-
access group in terms of Internet and computer
usage.5 It was therefore the aim of the present study
to attempt to collaborate with a community center
for the elderly, using an e-health education program
to provide health education to older people. The objectives
of the present study include (a) mastery of
basic computer skills for older people; (b) enabling
older people to access health information via the Internet;
and (c) improving elderly people’s health-related
knowledge.
引言
以滿足需要的體弱老人和促進
長壽功能，它是重要的
老年人接受健康教育的發展
健康的生活習慣，保持健康，預防
疾病。的成長和實施
支持Web的通訊和病人服務，
以及電子保健措施，讓病人，家屬，
和他們的照顧者，以獲取有用信息
和資源; 1因此，質量和服務
護理可以改善。電子健康是使用互聯網
技術和電子通信支持
交付和管理的衛生保健服務。
1-2互聯網用戶佔人口眾多
尋求信息，許多人尋求健康相關
信息。大約 60萬成年人
尋求與健康有關的信息，2000.1,3
儘管互聯網的優勢和墊款
在電子通訊，利用
在互聯網中老年人在華人社會
比較低，只有2％的成年人65歲以上的老年人
在香港和0.8％的成年人60歲以上的老年人
大陸中國是互聯網 users.4之一
原因可能是老年人文化水平低
人在香港和中國，也有
限制使用電腦，使他們難以
訪問組中的條款，互聯網和電腦
usage.5因此在本研究的目的
嘗試與社區合作中心
老人，使用電子健康教育計劃
提供健康教育，老年人。的目標
本研究包括：（1）精通
基本的計算機技能的老年人;（二）使
老年人獲得保健信息通過互聯網;
及（c）改善老人的健康相關
知識。
METHODS
Sample
This was an illustrative case study. Thirty older
people attending community centers were invited
to participate in an e-health education program. The
inclusion criteria were (a) being an older person
who scored 24 or above on the Mini Mental Status
Examination and (b) being able to speak, understand,
and read Cantonese. Those with severe visual
impairment and functional deficits that would
hinder learning and operating the computer were
excluded.
E-health program: Objectives, implementation,
and evaluation
The 4-week e-health program (1.5 hrs per week)
was held in the activity room of an elderly center.
The objective of the e-health program was to improve
elders’ autonomous access to and use of
health-related information in the form of physical
exercise videography from a government-sponsored
Web site. The content of the e-health program
included mastery of basic computing skills and accessing
government health Web sites that provide
health information regarding exercise. Participants
were invited to perform exercise as recommended
on the Web sites, and the process was videotaped
and subsequently viewed on video compact disc
(VCD). The contents and expected outcomes of the
program are itemized in Table 1.
Pre- and post-questionnaires about the e-health
program, a knowledge test, and focus group interviews
were used. Participants were asked to complete
a questionnaire in week 1 (pretest) and in week
4 (posttest). A 5-point Likert scale (1, not very much;
5, a great deal) was used. Knowledge gained after
browsing the Web site was accessed using true and
false questions. The face validity of the questionnaires
and true and false questions were established
by the research team. Also, the test–retest reliability
was established (r 0.93) by repeat testing
among five older people.
Focus groups were conducted at the end of the
e-health program for participants and staff working
in the elderly center. Data collection ceased when
saturation was achieved. The interviews were audiotaped
and transcribed. Related content was clustered
by themes and further analyzed into categories
for comparison and discussion.
方法
樣本
這是一個典型案例研究。 30老
人被邀請參加社區中心
參與電子健康教育計劃。該
納入標準分別為：（1）作為一個老年人
誰得分24或以上的迷你精神狀態
考試及（b）能夠說話，理解，
並宣讀粵語。那些有嚴重視覺
損害和功能缺損，將
妨礙學習和操作電腦的
排除在外。
電子保健方案：目標，執行，
和評價
4週電子保健方案（每週 1.5小時）
在舉行活動室的老人中心。
客觀的電子保健方案，以改善
長者自主獲取和利用
與健康有關的資料，實物的形式
演習錄像從政府資助
網站。內容的電子保健方案
包括掌握基本的計算機技能和獲取
政府衛生網站提供
關於衛生信息工作。與會者
被邀請的建議做運動
在這些網站上，整個過程進行了錄像
並隨後觀看視頻光盤
（光碟）。內容和預期成果的
分項計劃是在表1。
前和後的問卷對電子保健
方案，知識測試，焦點小組訪談
使用了。參與者被要求完成
本週一在一份調查問卷（預試）和週
4（後測）。阿五點李克特尺度（1，沒有多大;
5，一個偉大的交易）的使用。後獲得的知識
瀏覽該網站被訪問使用真實
虛假的問題。表面效度的問卷
和真正的和虛假的問題，建立
由研究團隊。此外，可靠性測試Etest法
成立（註冊商標 0.93）的重複測試
其中5老年人。
焦點小組進行，最後的
電子保健方案的參與者和工作人員的工作
在老人中心。數據收集時停止
飽和度達到了。在訪談錄音
和轉錄。相關內容是群集
按主題進行分類，並進一步分析
進行比較和討論。
RESULTS
Demographic data
Thirty older people (9 males, 21 females) participated
in the study (Table 2).
Mastery of computer skills, interest, and health-related
knowledge gained via the e-heath program
Table 3 shows a significant increase in mastery of
computer skills and interest in accessing health information
via the Internet after the 4-week e-health
program; knowledge of health information in the
area of physical exercise also increased significantly
(p ? 0.05). Participants were able to operate the
computer and access health information via the Internet,
and they expressed confidence in their ability
to do so. Participants were also found to have
increased their knowledge after reading information
on the Web sites, with a significant increase in
giving correct answers to health-related questions.
Focus group interview
Focus group interviews revealed that elderly center
staff were impressed by the active involvement
of the older persons in the e-health program. Staff
felt that providing such programs through elderly
centers would be useful. The following comments,
made by participants during the focus group interviews,
highlight their reactions to the e-health program
and their concerns about using technology.
Explore the technology. “It provides an opportunity
to explore technology that we had not imagined
before.” “I could obtain health information.
There is a lot of information out there, and I was
able to use it.”
Language barrier and lower education level. “We
don’t know many words.” “People think we are oldfashioned,
so there’s no need to learn about computers.”
“We can’t even type. How are we supposed
to manage Chinese typing?”
Physical disabilities. “Poor eye–hand coordination
makes it difficult for us to use the mouse.” “When
sitting for a period of time, I get severe low back
pain. It annoys me.”
Limited resources. “We live alone and on CSSA
[Comprehensive Social Security Assistance]. How
can we get a computer?”
Lack of guidance. “I don’t know where to get help;
my friends don’t know about computers, and they
cannot discuss computer use with me.” “I don’t
know the addresses of these Web sites.”
結果
人口統計數據
30老年人（男9例，女21）參加
在研究中（表2）。
掌握計算機技能，興趣，以及與健康有關
獲得的知識通過電子健康計劃
表3顯示了顯著增加精通
計算機技能和興趣在獲取衛生信息
通過互聯網後 4週的電子健康
方案;知識的健康信息在
面積也顯著增加體育鍛煉
（P值0.05）。參加者能夠操作
計算機和獲得保健信息通過互聯網，
他們表示，相信他們有能力
這樣做的。與會者還發現有
增加他們的知識在閱讀信息
在這些網站上，有顯著增加
給予正確的答案與健康有關的問題。
焦點團體訪談
焦點小組訪談發現，老人中心
工作人員留下深刻印象的積極參與
對老年人在電子保健方案。員工
認為，這種方案通過提供長者
中心將是有益的。以下評論，
與會者提出，在焦點團體訪談，
他們的反應突出的電子保健方案
他們的關注和使用技術。
探索這一技術。 “它提供了一個機會
探索技術，我們沒有想到
前。“”我可以得到健康的信息。
有很多信息在那裡，而我
可以使用它。“
語言障礙和教育程度較低。 “我們
不知道很多的話。“”人們認為我們是老式，
因此沒有必要學習電腦。“
“我們甚至不能類型。我們應該如何
管理中文打字？“
身體殘疾。 “可憐的手眼協調
使我們難以用鼠標“。”當
坐在一期的時候，我得到嚴厲的腰背
疼痛。這讓我很煩。“
有限的資源。 “我們獨居及領取綜援
[綜合社會保障援助]。如何
我們可以得到一台電腦？“
缺乏指導。 “我不知道在哪裡可以得到幫助;
我的朋友們不知道的電腦，他們
不能討論計算機使用我。“”我不
知道了這些網站的地址。“
DISCUSSION
The present study demonstrated an innovative
way of using the Internet to search for health information
and improve health promotion among
community-dwelling older adults. With the collaboration
of community services, the use of technology
in the form of an e-health program would be
an effective tool in providing health education to
older people. Computer skills, interest in accessing
health information, and health knowledge gained
were found among the 30 participants. It is suggested
that attending the e-health program helped
to build their confidence in searching health-related
Web sites and that they benefited from information
obtained from these Web sites. Therefore, the ehealth
program and the use of Internet technology
will be a new trend in health promotion and health
education among the older population.6
As older populations and their vulnerability to
health problems increase, e-health education can
help to enhance their health status.7 The use of ehealth
education can help promote healthy habits
and lifestyles and increase health knowledge among
older people. Continual and regular provision of ehealth
programs for older people will bring positive
health outcomes to older adults and to society as a
whole.
討論
目前的研究表明一種創新
使用互聯網的方式來搜索健康資訊
健康促進和改善中
社區中居住的老年人。隨著合作
社區服務，使用的技術
在表格的電子保健方案將
一個有效的工具，提供健康教育
老年人。計算機技能，興趣訪問
衛生信息，健康知識獲得
發現其中30人參加。這是建議
，出席電子保健方案幫助
建立自己的信心，查找與健康有關
網站，他們從信息中受益
從這些網站獲得。因此，電子衛生保健
方案和互聯網技術的使用
將是一個新趨勢，健康促進和健康
教育的老population.6
隨著老年人口和易受
健康問題的增加，電子健康教育能
有助於提高他們的健康status.7電子衛生保健的使用
教育可以幫助促進健康的生活習慣
和生活方式，提高健康知識調查
老年人。持續和定期提供電子衛生保健
方案將帶來積極的老年人
對老年人健康的成果和社會作為一個
整體。
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