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æ∫., «.«.( Ÿµ‘π√’‡«™»“ µ√å), .¡.(∫√‘À“√ “∏“√≥ ÿ¢) ° .∫., æ.¡.(æ—≤π“∫√‘À“√»“ µ√å)
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Walking for Health: a Community-Based Program Designed to Increase Physical Activity among Older Thais. M.D.,Board of OB & GYN,MSHCA (Science in Health Cace Administration) Bureau of Health Promotion, Department of Health. Aree Paramathakorn B.Ed.,MSS (Social Science) The 5th Regional Health Promotion Center, Nakhonratchasima. Ekachai Piensriwatchara
82
µÿ≈“§¡ - ∏—𫓧¡ 2553
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
‡¥‘π‡æ◊ËÕ ÿ¢¿“æ: √Ÿª·∫∫°“√ à߇ √‘¡°‘®°√√¡∑“ß°“¬„π™ÿ¡™π ”À√—∫ºŸâ Ÿß«—¬™“«‰∑¬
Abstract Thai older people are rapidly increasing in number. Nearly half have a chronic disease, often attributable to poor health habits. Therefore, an exercise program was designed for older Thai participants, and the outcomes were evaluated. The effect of 9 weeks physical intervention on 124 adults aged 60 and older was examined by assessing their walking levels with step counter and measuring physical performance change by fitness test. The participants were aged 67 years on average. The mean steps per day increased from 5,855 to 12,205 (p<.001). The results of fitness test significantly improved (p<.001). The overall program satisfaction was 82%. This program was associated with improved physical activities in older adults. Key words: health promotion, exercise, older adults
∫∑π” ”π— ° ß“π§≥–°√√¡°“√æ— ≤ π“°“√ ‡»√…∞°‘ ® ·≈– — ß §¡·Àà ß ™“µ‘ §“¥ª√–¡“≥ ª√–™“°√ºŸâ Ÿß«—¬ „πªï æ.». 2553 ¡’®”π«π 8 ≈â“π §π À√◊Õ√âÕ¬≈– 11.9 ¢Õߪ√–™“°√‰∑¬ ·≈–§“¥ °“√≥å«“à „πÕ’° 20 ªï¢“â ßÀπâ“®–‡æ‘¡Ë ‡ªìπ 17.7 ≈â“π §π À√◊Õ√âÕ¬≈– 25 ¢Õߪ√–™“°√‰∑¬ ∑”„Àâ ª√–‡∑»‰∑¬‡ªì π ª√–‡∑»Àπ÷Ë ß „π∑«’ ª ‡Õ‡™’ ¬ ∑’Ë ¡’ Õ— µ √“°“√‡æ‘Ë ¡ ¢÷È π ¢ÕߺŸâ Ÿ ß «— ¬ Õ¬à “ ß√«¥‡√Á « ·µà ¡’ ‡«≈“‰¡à¡“°‡¡◊ËÕ‡∑’¬∫°—∫À≈“¬ª√–‡∑»∑’Ëæ—≤π“ ·≈â « „π°“√‡µ√’ ¬ ¡§«“¡æ√â Õ ¡‡æ◊Ë Õ √— ∫ ¡◊ Õ °— ∫ ∂“π°“√≥å —ß§¡ºŸâ Ÿß«—¬1 ® “ ° ° “ √ ” √ « ® ¿ “ « – ÿ ¢ ¿ “ æ ¢ Õ ß ”π—°ß“π ∂‘µ·‘ Ààß™“µ‘„πªï 2550 æ∫«à“√âÕ¬≈– 48 ¢ÕߺŸâ Ÿß«—¬¡’‚√§‡√◊ÈÕ√—ß ‚¥¬æƒµ‘°√√¡‡ ’ˬß∑’Ë ‡°’ˬ«¢âÕ߉¥â·°à °“√¢“¥°“√ÕÕ°°”≈—ß°“¬ ¿“«– ∑ÿ æ ‚¿™π“°“√ °“√¥◊Ë ¡ ÿ √ “ Ÿ ∫ ∫ÿ À √’Ë ‡ªì π µâ π πÕ°®“°π’È ¬— ß æ∫«à “ ºŸâ Ÿ ß «— ¬ ™“«‰∑¬∑’Ë Õ Õ°°”≈— ß °“¬Õ¬à“ß ¡Ë”‡ ¡Õ¡’‡æ’¬ß√âÕ¬≈– 412 ºŸâ Ÿß«—¬∑’Ë ¢“¥°“√ÕÕ°°”≈—ß°“¬ À√◊Õ‰¡à‰¥âÕÕ°·√ß„π°“√ ∑”°‘®«—µ√ª√–®”«—π¡’§«“¡‡ ’¬Ë ßµàÕ°“√À°≈â¡3 ß“π «‘®¬— ®“°ª√–‡∑»≠’ªË πÿÉ æ∫«à“ºŸ â ߟ «—¬∑’¡Ë Õ’ “¬ÿ¡“°°«à“ 100 ªï¡’§«“¡ —¡æ—π∏å°—∫°“√ÕÕ°°”≈—ß°“¬Õ¬à“ß
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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010
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∫ ∑ «‘ ∑ ¬ “ ° “ √ «—µ∂ÿª√– ߧ尓√»÷°…“ ‡æ◊Ë Õ ª√–‡¡‘ π º≈≈— æ ∏å ¢ Õß‚ª√·°√¡ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ¥â « ¬°“√‡¥‘ π ÕÕ°°”≈— ß °“¬µà Õ ¡√√∂¿“æ∑“ß°“¬¢ÕߺŸâ Ÿß«—¬
«‘∏’°“√»÷°…“ √Ÿª·∫∫°“√«‘®—¬‡ªìπ pre & post investigation ‚¥¬¡’°“√ª√–‡¡‘π ¡√√∂¿“æ∑“ß°“¬ ¢ÕߺŸâ Ÿß«—¬°àÕπ·≈–À≈—߇¢â“ Ÿà‚ª√·°√¡ à߇ √‘¡ ÿ¢ ¿“æ¥â « ¬°“√‡¥‘ π ÕÕ°°”≈— ß °“¬ ‚ª√·°√¡π’È æ—≤π“¡“®“°§Ÿà¡◊Õ°“√‡¥‘πÕÕ°°”≈—ß°“¬ ”À√—∫ ™“«‰∑¬ ¢Õß°ÕßÕÕ°°”≈— ß °“¬ °√¡Õπ“¡— ¬ °√–∑√«ß “∏“√≥ ÿ ¢ ‚¥¬¡’ § «“¡¡ÿà ß À¡“¬„Àâ ºŸâ Ÿß«—¬¡’™’«‘µ∑’ˬ◊𬓫 ¡’ ÿ¢¿“æ·¢Áß·√ß ·≈–¡’ §«“¡ ÿ¢ ¥â«¬°“√‡¥‘πÕÕ°°”≈—ß°“¬ √Ÿª·∫∫¢Õß ‚ª√·°√¡¥—ß°≈à“«¡’≈°— …≥–‡√’¬∫ßà“¬ –¥«° ·≈– πà“ π„® ‡À¡“– ¡°—∫ºŸâ Ÿß«—¬µàÕ°“√𔉪ªØ‘∫—µ‘ ‡æ◊ËÕ§ÿ≥¿“æ™’«‘µ∑’Ë¥’·≈–æ÷Ëß擵π‡Õ߉¥âπ“π∑’Ë ÿ¥ ‚ª√·°√¡ à߇ √‘¡ ÿ¢¿“æ¥â«¬°“√‡¥‘πÕÕ° °”≈—ß°“¬ 9 —ª¥“Àå ª√–°Õ∫¥â«¬°“√∫√√¬“¬ —πÈ Ê ·≈–°“√∑”°‘ ® °√√¡°≈ÿà ¡ ‚¥¬„π — ª ¥“Àå · √° ‡ªì π °“√ª∞¡π‘ ‡ ∑» µ√«® ÿ ¢ ¿“æ·≈–∑¥ Õ∫ ¡√√∂¿“æ√à“ß°“¬‚¥¬„™â¡“µ√∞“π¢Õß Rikli9 ´÷ßË °ÕßÕÕ°°”≈— ß °“¬æ— ≤ 𓇪ì π ¡“µ√∞“π°“√ ∑¥ Õ∫ ¡√√∂¿“æ√à“ß°“¬ ”À√—∫ºŸ â ߟ «—¬™“«‰∑¬ — ª ¥“Àå ∂— ¥ ‰ª‡ªì π °“√ √â “ ߧ«“¡µ√–Àπ— ° ∂÷ ß ª√–‚¬™πå ¢ Õß°“√‡¥‘ π ºŸâ Ÿ ß «— ¬ ‡√’ ¬ π√Ÿâ ° “√„™â ‡§√◊ËÕßπ—∫°â“«°“√‡¥‘π °“√µ—È߇ªÑ“À¡“¬°“√‡¥‘π °“√¬◊¥‡À¬’¬¥°≈â“¡‡π◊ÈÕ ∑à«ß∑à“°“√‡¥‘π °“√ ÕÕ°°”≈—ß°“¬„Àâ‡À¡“– ¡°—∫ ¿“æ√à“ß°“¬ °“√ ÕÕ°°”≈—ß°“¬‡æ◊ËÕ‡ √‘¡ √â“ß°√–¥Ÿ° °“√¥◊Ë¡πÈ” „ÀâæÕ‡æ’¬ß °“√‡¥‘π„π ¿“æ·«¥≈âÕ¡µà“ßÊ °“√ ∑”°‘®°√√¡„π∫â“π ·≈–„π —ª¥“Àå ÿ¥∑⓬∑”°“√ ∑¥ Õ∫ ¡√√∂¿“æ√à“ß°“¬Õ’°§√—Èß À≈—ß®“°π—Èπ¡’ 84
µÿ≈“§¡ - ∏—𫓧¡ 2553
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
°“√µ‘ ¥ µ“¡ºŸâ Ÿ ß «— ¬ ¡“√à « ¡∑”°‘ ® °√√¡°≈ÿà ¡ ¿“¬ À≈—߇¢â“‚ª√·°√¡ 6 ‡¥◊Õπ·≈– 1 ªïµ“¡≈”¥—∫ ºŸâ Ÿ ß «— ¬ ‰¥â √— ∫ ¡ÿ ¥ ∫— π ∑÷ ° ®”π«π°â “ «°“√ ‡¥‘π„π·µà≈–«—π ¡ÿ¥¥—ß°≈à“«ª√–°Õ∫¥â«¬¢âÕ §«√ªØ‘∫—µ‘µπ„π°“√‡¥‘π·≈– √ÿª‡π◊ÈÕÀ“®“°°“√ ∫√√¬“¬„π·µà≈– —ª¥“Àå °“√°”Àπ¥‡ªÑ“À¡“¬ ®”π«π°â“«°“√‡¥‘π¢÷ÈπÕ¬Ÿà°—∫»—°¬¿“æ¢ÕߺŸâ Ÿß«—¬ ·µà≈–§π „π°√≥’∑’˺Ÿâ Ÿß«—¬ “¡“√∂‡¥‘π‰¥âµ“¡ ‡ªÑ“À¡“¬ ®–‰¥â√—∫§”·π–π”„Àâµ—È߇ªÑ“À¡“¬‡¥‘π ‡æ‘Ë¡¢÷ÈπÕ’°√âÕ¬≈– 10 „π —ª¥“ÀåµàÕ‰ª ºŸâ Ÿ ß «— ¬ ®”π«π 136 §π ‰¥â √— ∫ °“√ ÿà ¡ µ—«Õ¬à“ß®“° 14 À¡Ÿà∫â“π „π µ.‚§°°√«¥ Õ.‡¡◊Õß π§√√“™ ’¡“ ‚¥¬¡’Õ“¬ÿµß—È ·µà 60 ªï¢π÷È ‰ª “¡“√∂ ‡¥‘π‰¥â¥â«¬µπ‡Õß ‰¡à¡’ªí≠À“¥â“𧫓¡®” ·≈– “¡“√∂‡¢â“√à«¡‚ª√·°√¡‰¥âµ≈Õ¥ 9 —ª¥“Àå ‚¥¬ ∑”°‘®°√√¡∑’Ë»Ÿπ¬å à߇ √‘¡ ÿ¢¿“溟⠟߫—¬ »Ÿπ¬å Õπ“¡—¬∑’Ë 5 π§√√“™ ’¡“ √–À«à“߇¥◊Õπµÿ≈“§¡ ∂÷ß ∏—𫓧¡ æ.». 2551 ºŸâ Ÿß«—¬≈ß≈“¬¡◊Õ™◊ËÕ„π ‡Õ° “√¬‘π¬Õ¡‡¢â“√à«¡‚§√ß°“√ µ√«® ÿ¢¿“æ ·≈– §—¥°√Õß‚¥¬„™â·∫∫ Õ∫∂“¡ ¿“«– ÿ¢¿“æ·≈– 惵‘°√√¡ ÿ¢¿“溟 â ߟ «—¬¢Õß ”π—° à߇ √‘¡ ÿ¢¿“æ °√¡Õπ“¡—¬ ºŸâ ŸßÕ“¬ÿ®–‰¥â√—∫‡§√◊ËÕßπ—∫°â“«°“√ ‡¥‘ π ·≈–∑”°“√∫— π ∑÷ ° º≈≈ß„π ¡ÿ ¥ ∫— π ∑÷ ° ¥â « ¬ µπ‡Õß∑ÿ°«—π °“√ª√–‡¡‘ π √–¥— ∫ æ— ≤ π“°“√ÕÕ°°”≈— ß °“¬°àÕπ·≈–À≈—߇¢â“√à«¡°‘®°√√¡„™â§”∂“¡ ç§ÿ≥ ÕÕ°°”≈—ß°“¬ ¡Ë”‡ ¡Õ‡æ’¬ß„¥é (stage-ofchange question)10 ºŸ â ߟ «—¬‡≈◊Õ°µÕ∫®“°§”µÕ∫ 5 √–¥—∫ ‰¥â·°à√–¥—∫‰¡à‡§¬ÕÕ°°”≈—ß°“¬·≈–‰¡à ‡§¬§‘¥®–‡√‘Ë¡∑” (pre-contemplation) √–¥—∫‰¡à ‡§¬ÕÕ°°”≈— ß °“¬·µà ¡’ § «“¡µ—È ß „®«à “ ®–‡√‘Ë ¡ ∑” ¿“¬„πÕπ“§µÕ—π„°≈â (contemplation) √–¥—∫ ÕÕ°°”≈—ß°“¬ ·µà∑”‰¥â‰¡à∂÷ß 3 ‡¥◊Õπ (preparation) √–¥—∫ÕÕ°°”≈—ß°“¬·µà‰¡à ¡Ë”‡ ¡Õ‚¥¬
‡¥‘π‡æ◊ËÕ ÿ¢¿“æ: √Ÿª·∫∫°“√ à߇ √‘¡°‘®°√√¡∑“ß°“¬„π™ÿ¡™π ”À√—∫ºŸâ Ÿß«—¬™“«‰∑¬
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®”π«π§π
§à“‡©≈’ˬ (SD, Range) À√◊Õ or %
Õ“¬ÿ (ªï) ‡æ» ™“¬ À≠‘ß ∂“π¿“æ ¡√ Õ◊Ëπ Ê √–¥—∫°“√»÷°…“ ‰¡à‰¥â√∫— °“√»÷°…“ ª√–∂¡»÷°…“ 1 - 6 ¡—∏¬¡»÷°…“ 1 - 6 ª√‘≠≠“µ√’¢÷Èπ‰ª ∑’ÕË ¬ŸÕà “»—¬ Õ¬Ÿà§π‡¥’¬« Õ¬Ÿà°—∫ “¡’À√◊Õ¿√√¬“ Õ¬Ÿà°—∫ ¡“™‘°„π§√Õ∫§√—« √“¬‰¥âµË”°«à“‡ âπ¡“µ√∞“π°“√§√Õß™’æ Ÿ∫∫ÿÀ√’Ë ¥◊Ë¡ ÿ√“ ‚√§ª√–®”µ—« ‰¡à¡’ §«“¡¥—π‚≈À‘µ Ÿß ‡∫“À«“π Õ◊Ëπ Ê
124 38 86 82 42
67(5.4 60-80) 69 31 66 34
7 78 27 12
5 63 22 10
6 73 45 27 7 11
5 59 36 22 5 9
49 23 15 37
40 19 12 29
SD = standard deviation THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010
85
∫ ∑ «‘ ∑ ¬ “ ° “ √ “¡“√∂‡¥‘π‰¥â‡©≈’ˬ 5,855 °â“«µàÕ«—π ‡¡◊ËÕ ‡ª√’¬∫‡∑’¬∫°—∫ —ª¥“Àå ¥ÿ ∑⓬ºŸ â ߟ «—¬‡¥‘π‰¥â‡©≈’¬Ë 12,205 °â“«µàÕ«—π ‚¥¬‡æ‘Ë¡¢÷Èπ 2.1 ‡∑à“ (p<.001) º≈°“√µ√«® ¡√√∂¿“æ√à“ß°“¬¢ÕߺŸâ Ÿß «— ¬ „π — ª ¥“Àå ÿ ¥ ∑â “ ¬æ∫«à “ °“√∑¥ Õ∫·µà ≈ – ª√–‡¿∑¥’¢π÷È Õ¬à“ß¡’π¬— ”§—≠∑“ß ∂‘µ‘ (p<.001) ¥—ß µàÕ‰ªπ’È °“√µ√«®§«“¡·¢Áß·√ߢÕß°≈â“¡‡π◊ÈÕ¢“ ´÷Ëß®”‡ªìπµàÕ°“√¢÷Èπ≈ß∫—π‰¥·≈–°“√‡¥‘π¥â«¬°“√ ∑¥ Õ∫≈ÿ°π—Ë߇°â“Õ’È 30 «‘π“∑’(Thirty-second chair stand) ∑”‰¥â‡æ‘¡Ë ¢÷πÈ ®“° 16.9 §√—ßÈ ‡ªìπ 19.7 §√—Èß °“√µ√«®§«“¡∑π∑“π¢Õß°≈â“¡‡π◊ÈÕ´÷Ëß
®”‡ªìπµàÕ°“√‡¥‘π√–¬–‰°≈¥â«¬°“√∑¥ Õ∫¬Ë”‡∑â“ 2 π“∑’(Two-minute step test) ∑”‰¥â‡æ‘Ë¡¢÷Èπ®“° 79 °â“«‡ªìπ 101 °â“« °“√µ√«®§«“¡¬◊¥À¬ÿàπ ¢Õß°≈â“¡‡π◊ÈÕ´÷Ëß¡’§«“¡ ”§—≠µàÕ∑à«ß∑à“°“√‡¥‘π ¥â « ¬°“√∑¥ Õ∫π—Ë ß ‡À¬’ ¬ ¥·¢π·µ–ª≈“¬ ‡∑â“(Chair sit-and-reach) ∑”‰¥â‡æ‘¡Ë ¢÷πÈ ®“° 7.6 π‘È«‡ªìπ 11.7 π‘È« °“√µ√«®°“√∑√ßµ—«¥â«¬°“√ ∑¥ Õ∫‡¥‘π‰ª°≈—∫ 8 øÿµ (Eight-foot up-andgo) ∑”‡«≈“‰¥â¥’¢÷Èπ®“° 7.7 «‘π“∑’‡ªìπ 6.8 «‘π“∑’ (µ“√“ß∑’Ë 2) °àÕπ‡¢â“√à«¡°‘®°√√¡ ¡’ºŸâ Ÿß«—¬‡æ’¬ß√âÕ¬≈–
µ“√“ß∑’Ë 2 ®”π«π°â“«°“√‡¥‘π·≈–º≈∑¥ Õ∫ ¡√√∂¿“æ√à“ß°“¬‡ª√’¬∫‡∑’¬∫°àÕπ·≈–À≈—߇¢â“ √à«¡°‘®°√√¡ µ—«™’È«—¥ ¡√√∂¿“æ√à“ß°“¬ §à“¡“µ√∞“π
®”π«π°â“«°“√‡¥‘π (°â“«) 6,000-8,500 ≈ÿ°π—Ë߇°â“Õ’È 30 «‘π“∑’ (§√—Èß) 10-19 ¬Ë”‡∑â“ 2 π“∑’ (§√—Èß) 68-115 π—Ë߇À¬’¬¥·¢π·µ–ª≈“¬‡∑â“(π‘È«) (-4) - (+5) ‡¥‘π‰ª°≈—∫ 8 øÿµ («‘π“∑’) 3.8-7.6
°àÕπ√à«¡°‘®°√√¡
À≈—ß√à«¡°‘®°√√¡
§à“‡©≈’ˬ
(SD)
§à“‡©≈’ˬ
(SD)
5,855 16.9 79 7.6 7.7
(3,678) (4.9) (23.0) (6.9) (1.9)
12,205 19.7 101 11.7 6.8
(7,387) (4.4) (25.6) (6.9) (2.1)
P*
< .001 < .001 < .001 < .001 < .001
*Paired sample t tests.
22 ∑’Ë Õ Õ°°”≈— ß °“¬Õ¬à “ ß ¡Ë” ‡ ¡Õ ®“°°“√ µ‘¥µ“¡ºŸâ Ÿß«—¬ 6 ‡¥◊ÕπÀ≈—߇¢â“√à«¡°‘®°√√¡ æ∫ «à“¡’ºŸâ∑’Ë “¡“√∂ÕÕ°°”≈—ß°“¬Õ¬à“ß ¡Ë”‡ ¡Õ‡æ‘Ë¡ ¢÷Èπ‡ªìπ√âÕ¬≈– 51 ·≈–ºŸâ Ÿß«—¬∑’Ë¡’æ—≤π“°“√ÕÕ° °”≈—ß°“¬‡æ‘¡Ë ¢÷πÈ Õ¬à“ßπâÕ¬ 1 √–¥—∫¡’¡“°∂÷ß√âÕ¬≈– 76 (p<.001) ·≈–‡¡◊ËÕµ‘¥µ“¡®π§√∫ 1 ªï æ∫«à“ √âÕ¬≈– 45 ¢ÕߺŸâ Ÿß«—¬¬—ߧßÕÕ°°”≈—ß°“¬Õ¬à“ß ¡Ë”‡ ¡Õ ·≈–√âÕ¬≈– 89 ¢ÕߺŸâ Ÿß«—¬¡’§«“¡æ÷ß æÕ„®µàÕ‚ª√·°√¡°“√‡¥‘πÕÕ°°”≈—ß°“¬ ®“° °“√»÷°…“‰¡àæ∫ºŸâ Ÿß«—¬√“¬„¥‰¥â√—∫Õ—πµ√“¬À√◊Õ 86
µÿ≈“§¡ - ∏—𫓧¡ 2553
°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒
¿“«–·∑√°´âÕπ®“°°‘®°√√¡ 9 —ª¥“Àå
«‘®“√≥åº≈°“√»÷°…“ ®“°º≈°“√»÷ ° …“æ∫«à “ ‚ª√·°√¡ à ß ‡ √‘¡ ÿ¢¿“æ¥â«¬°“√‡¥‘πÕÕ°°”≈—ß°“¬ ”À√—∫ºŸâ Ÿß«—¬∑’ˇ¢â“√à«¡°‘®°√√¡§√∫ 9 —ª¥“Àå„π§√—Èßπ’È ∑”„Àâ ¡√√∂¿“æ√à “ ß°“¬·≈–√–¥— ∫ æ— ≤ π“°“√ ÕÕ°°”≈—ß°“¬¥’¢÷ÈπÕ¬à“ß¡’π—¬ ”§—≠ ‚ª√·°√¡π’È ª√– ∫§«“¡ ”‡√Á®‡°‘𧫓¡§“¥À¡“¬ ‡π◊ËÕß®“° ¡’§«“¡ –¥«° ª≈Õ¥¿—¬ ßà“¬µàÕ°“√ªØ‘∫—µ‘ ·≈–
‡¥‘π‡æ◊ËÕ ÿ¢¿“æ: √Ÿª·∫∫°“√ à߇ √‘¡°‘®°√√¡∑“ß°“¬„π™ÿ¡™π ”À√—∫ºŸâ Ÿß«—¬™“«‰∑¬
§à“„™â®à“¬‰¡à Ÿß πÕ°®“°π’ȺŸâ Ÿß«—¬¡’ à«π√à«¡„π °“√ª√—∫‡ª≈’ˬπ惵‘°√√¡·≈–°‘®°√√¡°“√ÕÕ° °”≈—ß°“¬∑’Ë πÿ° π“π °“√‡¥‘ 𠇪ì π °‘ ® °√√¡∑’Ë ”§— ≠ ∑’Ë „ ™â „ π°“√ »÷°…“„π§√—Èßπ’È °“√„À⺟⠟߫—¬π—∫®”π«π°â“«°“√ ‡¥‘π¥â«¬µπ‡Õ߇ªìπ‡√◊ËÕß∑’ˬ“°≈”∫“° ¥—ßπ—Èπ °“√𔇧√◊ËÕßπ—∫°â“«°“√‡¥‘π´÷Ëß¡’§«“¡‰«µàÕ°“√ ‡§≈◊ËÕπ‰À«¢Õß√à“ß°“¬¡“„™â„π°“√∫—π∑÷°®”π«π °â“«°“√‡¥‘π¢ÕߺŸâ Ÿß«—¬„π·µà≈–«—π ®÷ß¡’§«“¡ ‡À¡“– ¡„π°“√«— ¥ 惵‘ ° √√¡°“√‡¥‘ π ¢ÕߺŸâ Ÿ ß «—¬11,12 °“√»÷°…“§√—Èßπ’È¢“¥°≈ÿࡧ«∫§ÿ¡‡π◊ËÕß®“° °“√ ÿࡵ—«Õ¬à“ߺŸâ Ÿß«—¬‡¢â“¡“„π°≈ÿࡧ«∫§ÿ¡ Õ“® √â“ߧ«“¡‰¡àæÕ„®„Àâ°—∫§π°≈ÿà¡π’ȇπ◊ËÕß®“°‰¡à‰¥â √— ∫ §”·π–π”À√◊ Õ ¥Ÿ · ≈¥â “ π ÿ ¢ ¿“æ‡∑à “ ‡∑’ ¬ ¡°— ∫ °≈ÿà¡∑¥≈Õß ·≈–Õ“®‰¡à„À⧫“¡√à«¡¡◊Õ„π°“√ »÷°…“√–¬–¬“« °“√‡¥‘ 𠇪ì π °“√ÕÕ°°”≈— ß °“¬∑’Ë ¥’ ∑’Ë ÿ ¥ ‡√’¬∫ßà“¬·≈–‡À¡“– ¡°—∫ºŸâ Ÿß«—¬ ”À√—∫ºŸâ∑’Ë¡’ √–¥—∫°“√‡¥‘π∑’˵˔æ∫«à“ —¡æ—π∏å°—∫°“√¢“¥°“√ ÕÕ°°”≈— ß °“¬ ´÷Ë ß ‡ªì π ªí ® ®— ¬ ‡ ’Ë ¬ ß ”§— ≠ µà Õ ¿“«– ÿ¢¿“æ13 ¡’√“¬ß“π«‘®—¬· ¥ß„Àâ‡ÀÁπ«à“ºŸâ Ÿß«—¬∑’Ë¡’ ÿ¢¿“楒‡¬’ˬ¡ “¡“√∂‡¥‘π‰¥â¡“°°«à“ «—π≈– 10,000 °â“« ºŸâ Ÿß«—¬∑’Ë¡’ ÿ¢¿“楒∑—Ë«‰ª §«√‡¥‘π‰¥â‡©≈’ˬ«—π≈– 6,000 - 8,500 °â“« à«π ºŸâ Ÿß«—¬∑’Ë¡’‚√§‡√◊ÈÕ√—ßÀ√◊Õ∑ÿææ≈¿“槫√‡¥‘π‰¥â ‡©≈’ˬ«—π≈– 3,500 - 5,000 °â“«14 ‡¡◊ËÕ‡ª√’¬∫ ‡∑’¬∫°—∫ß“π«‘®—¬Õ◊ËπÊ ∑’Ë„™â‚ª√·°√¡°“√ÕÕ° °”≈—ß°“¬µ—Èß·µà 4 - 12 —ª¥“Àå æ∫«à“ºŸâ Ÿß«—¬ “¡“√∂‡¥‘π‰¥â‡æ‘¡Ë ¢÷πÈ ‚¥¬‡©≈’¬Ë √âÕ¬≈– 24 - 358,15 °“√»÷°…“§√—Èßπ’Ȫ√– ∫§«“¡ ”‡√Á® “¡“√∂‡¥‘π‰¥â ‡æ‘Ë¡¢÷Èπ√âÕ¬≈– 108 À√◊Õ‡©≈’ˬ 12,205 °â“«µàÕ«—π „πª√–‡∑»‰∑¬ °“√‡¥‘π‡ªìπ‡√◊ËÕߪ°µ‘„π ™’«‘µª√–®”«—π ºŸâ Ÿß«—¬„π™ÿ¡™πµà“ßÊ ¡’°“√√«¡
µ—«‡ªìπ™¡√¡ºŸâ ŸßÕ“¬ÿ ¡’°‘®°√√¡ à߇ √‘¡ ÿ¢¿“æ ·≈–·≈°‡ª≈’Ë ¬ π‡√’ ¬ π√Ÿâ ¥â “ π ÿ ¢ ¿“æ„π√–À«à “ ß ¡“™‘°™¡√¡ ªí®®ÿ∫—πª√–‡∑»‰∑¬¡’™¡√¡ºŸâ Ÿß Õ“¬ÿ¡“°°«à“ 20,000 ™¡√¡°√–®“¬‰ª∑—Ë«ª√–‡∑» À≈“¬Ê ™¡√¡¡’°‘®°√√¡°“√ÕÕ°°”≈—ß°“¬√à«¡ °— π Õ¬à “ ß ¡Ë” ‡ ¡Õ1 ¥â«¬«‘∂’™’«‘µª√–®”«—π¥—ß °≈à“«Õ“®‡ªìπªí®®—¬ ”§—≠∑’˙૬‡æ‘Ë¡®”π«π°â“« °“√‡¥‘π¢ÕߺŸâ Ÿß«—¬ ¡’ √ “¬ß“πæ∫«à “ ºŸâ Ÿ ß «— ¬ ∑’Ë Õ Õ°°”≈— ß °“¬ √–¥—∫ª“π°≈“ßÕ¬à“ßπâÕ¬«—π≈– 20 -30 π“∑’‡ªìπ ª√–®”∑ÿ°«—π¡’ ¿“«– ÿ¢¿“æ∑’Ë¥’°«à“„π°≈ÿà¡∑’ˉ¡à ÕÕ°°”≈—ß°“¬ ·¡â«à“®–ÕÕ°·√ß∑”ß“π∫â“πÕ◊ËπÊ ∑¥·∑πµ≈Õ¥∑—Èß«—π°Áµ“¡16 πÕ°®“°π’Ȭ—ßæ∫«à“ ¿“«– ÿ¢¿“æ¡’§«“¡ —¡æ—π∏åÕ¬à“ß Ÿß°—∫√–¥—∫ ¡√√∂π–√à“ß°“¬¢ÕߺŸâ Ÿß«—¬17 „πß“π«‘®—¬π’Èæ∫ «à“ºŸâ Ÿß«—¬„π°≈ÿà¡∑’Ë¡’ ÿ¢¿“楒·≈–„π°≈ÿà¡∑’Ë¡’‚√§ ‡√◊ÈÕ√—ß¿“¬À≈—߇¢â“√à«¡°‘®°√√¡§√∫ 9 —ª¥“Àå ≈â«π¡’√–¥—∫ ¡√√∂π–√à“ß°“¬¥’¢÷È𠂪√·°√¡ à߇ √‘¡ ÿ¢¿“æ¥â«¬°“√‡¥‘πÕÕ° °”≈—ß°“¬π’È¡ÿà߇πâ𧫓¡√—∫º‘¥™Õ∫ à«π∫ÿ§§≈·≈– §«“¡ ”π÷°„π°“√§«∫§ÿ¡æƒµ‘°√√¡¢Õßµπ‡Õß ‡æ◊ËÕº≈≈—æ∏å∑“ߥâ“π ÿ¢¿“æ∑’Ë¥’ ·µàº≈≈—æ∏å¥—ß °≈à “ «®– “¡“√∂§ßÕ¬Ÿà „ π√–¬–¬“«‡æ’ ¬ ß„¥ ¡’ √“¬ß“π™’È„Àâ‡ÀÁπ«à“‚ª√·°√¡ à߇ √‘¡ ÿ¢¿“æ¥â«¬ °“√ÕÕ°°”≈— ß °“¬„π√Ÿ ª ·∫∫°‘ ® °√√¡°≈ÿà ¡ ¡’ º ≈ ∑”„Àâ ºŸâ Ÿ ß «— ¬ ÕÕ°°”≈— ß °“¬¡“°¢÷È π ·µà ° “√ ‡ª≈’Ë ¬ π·ª≈ß惵‘ ° √√¡¥— ß °≈à “ «¡’ º ≈‡æ’ ¬ ߇≈Á ° πâ Õ ¬·≈–‰¡à ¬—Ë ß ¬◊ π 18 ‡π◊Ë Õ ß®“°æƒµ‘ ° √√¡¢Õß ¡πÿ … ¬å ‰ ¡à ‰ ¥â ‡ ª≈’Ë ¬ π·ª≈ßÕ¬à “ ß√«¥‡√Á « ‚¥¬°“√ µÕ∫ πÕß°—∫¢âÕ¡Ÿ≈§«“¡√Ÿâ∑’Ë„Àâ„π√–¬– —ÈπÊ ¥—ß π—Èπ‚ª√·°√¡ à߇ √‘¡ ÿ¢¿“æµà“ßÊ ∑’Ë¡ÿà߇πâπ¥â«¬ °“√„À⧫“¡√Ÿâ ®÷ßµâÕß¡’¢âÕ¡Ÿ≈∑’Ë¡’§«“¡πà“‡™◊ËÕ∂◊Õ ·≈– “¡“√∂ √â “ ߧ«“¡¬—Ë ß ¬◊ π „Àâ °— ∫ ºŸâ ‡ ¢â “ √à « ¡ °‘®°√√¡19
THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010
87
∫ ∑ «‘ ∑ ¬ “ ° “ √ ¢âÕ‡ πÕ·π– 1. ∫∑‡√’ ¬ π®“°°“√»÷ ° …“„π§√—È ß π’È “¡“√∂𔉪 Ÿà°“√æ—≤π“√Ÿª·∫∫°“√ à߇ √‘¡ ÿ¢ ¿“æÕ◊ËπÊ µàÕ‰ª ‡™à𠂪√·°√¡°“√ÕÕ°°”≈—ß °“¬·≈–‚¿™π“°“√ ”À√— ∫ ºŸâ Ÿ ß «— ¬ ∑—È ß „π°≈ÿà ¡ ∑’Ë ™à«¬‡À≈◊Õµπ‡Õ߉¥â·≈–„π°≈ÿà¡∑’Ë¡’‚√§‡√◊ÈÕ√—ß ‡™à𠧫“¡¥—π‚≈À‘µ Ÿß ‡∫“À«“π À√◊Õ‚√§ª«¥¢âÕ‡√◊ÈÕ√—ß ∑—Èßπ’ȧ«√¡’°“√ª√–‡¡‘πº≈°“√‡ª≈’ˬπ·ª≈ߢÕß ¿“«– ÿ¢¿“æ ‡™àπ ¥—™π’¡«≈°“¬ √âÕ¬≈–‰¢¡—π ¢Õß√à“ß°“¬ ·≈–º≈°“√µ√«®‡≈◊Õ¥∑’Ë ”§—≠ 2. ¢â Õ ¡Ÿ ≈ ∑’Ë ‰ ¥â § «√π”¡“«‘ ‡ §√“–Àå · ≈–
ª√–‡¡‘ 𠧫“¡‡ªì 𠉪‰¥â „ π°“√𔂪√·°√¡ à ß ‡ √‘¡ ÿ¢¿“æµà“ßÊ ¥—ß°≈à“« ¡“ª√–¬ÿ°µå„™â„Àâ ‡À¡“– ¡°—∫™ÿ¡™πµ“¡ ¿“ææ◊Èπ∑’Ë∑’Ë·µ°µà“ß°—π ·≈–¢¬“¬º≈„π√–¥—∫ª√–‡∑» √«¡∂÷ß°“√°”Àπ¥ ‡ªìππ‚¬∫“¬·≈–∫Ÿ√≥“°“√‡¢â“°—∫·ºπªØ‘∫—µ‘°“√ à߇ √‘¡ ÿ¢¿“æ„π√–¥—∫™ÿ¡™πÕ¬à“ß·æ√àÀ≈“¬‡æ◊ËÕ ÿ¢¿“æ∑’Ë¥’¢ÕߺŸâ Ÿß«—¬µàÕ‰ª
°‘µµ‘°√√¡ª√–°“» ß“π«‘®—¬™‘Èππ’ȉ¥â√—∫∑ÿπ π—∫ πÿπ°“√«‘®—¬ ®“°°√¡Õπ“¡—¬ °√–∑√«ß “∏“√≥ ÿ¢
‡Õ° “√Õâ“ßÕ‘ß 1. Foundation of Thai Gerontology Research and Development. Situation of the Thai elderly 2008. Bangkok: TQP Publisher; 2009 2. National Statistical Office. Report on the 2007 Survey of the Older Persons in Thailand. Bangkok: Thana Press Publisher; 2008 3. Assantachai P, Praditsuwan R, Chatthanawaree W. Risk factor for falls in the Thai elderly in an urban community. J Med Assoc Thai 2003; 86: 124-30 4. Ozaki A, Uchiyama M, Tagaya H. The Japanese centenarian study: Autonomy was associated with health practices as well as physical status. J Am Geriatr Soc 2007; 55: 95-101 5. Paterson DH, Jones GR, Rice CL. Ageing and physical activity: evidence to develop exercise recommendations for older adults. Can J Public Health 2007; 98: 69-108 6. De Jong N, Paw MJ, de Groot LC. Diet Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons. Am J Public health 2000; 90: 947-54 7. Conn VS, Minor MA, Burks KJ. Integrative review of physical activity intervention research with aging adults. J Am Geriatr Soc 2003; 51: 1159-68 8. Wellman NS, Kamp B, Kirk-Sanchez NJ. Eat Better & Move More: a community-based program designed to improve diets and increase physical activity among older Americans. Am J Public Health 2007; 97: 710-7 9. Rikli RE, Jones CJ. The senior fitness test items: a brief overview. J Active Aging 2002; 24: 25-30 10. Norman GJ, Benisovich SV, Nigg CR, Rossi JS. Examining three exercise staging algorithms in two samples. Ann Behav Med 1998; 20: 211
88
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