臺灣地區疾病型態的改變，其中百分之五十以上的健康問題導因於不正常的生活習慣和行為。而許多民眾趨向長時間的坐式生活，加上欠缺足夠的身體活動及不均衡的飲食攝取，導致慢性疾病、體重過重、失眠、體能衰退等健康問題。因此本研究致力於設計一套健康自主管理計畫，藉由運動及飲食的自我指引技巧來提昇研究對象生、心理的健康狀態。採用類實驗設計介入一所大學及醫院的教職員工生，共計51名，研究工具包括結構式問卷、SF-36健康量表、生理測量之抽血檢查及健康體適能，以探討研究對象在生活習慣、健康信念、自覺健康狀態、抽血檢查數值、身體組成及健康體適能間之成效。結果顯示經3個月計劃介入後，研究對象在睡眠時間、飲食行為上有顯著性改善。而健康信念中顯著提升了自覺罹患性、自覺嚴重性及自覺障礙的認知。再者，SF-36量表中有較高得分的心理健康及較佳的自覺健康狀態。在血液理學檢查中的膽固醇、SGOT、SGPT、血尿素氮、血肌酐酸、尿酸及空腹血糖也均顯著性降低。最後，身體組成中的體脂肪率、腰臀圍比顯著性降低，而顯著性強化肌力/肌耐力及心肺耐力之體適能。因此，設計一套完善的健康自主管理計畫，可達到較佳的行為改變及提升生心裡的健康狀態，而這些都是達成健康促進過程中有效的捷徑。

According to a recent report that in Taiwan, more than 50% health problems were due to unhealthy and harmful life styles. Most people, especially at workplace, either live under pressure, work sedentarily, exercise their body little or have a unhealthy diet. The subsequent problems of the overweight, sleeplessness and a declined condition of physical fitness all lead to health problems. A Quasi-experimental design of purposive samples was conducted using 51 participants from employees or faculty members from one school and one hospital. The purpose of this study is to investigate the effects of health self-management program with nutritional and exercise intervention to improve the participants’ physical and psychological health status. Research measuring tools include a structural questionnaire, SF-36 scale, laboratory examination (blood test), physical fitness test administrated to the participants, and a 12-week follow-up test. After the intervention of health self-management, there were significant differences in sleep pattern and diet behavior. On health belief congnition, perceived susceptibility, perceived seriousness, and percieived barriers were increased. On the SF-36 scale, higher scores were attained on mental health dimension. Furthermore, Cholesterol, SGOT, SGPT, B.U.N, Crattinine, Uric acid and blood sugar were significantly decreased. As for body composition, fat mass and waist-hip-ratio were significantly reduced, while for physical fitness, muscular strength endurance and cardiorespiratory endurance were much improved among participants. The results suggest well-designed health self-management activities can reduce unhealthy habit and improve mental and physical health status. Furthermore, it can serve as one important component of health promotion stratigies.

誌謝 I
摘要 II
ABSTRACT III
目錄 IV
表目錄 VI
圖目錄 VIII
第一章 緒論 1
第一節 研究動機與背景 1
第二節 研究目的 3
第三節 研究流程 5
第四節 研究甘特圖 6
第五節 研究假設 6
第六節 名詞界定 7
第二章 文獻回顧與探討 8
第一節 關於自主管理 8
第二節 關於健康促進 12
第三節 自主管理、健康促進與工作職場的關係 14
第四節 認識體適能 16
第五節 規律運動之意涵 25
第六節 飲食及營養 27
第七節 健康信念模式 34
第八節 健康狀態 37
第三章 研究方法 41
第一節 研究架構 42
第二節 研究設計 43
第三節 研究對象 43
第四節 實施時間及地點 44
第五節 研究工具 45
第六節 計畫措施 50
第七節 資料處理與統計分析方法 56
第四章 研究結果 58
第一節 個人背景資料 58
第二節 計畫介入前研究對象之生活習慣、健康信念、自覺健康狀態、就醫行為、生理測量及健康體適能分布分布情形 60
第三節 健康自主管理計劃介入前後之差異 72
第四節 影響計劃介入對飲食及運動行為之相關性探討 85
第五章 討論 89
第一節 計畫介入對生活習慣的影響及相關因素探討 89
第二節 計畫介入對健康信念的影響 90
第三節 計畫介入對自覺健康狀態的影響 91
第四節 計畫介入對就醫行為的影響 92
第五節 計畫介入對生理測量之血液理學檢查的影響 93
第六節 計畫介入對健康體適能的影響 94
第七節 影響計劃介入對飲食及運動行為之相關性探討 95
第六章 結論與建議 97
第一節 研究結論 97
第二節 研究限制 98
第三節 研究建議 99
第四節 未來研究之參考 100
參考文獻 102
中文部分 102
英文部分 105
附錄 117

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