目的：本研究以社區為據點，建構電子化(E化)健康管理平台，期望藉社區互助及健康促進氛圍，鼓勵民眾執行自我健康管理，探討透過使用E化健康管理平台是否能影響長者的血壓、幸福感與靈性安適。
方法：本研究為介入性縱向研究，以便利取樣方式，自2021年1月至2022年6月參與某醫學中心里民健康篩檢活動之民眾，共74位納入本研究。藉由E化健康管理平台收集研究對象介入前後血壓數據，介入前施行健康識能量表、幸福感量表及靈性安適量表，一年後再施行幸福感量表及靈性安適量表。研究採用卡方檢定、單因子變異數、配對t檢定與多變項羅吉斯迴歸進行分布比較與關聯分析。
結果：年齡越大與教育程度越低者血壓越容易變偏高(p=0.012、0.036)；月平均收入較低者血壓越容易變正常(p=0.027)；健康識能五大構面中，應用健康資訊能力越好血壓越不易變偏高(p=0.040)，但理解健康資訊程度越好血壓維持正常的機率反而越低(p=0.018)；而E化介入前後幸福感分數增加越多，血壓偏高機率越低(p=0.015)、維持正常機率越高(p=0.010)；介入前後靈性安適分數增加越多，則血壓越不容易變偏高(p=0.009)。
結論：E化健康管理有助於增加研究對象的靈性安適健康。E化介入後血壓維持正常的幸福感與靈性健康有顯著提升。年齡、教育程度、月平均收入、健康識能、幸福感與靈性安適差異值皆為影響E化健康管理介入前後血壓變化之顯著相關因子。經由本計畫，長者藉此執行自我健康管理，使醫療產業之發展朝向更為個人化、在地化的健康服務，也做為未來社區發展之參考。
(台灣家醫誌2025; 35: 186-198) DOI: 10.53106/168232812025093503004
 
關鍵詞：電子化健康管理、E化健康管理、幸福感、靈性安適、社區長者

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¹國泰綜合醫院家庭暨社區醫學科
²國泰綜合醫院護理部
受理日期：114年2月7日 修改日期：114年3月27日 同意刊登：114年4月29日
^*通訊作者：陳品安 通訊地址：台北市大安區仁愛路四段280號
E-mail：ann831114@gmail.com

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Effects of Electronic Health Management on Blood Pressure, Happiness, and Spiritual Well-being among Community-dwelling Older Adults
 
Yi-Chu Yang¹, Chen-Jung Liu², Ping-An Chen^1* and Tai-Ling Chung¹
 

Purpose: The study established a community-based e-health management platform to encourage participants to practice self-health management with community mutual support within a health-promoting environment. The study explored whether the e-health management platform could influence the blood pressure, happiness, and spiritual well-being of community older adults.
Methods: This intervention-based longitudinal study used convenience sampling to recruit 74 participants aged 65 years and over who attended a community health screening event from January 2021 to June 2022. Blood pressure data were collected through the e-health management platform. Health literacy was assessed using the Mandarin Multidimensional Health Literacy Questionnaire (MMHLQ). Pre- and post-test measurements of happiness and spiritual well-being were conducted using the Subjective Happiness Scale (SHS-C) and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being (FACIT-Sp) scale. Chi-square tests, one-way ANOVA, paired t-tests, and multivariate logistic regression were performed to compare distributions and analyze correlations.
Results: Blood pressure was more likely to become abnormally high with increasing age and lower educational level (p=0.012, 0.036). Individuals with lower average monthly incomes were more likely to maintain normal blood pressure (p=0.027). Among the five dimensions of health literacy, better ability to apply health information was associated with a lower likelihood of developing high blood pressure (p=0.040). Conversely, better understanding of health information was unexpectedly associated with a higher likelihood of developing high blood pressure (p=0.018). A greater increase in happiness scores from pre- to post-intervention was associated with a lower likelihood of developing high blood pressure (p=0.015) and a higher likelihood of maintaining normal blood pressure (p=0.010). A greater increase in spiritual well-being scores was also associated with a reduced likelihood of developing high blood pressure (p=0.009).
Conclusion: The e-health management platform contributed to enhanced spiritual well-being among the study participants. Following the intervention, those with normal blood pressure experienced significant improvements in both happiness and spiritual well-being. Factors significantly associated with blood pressure changes before and after the intervention included age, education level, average monthly income, health literacy, happiness, and spiritual well-being. The study demonstrated that older adults could successfully engage in self-health management using a community-based platform. The findings suggest potential for developing more personalized and localized health services in community settings and may inform future community health initiatives.
(Taiwan J Fam Med 2025; 35: 186-198) DOI: 10.53106/168232812025093503004
 
Key words: community elderly, E-health management, happiness, spiritual well-being
 

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¹Departments of Family and Community Medicine, Cathay General Hospital, Taipei, Taiwan.
²Departments of Nursing, Cathay General Hospital, Taipei, Taiwan.
Received: February 7, 2025; Revised: March 27, 2025; Accepted: April 29, 2025.
^*Corresponding author