性是生而為人的基本需求，高齡者性議題卻鮮少受到關注，大眾對年長者的性甚至具有刻板印象、偏見、歧視的態度。現有中高齡者對年長者性態度的現況與相關因子尚未明朗，且尚無與其身心健康相關性之研究。故本研究旨於依照Collins歧視與壓迫三階層理論，探討台灣中高齡者對年長者性之文化、機構、個人態度的現況、相關因子，並與其身心健康之相關性分別為何。
本研究對象為出生於1946-1980年間、能自行填答問卷且居住於社區者，以單位大小比例等距法抽樣與分層多階段抽樣、過取樣、網路問卷等方式，招募居住於台灣本島之受試者。受試者排除條件為非出生於1946-1980 年間、無法自行填答、非居住於社區者，或未完整填寫對年長者性態度量表SASE其一構面問卷者。受試者人數為1690人，平均年齡為59.24±9.52歲。測量工具為對年長者性態度量表SASE、自編自覺健康狀態、孤獨感ULS-8、生活滿意度SWLS、基本資料、高齡健康與長照政策、社會支持MSPSS等變項。使用ANOVA、卡方、T-test查驗不同構面對年長者性態度之歧視程度高低組的人口組成差異，再透過二元邏輯回歸，探討具人口差異之變項是否為獨立預測因子。以及使用皮爾森回歸，查看對年長者性之不同構面態度，與身心健康之相關為何，最後使用線性邏輯回歸，探討經控制社會人口與健康變項後，不同構面對年長者性態度是否仍為身心健康的獨立預測因子。
研究結果為(1)對年長者性之文化、機構、個人構面與整體方面態度的歧視組占比分別為39.9%、50.8%、37.6%、52.4%；(2)經由各因子控制後，不論在文化、機構、個人構面與整體方面，女性(OR=1.241, 95% CI =1.01 - 1.53, p=0.045; OR=2.096, 95% CI =1.69 - 2.60, p<0.001; OR=5.25, 95% CI =4.14 - 6.66, p<0.001; OR=2.419, 95% CI =1.95 - 3.00, p<0.001)、較低教育程度者(OR=0.797, 95% CI =0.70 - 0.91, p=0.001; OR=0.616, 95% CI =0.54 - 0.71, p<0.001; OR=0.732, 95% CI =0.64 - 0.84, p<0.001; OR=0.629, 95% CI =0.55 - 0.72, p<0.001)、較低長照服務知識者(OR=0.81, 95% CI =0.72 - 0.91, p=0.001; OR=0.814, 95% CI =0.72 - 0.92, p=0.001; OR=0.816, 95% CI =0.72 - 0.93, p=0.002; OR=0.789, 95% CI =0.70 - 0.89, p<0.001)，皆顯著擁有較歧視對年長者的性態度，非已婚者經由各因子控制後則皆不再具顯著對年長者性之歧視態度。年齡、獨居與否、是否參與樂齡課程據點活動、社會支持感等因子，僅於特定構面對年長者性態度具顯著影響力；(3)經由各因子控制後，較歧視個人構面與文化構面對年長者性態度者，分別顯著擁有較差自覺健康狀態(β=-.117 ,p<0.001)與較高的孤獨感(β=.237 ,p<0.001)，而生活滿意度則無與任一構面性態度具顯著相關性。
本研究發現部分變項僅於特定構面中具有顯著影響力，可支持Collins歧視與壓迫三階層理論所強調之態度具多層次與交織性的觀點。未來研究可進一步探討各因子在不同構面呈現影響力差異的原因為何。研究限制為橫斷面問卷無法探討因果關係。受試納入者與排除者之社會人口具顯著差異，研究結果代表性可能受到挑戰。整體而言，本研究補足台灣中高齡者對年長者性態度相關因子並其與健康相關性之研究缺口，期盼可成為全齡性教育與高齡性健康促進政策提供重要參考依據。

Sexuality is a basic human need, but people often have discriminatory sexual attitude toward older adults. The study aims to explore the current sexual attitudes toward older adults among middle-aged and older adults in Taiwan from three dimensions—cultural, institutional, and personal—based on Collins' oppression theory, also examines what factors are related to these attitudes and how they associated with health.

Participants were community-dwelling, born between 1946-1980, could complete the questionnaire independently, who recruited by PPS and stratified multistage sampling, supplemented by oversampling and online surveys. Exclusion criteria were not community-dwelling, not born between 1946-1980, couldn’t complete the questionnaire independently, or didn’t complete at least one dimension of the Scale for Attitudes toward Sexuality of the Elderly (SASE). 1,690 participants were included and their mean age were 59.24 ± 9.52 years. Measures included SASE, self-rated health, ULS-8, SWLS, MSPSS, demographic variables, knowledge and participation in long-term care policies. Group differences were examined using ANOVA, chi-square and t-tests; independent predictors were identified using binary logistic regression, associations with physical and mental health indicators were assessed using Pearson’s correlation and linear regression controlling for demographic variables.

Women, lower educational level and long-term care service knowledge were significantly hold discriminatory SASE. More discriminatory attitudes in the personal and cultural dimensions were associated with poorer self-rated health and higher loneliness respectively (β = −0.117 and 0.237; both p < 0.001). This study provided empirical evidence to inform importance of life-course sexuality education and sexual health promotion policies in later life.

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