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台灣地區老人的生理疾病多寡、自覺生理健康、社會支持度與憂鬱嚴重度

The Relationship of Severity of Physical Disease, Perceived Physical Health and Social Support to Depression among the Elderly in Taiwan

摘要


目的:旨在探討老人生理疾病多寡、自覺健康及社會支持與憂鬱之關係,以及工具性與情感性社會支持所扮演的不同角色。 方法:針對家庭計畫研究所三次追蹤調查的2669名老人,於2002年再度調查,共完訪2125人。 結果:以憂鬱程度爲依變項之階層迴歸發現,較多生理疾病、低自覺健康、低情感性支持,都可直接預測高憂鬱度;但生理疾病多寡與工具性支持產生交互作用而影響憂鬱度。再將生理疾病分為較多組與較少組進行分析,結果顯示,針對生理疾病較多組,工具性支持愈多,憂鬱度愈高;而針對生理疾病較少組,則工具性支持不能顯著預測憂鬱度。 結論:生理疾病多、低自覺健康及低情感性支持直接影響高憂鬱度;而工具性支持對憂鬱度的影響,因生理疾病多寡而有所不同。

並列摘要


Objective: The study was designed to examine the relationships of the severity of physical disease, perceived physical health, and social support to depression as well as the differential roles of instrumental and social support among the elderly in Taiwan. Method: During 2002, we conducted a cross-sectional survey by interviewing a random sample of 4049 elderly subjects enrolled in 1989 and followed up in 1993 and 1996. The present study successfully completed the follow up of 2125 subjects. Results: The results illustrated, (1) with depression as a dependent variable, by performing hierarchical regression analyses, severity of physical disease, perceived physical health, emotional social support would directly predict the level of depression. However, the interaction between the severity of physical disease and instrumental social support would influence the degree of depression. (2) Furthermore, we separated the subjects by severity of physical disease into high and low groups, and performed hierarchical regression analyses a second time. The results showed that as to the group with high physical disease, the more instrumental social support they had, the lower degree of their depression. Regarding the group with lower severity of physical disease, instrumental social support would not significantly predict the level of depression. Conclusion: The results of the present study suggested that perceived physical health and emotional social support directly influenced the degree of depression, while the severity of physical disease would buffer the impact of the instrumental social support on depression among the elderly in Taiwan.

參考文獻


Bell, M.,Goss, A. J.(2001).Recognition assessment and treatment of depression in geriatric nursing home residents.Clinical Excellence for Nursing Practitioners.5,26-36.
Berkman, L.(1977).Community mental health services for the elderly.Community Mental Health Review.2,1-9.
Berkman, L.(1984).Annual Review of Public Health.Palo Alto, CA:Annual Reviews.
Berkman, L. F.,Oxman, T.,Seeman, T. E.,R. B. Wallace,R. F. Woolson(Eds.)(1992).The Epidemiological Study of The Elderly.New York:Oxford University Press.
Berkman, L. S.,Syme, S. L.(1979).Social networks, lost resistance, and mortality: A nine year follow-up study of Alameda County residents.American Journal of Epidemiology.69,186-204.

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