我國老人憂鬱程度、健康狀況與醫療服務利用之相關性探討－「2005年國民健康訪問調查」資料分析

A Study of the Relationships among Depression, Health Status and Medical Services Utilization of the Elderly in Taiwan – results of 2005 National Health Interview Survey

吳玟蕙(Wen-Hui Wu)

指導教授 ： 徐尚為

亞洲大學/健康學院/健康管理研究所/碩士(2012年)

摘要

目的：分析老人憂鬱盛行率及探討影響老人憂鬱的相關因子。
方法：以「2005年國民健康訪問調查」所蒐集的資料，利用SPSS/PC 12.0中文版套裝軟體進行統計分析。分析的內容自變項包括社會人口學特性、個人健康狀態（自評健康狀況、日常活動能力及慢性病罹患情形）、醫療服務利用情形（西醫門診次數、住院次數），依變項則是以美國流行病學憂鬱症量表篩檢結果，總分大於或等於10分者則界定有憂鬱傾向。刪除非本人回答及遺漏值後，實際進入分析的樣本數為2335人。
結果：研究結果發現有憂鬱傾向的老人有261人，佔19.74%。女性、喪偶、教育程度越低、獨居、個人經濟狀況較差的老人其憂鬱情況較高。自評健康越好、日常活動能力越好的老人，其發生憂鬱的情形會減少。罹患慢性疾病數越多、住院或西醫門診次數越多者，其憂鬱程度越高。依據多元逐步回歸分析的結果，「教育程度」、「居住安排」、「個人經濟狀況」、「自覺健康狀況」、「慢性病個數」、「日常活動能力」、「住院次數」、「西醫門診次數」等皆是預測憂鬱傾向的重要因子。
結論：依據本研究的結果，老人憂鬱程度預測因子中，「自覺健康狀況」最具預測力，因此未來有關老人健康照護政策之擬定應加強政策的實施須能提升老人的自覺健康程度。另外，罹患慢性病狀況也與憂鬱情形成正相關，因此建議未來在公共衛生與臨床醫療上可積極對慢性病患者進行憂鬱篩檢，進而早期發現與治療。

關鍵字

老人 ； 憂鬱 ； 自覺健康狀況 ； 日常活動能力 ； 醫療服務利用

並列摘要

Objective：The purposes of this study are（1）to explore the prevalence of depression among the elderly, and（2）to examine factors related to depression among the elderly.
Method：We used SPSS/PC software to analyze data that was collected from the 2005 National Health Interview Survey, provided by the Bureau of Health Promotion, Department of Health, R.O.C. The independent variables include personal characters, health status （self-perceived state, activity of daily living and chronic diseases）and medical services utilization（frequencies of doctor-visiting and hospitalization）. Depression symptom was the dependent variable and scored by using Center for Epidemiological Studies Depression Scale（CES-D）. Score of 10 or more was defined as having depression symptom. Delete the non-respondents to answer and missing values, the actual number of samples into the analysis for 2335 people.
Results：The results showed that the prevalence of depression among the elderly was 19.74%. Those who were female gender, widowed, single, less education, lower income , higher numbers of chronic diseases, more physician visits and hospitalization, lower scores of self-perceived health status and activity of daily living（ADLs）were more likely to develop depressive symptoms. Using stepwise multiple regression, education, living arrangement, Economic conditions, self-perceived health status, the number of chronic diseases, activity of daily living, the frequency of physician visits and hospitalization dependency satisfaction among elderly people can explain 21.4％ of total variance in depression.
Conclusion：Results generated from this study, self-perceived health status was the strongest predictor for the depression. Researcher suggests that health care policy for the elderly should be strengthened to develop the implementation of the policy must be able to enhance perceived health status. Many chronic diseases were related to depression symptoms. When we take care of the patients with above chronic diseases, the depression should be always in considerations.

並列關鍵字

Elderly ； Depression ； Self-perceived state ； Activity of daily living ； Medical services utilization

參考文獻

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