工具性與情緒性社會支持對台灣地區中老年人憂鬱傾向關聯性探討

背景：在人口老化現象日漸嚴重的背景之下，許多研究發現，中老年人的社會支持，具有保護緩衝作用，可調節身心狀況的損害。目的：探討台灣地區中老年人工具性與情緒性社會支持對憂鬱傾向之關聯性。方法：本研究採用衛生福利部國民健康署「台灣中老年身心社會生活狀況長期追蹤調查」第六次調查資料進行分析。以2007年4,440名個案為對象，排除資料不全者，實際有效個案共4,029名為研究對象。以SPSS 21.0中文版套裝軟體進行描述性及推論統計分析，分析工具性社會支持與情緒性社會支持對憂鬱傾向的關聯性，以邏輯斯迴歸控制人口學變項及健康危險因子。結果：有幫忙照顧小孩（工具性社會支持）可有效降低憂鬱的風險29.3%（OR＝0.707，p＝0.007）；需要和人談心事時，覺得家人願意傾聽有效降低憂鬱風險45.2%（OR＝0.548，p＜0.000）；家人的關心（指精神或心理）程度，覺得滿意可有效降低憂鬱風險達52.9%（OR＝0.471，P＝0.012）；覺得自己對家人的關心，是有幫助可有效降低憂鬱風險62.8%（OR＝0.372，p＜0.000）；家人在決定事情時，他們會問您意見可有效降低憂鬱風險27.6%（OR＝0.724，p＝0.020）；覺得家人對您做的事，會常常嫌東嫌西會使憂鬱風險高出133.9%（OR＝2.3339，p＜0.000），具顯著達統計意義。結論：針對中老年人之工具性社會支持與情緒性社會支持對憂鬱傾向關聯性之研究發現呈現負相關，而邏輯斯廻歸分析發現，缺乏工具性社會支持與情緒性社會支持易發生中老年人憂鬱。建議社區健康照護工作者應強化對中老年人的工具性社會支持與情緒性社會支持，鼓勵家人朋友多陪伴傾聽並表達關心，適時提供實質性支持，以減緩憂鬱產生。

關鍵字

工具性社會支持；情緒性社會支持；憂鬱；中老年人

並列摘要

Background: The population structure presents the aging and longevity for the middle aged and elderly. Therefore, under the background that the phenomenon of population aging is gradually severe, the researches related to the health of the middle aged and elderly are gradually valued. Many studies have shown that the social supports of the middle aged and elderly have the protective and buffer effect, which can adjust the injury in physical and psychological status. Objective: The purpose for this study is to discuss the correlation of the middle aged and elderly, s instrumental social support and psychological social support on depression tendency. Method: This study adopted the 6th survey data of ＂Taiwan Longitudinal Survey on Aging (TLSA)＂ by Health Promotion Administration, Ministry of Health and Welfare for analysis. By excluding those with incomplete data from the 4,440 cases in 2007, there were totally 4,029 valid cases as the research subjects. The software package in Chinese version of SPSS 21.0 was used for statistics to analyze the relationship of instrumental social support and psychological social support on depression tendency. Logistic regression was used to control the demographic variables (gender, age, education years, marriage), life style (smoking and drinking) and disease status (hypertension, heart disease and diabetes). Results: Taking care of children(instrumental social support) can effectively reduce 29.3% depression risk (OR=0.707, p=0.007); sharing thoughts or worries with family and friends can effectively reduce 45.2% of depression risk (OR=0.548, p＜0.000); the psychological social support from family members (spiritual or mental support) can effectively reduce 52.9% depression risk (OR=0.471, p=0.012); care for the family can effectively reduce 62.8% of depression risk (OR=0.372, p＜0.000); being able to offer suggestions to family members when needed can effectively reduce 27.6% of depression risk (OR=0.724, p=0.020); being rejected or avoided by family members can increase the depression risk by 133.9%(OR=2.3339, p＜0.000), which has the significantly statistical significance. Conclusion: The results showed that the middle aged and elderly, s the instrumental social support and psychological social support are negatively correlated to depression and the logistic regression analysis found that the lack of instrumental social support and psychological social support for the middle aged and elderly prone to depression. According to the research results, people should intensify the health care personnel in the community, promote the instrumental social support and psychological social support towards the middle aged and elderly, encourage family members to listen to them and appropriately express their concern, and provide the instrumental social support (such as the care and attention when they are sick) for the middle aged and elderly, so as to slow down the emergence of depression, further improve the living quality of the middle aged and elderly and reach the successful aging..

並列關鍵字

instrumental social support ； psychological social support ； depression ； middle aged and elderly

參考文獻

Chan, N., Anstey, K. J., Windsor, T. D., & Luszcz, M. A. (2011).Disability and Depressive Symptoms in Later Life: The Stress-Buffering Role of Informal and Formal Support, Gerontology, 57, 180–189. doi: 10.1159/000314158.

Reblin, M.,& Uchino, B.M.(2008).Social and emotional support and its implication for health. Curr Opin Psychiatry , 21 (2), 201-205. doi: 10.1097/YCO.0b013e3282f3ad89.

內政部統計處 (2014) 。重要參考指標．台北市：內政部統計處。