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  • 學位論文

台灣中老年人社會參與對存活情形之影響:喪偶與有偶之比較

The effect of social participation on mortality among the elderly in Taiwan: a comparison between the widowed and the non-widowed

指導教授 : 董和銳
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摘要


目的:探討中老年人其社會參與對存活的影響,並進一步分析喪偶者與有偶者其社會參與對死亡的影響是否不同。 方法:資料來源為1999年「台灣地區中老年身心社會生活狀況長期追蹤調查系列研究調查資料庫」,並擷取53歲以上中老年人,扣除死亡、資料不完整的個案,共3832個樣本,社會參與定義為活動參與及有酬工作,影響存活主要因素為喪偶情形及社會參與,在控制人口社經、生理與心理健康狀況、社會支持、社會參與等變項,採用COX迴歸進行分析預測 1999至2003年四年之間及1999至2007年八年之間的死亡風險,並進一步針對持續喪偶及持續有偶進行分析比較。 結果:在四年期間存活分析結果發現持續喪偶者的死亡風險為持續有偶者1.47倍;男性的死亡風險為女性2.23倍;65至74歲的老人的死亡風險為53至64歲的2.73倍,75歲以上的老人則5.62倍;籍貫為其它的中老年人死亡風險是外省為1.58倍;認知功能障礙的死亡風險為正常1.34倍;日常生活活動障礙的死亡風險為正常1.76倍;工具性日常生活活動障礙的死亡風險為正常1.99倍;自覺健康狀態不佳的死亡風險為良好1.59倍;活動參與程度每增加一個測量單位,死亡風險減少19%,沒有工作者的死亡風險為有工作者的1.57倍。 在八年期間存活分析結果發現持續喪偶者的死亡風險為持續有偶者1.2倍;而男性、年齡較大、非外省籍、罹患三種以上慢性病、有日常活動功能障礙者、自覺健康狀態較差者及有憂鬱傾向者死亡風險較高;老人的活動參與程度每增加一個測量單位,其死亡風險減少14%,沒有工作者之死亡風險為有工作者的1.7倍。 結論:社會參與及喪偶對存活有各自的影響作用,喪偶對存活有負向的影響,但在社會參與當中,活動參與對持續喪偶者及持續有偶者都有正向的影響作用,有酬工作對持續有偶者有正向影響,因此,社會參與的提升有助於所有中老年人晚年生活福祉。

關鍵字

喪偶 社會參與 存活

並列摘要


Objectives:This longitudinal study examines the effect of social participation on mortality for the elderly in Taiwan, comparison between the widowhood and the non-widowhood . Methods:Data were from an elderly population panel in Taiwan ‘The Survey of Health and Living Status of the Elderly’ 1999-2003-2007. Three thousand eight hundred and thirty two people aged 53 in 1999 were included. Baseline social participation was measured by using social activity and paid job. The major factors in survival were widowhood and social participation. Cox regression models were used to analyze and forecast relative hazards of mortality respectively four years (1999-2003) and eight years (1999-2007), while controlling for participants socioeconomic status, physical and psychological health conditions, social support, and social participation. Results:It was found in the four-year mortality analysis that relative hazards of widowhood were 1.47 times higher than the non-widowhood. The relative hazards of males were 2.23 times higher than that of females. The relative hazards of the seniors between 65 years old and 74 years old were 2.73 times higher than that of the seniors between 53 years old and 64 years old, and that of the seniors above 75 years old was 5.62 times higher. For the mortality analysis between 1999 and 2007, that relative hazards of widowhood were 1.2 times higher than the non-widowhood. Furthermore, people who were male, older, non-provincial, with more than three chronic diseases, and with activities of daily living impairment, who felt the health was worse, and who had a melancholy tendency had a higher relative hazards. Conclusions:Social participation and the widowhood had their respective influences on mortality. The widowhood had influence on mortality. However, in social participation, activity participation had positive influence on both the widowhood and the non-widowhood; paid employment had positive influence on the non-widowhood. Hence, improvement in social participation would improve older people’s welfare.

並列關鍵字

widowhood social participation mortality

參考文獻


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被引用紀錄


莊雅貴(2015)。探討台灣年長者社會支持對工具性日常生活功能改變之影響〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834%2fCSMU.2015.00077
呂建駒(2014)。台灣社區老年人居住安排與認知功能退化相關性探討〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834%2fCSMU.2014.00157

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