台灣地區老人自覺健康狀況相關因子之探討

Predictive Factors of Self-rated Health Status among Elderly Population in Taiwan

林佳臻(Chia-Chen Lin) ； 杜明燦(Ming-Tsan Tu) ； 陳俊傑(Chun-Chieh Chen) ； 陳宣志 (Shiuan-Chih Chen) ； 顏啟華(Chi-Hua Yen) ； 李孟智(Meng-Chih Lee)

《台灣老年醫學暨老年學雜誌》 8卷2期 (2013/05) Pp. 75-89

https://doi.org/10.29461/TGG.201305_8(2).0001

摘要

目的：老化是台灣及世界各國人口發展趨勢，因此老人的健康照護之研究更顯重要，而自覺健康狀況對於測量個人生理、心理與社會健康具有綜合性指標意義。本研究欲探討影響自覺健康狀況之相關因素。方法：本研究使用國民健康局「台灣中老年人身心社會狀況長期追蹤調查」之1,646位老年人資料，以1999年（第四波）調查為基期，調查各項可能影響自覺健康狀況之因素，再進一步追蹤2003年（第五波）調查之自覺健康狀況。探討因素包括：教育、慢性疾病、日常生活功能、工具性日常活動功能、憂鬱症狀、認知功能、身體質量指數、休閒娛樂、社團活動參與等，以及各項家庭因素包括：婚姻狀況、居住穩定度、獨居、居住安排滿意度、與家人情緒支持意願、家人關心程度、經濟狀況困難度等因素。先以卡方檢定作為各項因子對於自覺健康狀況的單變項分析，顯著意義之變項再進行邏輯式回歸分析，探討各個因素對自覺健康狀況之相關性與預測能力。結果：經過四年的追蹤，發現老人之慢性疾病數、日常生活功能、工具性日常活動功能、憂鬱症狀等因素皆為自覺健康狀況的強烈預測因子。家庭因素方面，居住穩定度（OR: 0.59, 95.0% CI=0.39-0.91）以及家庭經濟狀況滿意度（OR: 1.52, 95.0% CI: 1.17-1.98）在經過調整其他明顯因子之後，仍具有顯著相關性。結論：本研究發現除了慢性疾病、日常生活功能、憂鬱症狀等生理和心理狀態，老年人的居住安排、自覺家庭經濟狀況、休閒娛樂等社會環境和家庭狀態，皆是自覺健康狀況的重要預測因子。

關鍵字

自覺健康狀況 ； 老人 ； 預測因子 ； 長期追蹤 ； 台灣

並列摘要

Objectives: Aging is a global trend, and Taiwan is one of the world's fastest aging nations. For the elderly, self-rated health status has been regarded as an indicator of each individual's physical and psychological health and society's health in general. This study aims to explore the factors influencing the self-rated health status of elderly people, emphasizing on intra-familial factors, from a longitudinal study of ”Survey of Health and Living Status of the Elderly in Taiwan”, during a four year period (1999-2003).Method: Data were collated from a population-based cohort study of 1646 elderly Taiwanese conducted respectively in 1999 and 2003. Self-rated health status and potentially associated factors were used for analyses. These factors included educational level, status of chronic diseases, activities of daily living score, instrumental ADL, depressive symptoms, cognitive function, body mass index, leisure/entertainment, social participation, and intra-familial factors (marriage status, living arrangement stability, living alone, degree of satisfaction with living arrangement, willingness to share worries with family, degree of family's care, degree of satisfaction with family's care, and financial status). The above factors as the independent variables and the 2003 self-rated health status as the dependent variable were analyzed with Chi-square test. Variables emerging as significant were subsequently analyzed using stratum logistic regression, and odds ratio (OR) and the 95% confidence interval (CI) were calculated.Results: The factors associated significantly with self-rated health status included years of formal education, having chronic diseases, activities of daily living, instrumental activities of daily living, and depressive symptoms. After adjustment for the above significant variables, two intra-familial factors appeared to be associated significantly with self-rated health status: living arrangement stability (OR: 0.59, 95.0% and CI: 0.39-0.91] and financial status (OR: 1.52, 95.0% and CI: 1.17-1.98).Conclusions: Chronic disease, activities of daily living, instrumental activities of daily living and depressive symptoms were strong predictors of self-rated health status. Intra-familial factors associated with self-rated health status were living arrangement stability and financial status.

並列關鍵字

self-rated heath status ； elderly ； risk factors ； longitudinal study ； Taiwan