台灣老年人憂鬱之長期追蹤研究（1993年-2003年）

A Longitudinal of Depressive Symptoms Study in Taiwanese Elderly (1993-2003)

黃瑞芳(Ruei-Fang Huang)

指導教授 ： 王理

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2009年)

摘要

背景與目的：憂鬱是老年人最常見的精神疾患，隨著年齡的增加其憂鬱的情形也愈嚴重。本研究利用台灣1993-2003年65歲以上老年人縱貫性資料，檢視台灣男女老年人憂鬱隨時間變動的軌跡以及其憂鬱與健康、失能狀況、社會支持及經濟等影響因素隨時間演變的關係。研究方法：本研究以國民健康局「臺灣地區中老年身心社會生活狀況長期追蹤調查」之1993、1996、1999及2003年四波調查為研究資料；排除此四波未連續接受調查的研究對象後，共計1,017名。以結構方程式之潛在成長曲線模型探討老年人憂鬱狀況與混合潛在成長模型探討影響老年人憂鬱因素在此十年間變動的軌跡。研究結果：台灣老年人憂鬱程度，在男女上有顯著的差異。台灣老年人憂鬱狀況均不能單純由時間來做預測，男性與女性老年人憂鬱起始狀況與自覺健康、失能狀況及社會支持均有關。男性老年人會因自覺健康及失能狀況隨著時間的演變，影響其憂鬱變動的軌跡。女性老年人會因失能狀況及社會支持隨著時間的演變，影響其憂鬱變動的軌跡。結論：在此縱貫性的研究，我們發現影響老年人憂鬱因素在男性及女性有所不同；台灣政府及社會應該對影響男性及女性老年人憂鬱因素，提供資源給予幫助。

關鍵字

老年人 ； 憂鬱 ； 健康 ； 失能狀況 ； 社會支持 ； 經濟 ； 潛在成長曲線模型 ； 結構方程式

並列摘要

Background and Purpose: Depression is the most common psychiatric disorder problem in the elderly. The depressive situation will be more serious with increasing age. In this study, we used the 1993-2003 longitudinal data of the elderly, ages 65 and over, to examine the trajectories coming after time in male and female depression and its influencing risk factors including health, disability, social support and economy during these four stages. Methods: The data was from a longitudinal Survey of Taiwan Bureau of Health Promotion of Health, in which data was comprised of the investigation in 1993, 1996, 1999, and 2003. The total samples were 1,017 excluded those who didn’t get a sequence of investigation over these years. Using latent growth curve modeling of structural equation modeling (SEM) to explore the elderly depression and Growth Mixture Modeling of SEM was employed to assess the depressed influencing factors and its trajectory over these 10 years. Results: There was a significant difference in gender with elderly depression. Taiwanese elderly depression couldn’t simply predicted by age. The initial stage of the elderly depression in male and female was associated with perceived health, disability and social support. The trajectory of elderly depression in men was influenced by perceived health and disability with the process of time. The trajectory of elderly depression in women was affected by disability and social support with the process of time. Conclusion: In this longitudinal study, there were differential risk factors in elderly depression between men and women. Taiwan government and society should provide resources help those who were depressed male and female elderly in need.

並列關鍵字

elderly ； depression ； health ； disability ； social support ； economy ； structural equation modeling ； latent growth curve modeling

參考文獻

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