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  • 學位論文

喪偶與中老人之睡眠狀況、鎮靜、安眠藥物使用及醫療服務使用之相關性

The sleep status, use of sedatives and hypnotic drug, and medical service utilization after spouse death in older people in Taiwan

指導教授 : 葉志嶸
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摘要


台灣已成為「高齡化社會」,即將邁入「超高齡社會」,面對社會結構變遷,長期照顧方案陸續祭出,其中「中老年人喪偶者」值得特別關注。文獻指出中老年人喪偶者有較多健康,社會問題,如睡眠、就醫情形等,本研究探討其睡眠狀況、鎮靜及安眠用藥情形以及醫療服務使用之相關。 研究對象為台灣地區50歲以上的喪偶者,資料來源為國健署之「台灣地區中老年人身心社會生活狀況長期追蹤調查」,共計5300名,其中935名為喪偶者,以世代追蹤蒐集變項資料,比較中老年人與喪偶者以及喪偶後半年、一年、兩年以及兩年以上。使用SAS 9.4版本,描述性統計、卡方檢定和多變項羅吉斯迴歸進行分析。 結果顯示喪偶者年齡較大,多為女性 (61.7%)。喪偶者與睡眠狀況 (OR=2.29 p=0.0211)和近一年入急診(OR=1.60 p=0.0108)相關,尤其是男性及年齡為65-75歲者,隨時間增加而相關遞減。 較多文獻將睡眠不好的原因和就醫情形多歸為老化的關係,本研究喪偶者中老年人情形較未喪偶者中老年人明顯,期望在長期照顧發展方面,能對喪偶中老年者在社會協助部分其資訊提供有所幫助。

並列摘要


We are facing an "aging society" in Taiwan and are about to enter the "super-old society". Facing the changes in social structure and long-term care programs, "Middle-aged andelderly widowed person" deserves special attention. The literaturesshow that there are more health and social problems in middle-aged and elderly widowed people, such as sleep, medical treatments, etc. This study explores the sleep status, use of sedatives and hypnotic drug, and medical service utilization after spouse death in older people in Taiwan. The study based on the follow-up survey of the physical and mental health status of the middle-aged and elderly people in Taiwan, with a total 5,300 subjects, where were 935 widowed subjects. For those widowed subjects, four different follow-up time point were observed, six months, one year, two years and more than two years. SAS 9.4 were applied for statistical analysis, and descriptive statistics, chi-square test, and multivariate Logistic regression were used for analysis. In widowed subjects, 61.7% were female The widowhood are statistically associated with sleeping status (OR = 2.29, p = 0.0211) and medical utilization of emergency within 1 year (OR = 1.60, p = 0.0108), especially in men and those aged 65-75 years. Most literatures attribute the cause of poor sleep and medical service utilization to “aging”, but this try to focus the importance of spouse death. Inthe long-term care policy development, the health effect for the widowed elders after spouse death should provide useful information in long-term care practices.

參考文獻


Sheng-Ta Chiang, Sheng-Kuang Wang, Tung-Wei Kao,Wen-Hui Fang,Yao-Wen Chang , Sen-Yeong Kao,Chih-Chieh Chou . (2011年5月1日). Influential Factors of Medical Utilizations among. 台灣老年醫學暨老年學雜誌, 頁 86-104.
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Yi-Chen Wu, M.S, Yea-Jou Lou, M.S. (2016年3月17日). Use of Sedatives among Patients in the Hospital-based. Taipei City Med J, 頁 263-271. doi: 10.6200/TCMJ.2016.13.2.16
李月萍, & 陳清惠. (2016年08月01日). 喪偶對高齡者健康及生活之衝擊及護理. 護理雜誌, 63(4), 頁 19-24.
李月萍、陳清惠. (2016年5月27日). 喪偶對高齡者健康及生活之衝擊及護理. 護理雜誌, 頁 19-24. doi:10.6224/JN.63.4.19

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