戶基護航網絡與老年人憂鬱傾向之影響

The Impact of Household-based Convoy on the Elderly’s Depression

林欣韻(Xin-yun Lin)

指導教授 ： 陳肇男

亞洲大學/健康學院/長期照護研究所/碩士(2008年)

摘要

本研究採用戶基護航網絡來反應一個人的社會支持體系。它包含四圈，最內圈為家庭，依序外推為常來往之不同住親屬、親戚與朋友。研究目的有二，一是討論各圈對憂鬱是否有獨立影響。其次為四圈的完整性是否也會影響憂鬱。
本研究使用行政院衛生署國民健康局所提供之「台灣地區中老年身心社會狀況長期追蹤調查系列」之第一波(1989年)資料。扣除憂鬱問題回答八題以下之個案，樣本數為3856位。
憂鬱傾向以問卷中之憂鬱指數(CESD-10)為研究工具。將所有題目之分數加總來判定有無憂鬱傾向。CESD-10總分最高為30分，最低為0分，並以10分為切點(cut-off)辨別有無憂鬱傾向，10分以上者為有憂鬱傾向而未滿10分者為無憂鬱傾向。
本研究結果發現於1989年時， 60歲以上老年人中有15%為有憂鬱傾向。於邏輯斯迴歸分析結果中發現，未加入戶基護航網絡變項時，旅遊活動數、IADL失能數、疾病數、自覺健康、自覺經濟以及外省人會影響老年人憂鬱傾向。然而分別加入戶基護航網絡各圈有無以及完整性後，旅遊活動數與外省人此二影響因素被戶基護航網絡變項解釋掉。而戶基護航網絡之四圈中，除親戚外都有顯著影響。另外，缺2圈以下則不會有顯著影響力。

關鍵字

老年人 ； 憂鬱 ； 戶基護航網絡

並列摘要

This study uses household-based convoy to indicate one’s informal social support system. It consists of four circles. The most inner circle reflects one’s household structure. It is followed by non-coresiding family members, relatives, and friends who have contacted the focal person more than once a week. At first, we are interested to know whether each circle of the household-based convoy has an independent effect on depression. Secondly, we are also interested to know whether the completeness of the household-based convoy has an effect on depression.
The data used for analysis come from the Survey of Health and Living Status of the Elderly in Taiwan conducted by the Provincial Institute of Family Planning and the Population Studies Center and Institute of Gerontology of the University of Michigan in 1989. When the cases who answer less than eight questions on depression are deleted, it has a total of 3,856 cases aged 60 or above for this analysis.
The questions on depression are adopted from CESD-10. Three answers are provided for each question and scored with 0, 1.5, and 3. The scores of the ten questions are accumulated to form an index of depression ranged from 0 to 30. The score of 10 is taken as the cutting point. Those who have a score of 10 or above are taken as having a propensity of depression; and the rest, without the propensity of depression.
The results of this study show that 15% of the sample has a propensity of depression. It has also been found that number of traveling activities, IADL, number of chronic diseases, self-rated health and income, and ethnic have a significant effect on depression, when the household-based convoy is not included in the Logistic regression model. Once the household-based convoy is included, the effect of number of traveling activities and ethnic disappeared. On the other hand, we have found that three out of the four circle of the household-based convoy have a significant effect on depression, with the exception of the circle for relatives. In addition, the completeness of the household-based convoy also has a significant effect on depression.

並列關鍵字

depression ； household-based convoy ； social support

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