休閒活動對老人工具性日常活動失能的影響－一個縱貫性研究

The influence of leisure activities on the disability of the elderly's instrumental daily activities –A longitudinal study

劉千榆(Chien-Yu Liu)

指導教授 ： 李淑杏

中山醫學大學/醫學院/護理系長期照護碩職專班/碩士(2021年)

https://doi.org/10.6834/csmu202100262

摘要

研究背景與目的：高齡化社會已是目前全球人口變遷之趨勢，文獻顯示全球失能的人口超過十億人罹患某種形式的失能，並隨著人口老化持續成長。過去研究已提及老人休閒活動參與的重要性，參與休閒活動能使老人的功能障礙進展趨向緩慢。社會中有許多因子共存互相影響的狀況，本研究更進一步在不同的「休閒活動」中將老人的「年齡」及「性別」做分層分析，補足過去文獻較少提及，在年齡層的老人與性別差異對IADL失能的各別調節效應影響的研究缺口。基於上述研究背景與動機，本研究目的為分析『臺灣地區中老年身心社會生活狀況長期追蹤調查』探討臺灣不同的休閒活動對老人IADL失能的影響及其相關因子探討。
研究方法：本研究為縱貫性長期追蹤研究設計，使用『衛生福利部國民健康署』2007年（第六波）及2011年（第七波）辦理之『臺灣地區中老年身心社會生活狀況長期追蹤調查』之問卷調查資料。資料庫分析數據是以2007年時65歲以上存活及IADL功能正常之老年個案為研究樣本，含男性1,300人，女性1,271人，共計2,571人。受訪個案所陳述其休閒活動情形來追蹤探討個案在其後續4年（自2007年至2011年）期間之失能狀況，研究其相關性。採用SAS 9.4版統計軟體進行資料分析，描述性統計含個數、百分比、平均值及標準差，推論性統計含卡方檢定、t-test及邏輯式迴歸進行分析。
結果：本研究IADL失能的平均年齡是75.21(±6.33)歲，年齡≥75歲有較高的失能趨勢佔52.56%，IADL失能者多數為男性佔52.82%。將老人所參與的休閒活動區分為「智力型」、「體力型」、「社交型」三組的休閒活動，研究發現參與「智力型」和「社交型」休閒活動可以預防IADL失能（OR=0.73, p = 0.0019, 95%CI [0.59,0.89]；OR=0.66, p = 0.011, 95%CI [0.48,0.91]），因此提供「智力型」和「社交型」休閒活動對於IADL失能具統計顯著性之保護作用。本研究更進一步將年齡分層分析後發現，年齡65-74歲「智力型」休閒活動為邊際統計顯著性（OR=0.77, p =0.0585, 95%CI [0.59,1.01]）；年齡≥75歲在「智力型」和「社交型」休閒活動均對IADL失能達統計顯著（OR=0.63, p =0.0053, 95%CI [0.46,0.87]及0.58, p=0.0411, 95%CI [0.34,0.98]）。在進行邏輯式迴歸性別分層分析後，結果顯示男性在「智力型」（OR=0.70, p =0.0071, 95%CI [0.54,0.91]）和「社交型」（OR=0.63, p =0.027, 95%CI [0.42,0.95]）是有顯著保護作用。
結論：本研究建議65歲以上的老人多參與「智力型」和「社交型」休閒活動能降低IADL失能。在進行預防及延緩失能照護衛教時，男性可以給予「智力型」和「社交型」的衛教資訊，對於預防及延緩IADL失能會較有顯著的效果。

關鍵字

工具性日常活動功能 ； 休閒活動 ； 老人 ； 失能

並列摘要

Objectives：An aging society has become the current trend of global population migration. The literature shows that one billion people lost in the global population will lose their ability with age and continue to grow with age. Social activities slow down the functional progress of the elderly. Analyze, supplement the previous IA knowledge, the research report in the region where the elderly and gender differences affect the effect of the other-level moderating effect on disability. Based on the above research background and motives, the purpose of this research is to investigate the influence of long-term different leisure activities in Taiwan on the disability of the elderly and related factors.

Methods：This research is a longitudinal long-term follow-up research design, using the “Long-term follow-up survey on the mental and social life of middle-aged and elderly people in Taiwan” conducted by the National Health Administration of the Ministry of Health and Welfare in 2007 (the sixth wave) and 2011 (the seventh wave) The questionnaire survey data. The database analysis data is based on the elderly cases over 65 years of age and normal IADL function in 2007 as the research sample, including 1,300 males and 1,271 females, a total of 2,571 people. The interviewed case's state of leisure activities is used to track and explore the disability status of the case during the subsequent 4 years (from 2007 to 2011), and to study its relevance. Use SAS 9.4 version of statistical software for data analysis. Descriptive statistics include number, percentage, average and standard deviation, and inferential statistics include chi-square test, t-test and logistic regression for analysis.

Results：In this study, the average age of IADL disability was 75.21 (±6.33) years old, 52.56% of the age ≥ 75 years old had a higher tendency of disability, and the majority of IADL disability was male, accounting for 52.82%. The leisure activities that the elderly participate in are divided into three groups of leisure activities: "intellectual", "physical" and "social". The study found that participating in "intellectual" and "social" leisure activities can prevent IADL disability (OR =0.73, p = 0.0019, 95%CI [0.59,0.89]; OR=0.66, p = 0.011, 95%CI [0.48,0.91]), therefore, providing "intellectual" and "social" leisure activities is not the Can have a statistically significant protective effect. This study further analyzed the age stratification and found that “intellectual” leisure activities aged 65-74 years old were statistically significant at the margin (OR=0.77, p=0.0585, 95%CI [0.59,1.01]); age ≥75 Both "intellectual" and "social" leisure activities have statistically significant effects on IADL disability (OR=0.63, p=0.0053, 95%CI [0.46,0.87] and 0.58, p=0.0411, 95%CI [0.34] ,0.98]). After performing a logistic regression gender stratification analysis, the results showed that men are in the "intelligence type" (OR=0.70, p =0.0071, 95%CI [0.54,0.91]) and the "social type" (OR=0.63, p =0.027). , 95%CI [0.42,0.95]) is a significant protective effect.

Conclusion：This study suggests that elderly people over 65 participate in "intellectual" and "social" leisure activities to reduce IADL disability. In the prevention and delay of disability care, men can give "intellectual" and "social" health education information, which will have a significant effect on preventing and delaying IADL disability.

並列關鍵字

Instrumental Activities of Daily Living ； Leisure activities ； Elderly ； Disability

參考文獻

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