探討台灣老年人成為需要照顧的決定因子

Determinants of the Onset of Needing Care by Older Taiwanese

林佑穗(LIN YU SUI)

指導教授 ： 蔡仲弘

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2011年)

摘要

背景與目的：影響老人成為需照顧的因子很多，且可能因族群及社經因素而異。本研究的目的在探討台灣老人成為需要照顧的影響因子。
方法：本研究分析國民健康局「中老年身心社會生活狀況長期追蹤調查」2003及2007年的資料，但只以1989年收案的個案群為對象，因該樣本群於2003年皆為≥74歲，照護需求高，符合本研究的需要。以SPSS 12.0軟體進行統計分析。以描述性統計呈現個案的基本資料。以卡方檢定檢測單因子關聯顯著性，二元邏輯斯迴歸依有無含日常活動功能(Activities of Daily Living, ADL)及工具性日常活動功能(Instrumental Activities of Daily Living, IADL)障礙或惡化變項以四模式分析2003年可自我照顧者於2007年成為需照顧的關聯因子。以p<0.05界定顯著意義。
結果：ADL, IADL惡化及認知不良是成為需照顧最主要的決定因子。當模式只含「2003年ADL障礙狀況」變項時，ADL失能、大便失禁、曾住院、曾急診、認知不良是成為需照顧的顯著正向預測因子；而獨居、抽菸、每週運動三次以上則是顯著負向因子。當模式增加「2003年IADL障礙狀況」變項時，IADL中度及重度失能、大便失禁、曾住院、曾急診、認知不良為顯著正向預測因子；而獨居、抽菸、每週運動三次以上則為顯著負向因子。當模式又增加「2003至2007年ADL惡化」變項時，ADL惡化及2003年ADL失能、心臟病、認知不良為顯著正向關聯因子。當模式再增加「2003至2007年IADL惡化」變項時，2003年ADL重度失能、IADL嚴重失能、ADL惡化、IADL惡化、心臟病、認知不良為顯著正向關聯因子。
結論：本研究顯示老人成為需要被照顧的主要影響因子是行動失能、認知不良、及較重大的疾病。社經因素的影響不大。因此，推遲認知及行動失能應是老人健康促進的重點。

關鍵字

老年人 ； 需要照顧 ； 行動失能 ； 認知不良

並列摘要

Introduction and objective: Many factors, including social and physiological, can impact the onset of needing care of the elderly persons. This study was aimed to examine these factors in older Taiwanese.
Method: This study analyzed the 2003 and 2007 datasets of the “Survey of Health and Living Status of the Elderly in Taiwan”. The study analyzed only data of the original cohort because all subjects would over 74 years old in 2003s and would have greater care needs. Statistical analyses were carried out with SPSS for Windows Version 12.0. Binary logistic regression analysis was used to analyze the factors associated with the initiation of needing personal care.
Results: Results showed that ADL (Activities of Daily Living), IADL(Instrumental Activities of Daily Living) dependency and cognitive impairment were the major determinants of becoming needing care. Other factors such as old age, being a female, incontinency, poor cognition and heart disease were also associated with increased risk of needing care.
Conclusion: The study showed that functional disability, cognitive impairment and serious illness are the major determinants of becoming needing care in the elderly. Social factors are not among the major determinants. Results suggest that prolonging functional activity and normal cognition appears to be the major focus point of delaying the onset of needing care.

並列關鍵字

Older adults ； Needing care ； Functional disability ； Cognitive impairment

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