探討台灣中老年人喪偶對憂鬱風險的影響

The Impact of Conjugal Loss on Depressive Symptoms in Older Taiwanese

王芷湄(Chih-mei Wang)

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

摘要
目的：本研究的目的在探討台灣地區中老年人喪偶及其他因子對憂鬱的影響。
方法：本研究資料來源為「台灣地區中老年人身心社會生活健康狀況長期追蹤調查研究」資料庫。以SPSS/Window 12.0中文版統計套裝軟體(SPSS version 12.0. Chicago, IL)分析2003年受訪時有偶、及2003與2007年均完訪3164名個案，但排除2003年已具憂鬱(CES-D≧10分)風險者448名，實際共2716人。以羅吉斯迴歸(Logistic regression analysis)分析(1)喪偶與憂鬱的關聯(n=2716)及(2)影響喪偶者憂鬱的因子(n=147)。兩模式均控制2007年的人口學、社經、生活方式及健康變項。以α=0.05界定顯著統計意義。
結果：在控制婚姻狀況、年齡、性別、族群、正規教育年、居住安排、整體經濟滿意度、自覺健康狀況、2003配偶健康狀況、高血壓、糖尿病、中風、癌症、疼痛、ADL、抽菸、喝酒、日常運動頻率、及和家人互動等變項下，喪偶顯著增加憂鬱風險(OR=4.04, p=0.015)，但只限於6個月之內。6個月之後則不顯著。影響喪偶者憂鬱的因子包括高齡≧75歲、低血壓、與家人互動不良。其它變項包括性別、族群、正規教育年、整體經濟滿意度、自覺健康、居住安排、糖尿病、中風、疼痛、抽菸、喝酒、ADL惡化及運動則不顯著。
結論：本研究結果顯示喪偶增加中老年人的憂鬱，尤以六個月以內為最。而高齡≧75歲及和家人互動不良是影響喪偶者憂鬱的主要因子。喪偶初期應加強家庭或社會支持，以減少喪偶憂鬱風險。本研究結果可供有關單位研擬台灣中老年人憂鬱介入政策之參考。

關鍵字

喪偶 ； 憂鬱風險 ； 老人 ； 社會支持

並列摘要

Abstract

Introduction: Many factors can trigger a depression, a major disease in the elderly. The loss of a loved one, especially spouse, can have a profound impact on the psychological health of many elderly.
Objective: the purpose of the study is to investigate the impact of conjugal loss on depressive symptoms and to identify the factors associated with the depressive symptom in older Taiwanese. Methods: The study analyzed the datasets of “The Survey of Health and Living Status of the elderly in Taiwan”. The study first identified 3164 participants who had spouse and completed both 2003 and 2007 interviews. After excluding 448 participants who self-reported depressive symptoms (DES-D score ≥10) at baseline, 2716 participants qualified as study subjects. Statistical analysis was carried out with SPSS/Window 12.0 Chinese version statistic package. Logistic Regression Analysis was applied to analyze (a) the impact of spousal death on depression and (b) the factors affecting the risk of depression in bereaved spouse. Both models controlled for demographic, social economics, life style and health-related variables. α= 0.05 was chosen as the level of statistical significance.
Results: Results showed that the loss of a spouse was significantly (OR = 4.04, p = 0.015) associated with a increase in the risk of depression in older Taiwanese in a regression model controlled for age, gender, ethnicity, years of formal education, living arrangements, overall economic satisfaction, self-perceived health status, health status of spouse (in 2003), health condition (hypertension, diabetes, stroke, cancer and pain), functional status, smoking, drinking, daily exercise and family support. However, the association was significant only during the first 6 months of spousal death. Factors positively impacting conjugal loss included old age and poor family interaction, whereas high blood pressure was negatively associated with conjugal depression.
Conclusions: Results suggest that conjugal loss increases the risk of depression of the elderly, especial within six months of loss. Older elderly and those who have poorer family support are at increased risk. These results suggest that increasing family support, especially during the early phase of a conjugal loss would be an important strategy to reduce the risk of depression in older elderly. These findings should be relevant for developing elderly care policy in Taiwan.

並列關鍵字

Conjugal loss ； Depression ； Elderly ； Social support

參考文獻

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