中高齡幸福感變遷與相關因素探討─臺灣地區中老年身心社會生活狀況長期追蹤三波調查分析

The Influential factors of Well-being among Middle Aged and Elders in Taiwan─ A longitudinal study using Taiwan Longitudinal Study on Aging database during 1999, 2003 and 2007

吳佳蓉(Chia-Rong Wu)

指導教授 ： 許怡欣

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2015年)

https://doi.org/10.6831/TMU.2015.00037

摘要

背景：高齡化社會已成為開發國家的重要人口議題，而近年來臺灣民眾的快樂程度平均值不低但卻呈現下滑趨勢，且隨著時間的推進，一連串連鎖效應造成長者幸福感改變。該如何讓長者在改變的同時讓生活過得有意義且更加快樂是目前刻不容緩的重要議題。本研究主要目的在於瞭解中高齡幸福感之相關影響因素，並針對幸福感變遷探討，期望藉此作為政府日後優先施政之依據，並以高齡友善思維營造幸福樂齡的社會。
方法：本研究為縱貫性研究，以臺灣中高齡族群為研究對象，並採用衛生福利部國民健康署1999年、2003年及2007年之「臺灣地區中老年身心社會生活狀況長期追蹤調查(Taiwan Longitudinal Study on Aging, TLSA)」資料。以1999年調查資料為基期來瞭解幸福感之相關因素，再進一步追蹤2003年及2007年幸福感變遷情況及探討相關影響因素。所有數據將以SAS 9.2軟體進行描述性統計分析、迴歸分析及廣義估計方程式等分析方法。
結果：研究結果發現，無論是任一模式之相關因素解釋幸福感，幸福感皆與教育程度、子女(養子女)數、經濟滿意度、社會支持、自評健康及憂鬱顯著相關。若以當年度之相關因素解釋幸福感，性別、婚姻、志工、日常生活活動(ADL)及工具性日常生活活動(IADL)皆達統計顯著相關；而若以基期之相關因素解釋幸福感，志工、日常生活活動(ADL)狀態等因素皆與幸福感顯著相關；而若為不同時期之休閒活動、社會支持等因素亦達統計顯著相關。在幸福感改變程度方面，無論是基期之相關因素抑或是不同時期之相關因素狀態，婚姻、經濟滿意度、社會支持、憂鬱及心臟病等因素皆會顯著影響幸福感平均改變程度，而若以基期因素解釋幸福感改變程度，工作狀態亦達統計顯著相關。
結論：為增加中高齡者之幸福感，長者健康預防、社會福利與社會救助等議題皆為政府目前首要目標，而增加長者社會連結及接觸機會則為需持續加強之部份，長者本身亦需努力讓自己生活更加多采多姿，便能建立中高齡者之社會、生活重心並給予其身心靈依靠，以提升中高齡人口的幸福感受。未來研究建議若能將TLSA資料庫串聯健保資料庫進行長期調查分析，將能排除回憶性偏差，亦可詳細探討醫療利用對幸福感變遷之影響，以更貼近中高齡長者之需求。

關鍵字

中高齡、幸福感、變遷、縱貫性研究

並列摘要

Background: Ageing society is an important issue for developed country. Moreover, the average Well-being among Taiwanese is not low, but it is towards a decreasing trend. Therefore, enabling the elderly to live a meaningful and happier life is becoming crucial topic to discuss. The purposes of this study were to: (1) understand the factors that influence the well-being among elderly population, and (2) explore the change of the factors in different year.
Methods: This study used longitudinal and secondary data specifically, the Surveys of Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan (TLSA) in 1999, 2003, and 2007 which were conducted by the Bureau of Health Promotion. This study used the data collected in 1999 as a baseline. It further investigated the factor which could affect Well-being in 2003 and 2007. All the data used the SAS 9.2 for descriptive statistics, regression, and Generalized Estimating Equation.
Results: This study found out that well-being are significantly associated with educational level, number of children, economy satisfaction, social support, self-evaluation and depression in every models. Well-being is significant associated with gender, marital status, volunteering, ADL, and IADL in the same year. Use the first year as baseline, the well-being is associated with volunteering and ADL. Moreover, when using different year as baseline, recreational activity and social support show significant association. Under the change of well-being, marital status, economy satisfaction, social support depression and cardiovascular disease are all associated with the average change of well-being.
Conclusion: In order to improve the well-being of elderly population, prevent and promote health in elderly, improve social welfare, the increase connection between elderly population and society is important. Elderly populations are also suggested the needs to live a happy life. For future research implication, TLSA can be combined with NHI research database for a longitudinal study. This can avoid recall bias and further assess the effect of medical utilization on well-being of the elderly.

並列關鍵字

Elderly, Well-being, Change, Longitudinal study

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