社區肥胖老人健康情形之探討:國民健康局2002年次及資料分析

The investigation of health status on community-dwelling obese elder: Secondary analyze data obtained from the 2002 bureau of health promotion

洪淑娟(Shu-Chuan Hung)

指導教授 ： 李選 ； 汪正青

中山醫學大學/護理學院/護理研究所/碩士(2010年)

摘要

隨著社會的變遷、經濟的安定、醫學的成長與公共衛生的進步，台灣人的平均壽命正逐年延長。顯示老年人未來生活的適應可能會面臨許多的難題，可能同時需要生理、心理、社會各方面的護理照顧。快速發展的肥胖人口不僅是增加了健康的問題外，還提升了老人的負向心理因素及心理社會功能問題進而影響到生活品質，因此研究肥胖對老人的影響是現代社會刻不容緩的事情。本研究旨在探討社區肥胖老人健康情形及日常生活功能、自覺健康狀態、憂鬱狀態、慢性病罹患狀況之相關性，用以社區肥胖老人相關醫療照顧規劃參考。
本研究以「民國2002年臺灣地區國民健康促進知識、態度與行為調查」之資料檔為研究樣本進行次級資料分析。有效樣本為424位社區肥胖老人，以結構式問卷調查，橫斷式、描述相關性研究，以日常生活量表、自覺健康量表、台灣人憂鬱量表、自述慢性病數量等為研究工具。本研究採用spss12.0之統計套裝軟體，依研究目的進行描述性及推論性統計分析，以臨界值小於 .05為可接受顯著水準。
研究結果顯示(1) 平均年齡72.38歲，肥胖女性(56%)多於男性(44%)；肥胖老人罹患慢性病比例以高血壓(62.7%）為最高，其次為高血脂有155人（36.6%）。(2)社區肥胖老人日常生活功能的評量結果，顯示多數肥胖老人有基本日常生活功能的限制，其整體的基本日常生活功能至少一項日常生活功能有困難者佔68.6％，以沐浴困難度為最高，平均得分2.27分；社區肥胖老人憂鬱狀態整體得分介於0-45分，介於沒有或極少憂鬱狀態較多，顯示大部分社區肥胖老人情緒穩定。(3)日常生活功能並不因不同人口學特徵有所差異；自覺健康狀態受到人口學中教育程度、收入影響；罹患慢性病數量受人口學變項教育程度、年齡及收入影響；憂鬱狀態受到人口學性別、宗教、教育程度影響；肥胖老人自覺健康狀態與憂鬱狀態、慢性病罹患成負相關，憂鬱狀態則與慢性病數量呈正相關。
本研究提供社區健康照護人員參考，提供照顧者之照護服務，以擬定有效衛生政策措施，達到預防保健之目標，及促進社區肥胖老人良好自我管理。

關鍵字

日常生活功能 ； 自覺健康狀態 ； 慢性病 ； 憂鬱 ； 肥胖老人 ； 社區 ； 國民健康局

並列摘要

As the society development, steady economy, medical progression, and the advancement of public health, resulting in the average lifespan of Taiwanese extended gradually year by year. It means that the elders would face more problems of adaptation with the future life, and would need nursing care that include physiological, psychological, and social support. The rapid growth of obese population raises that not only increasting the health problems, also increasting the negative psychological factors and psychosocial function problems that may affect their quality of life. Consequently, studying of obesity to work upon in old persons is becoming important matter. The purpose of study was to discuss the relationship among activity of daily life, perceived health status, depressed status, and the co-morbidity within the community-dwelling obese elderly in order to provide the appropriate medical care.
This study is used the samples of Database of the Investigation of the Promotional Knowledge, Attitudes and Behaviors of Citizen’s Health in Taiwan in 2002 published by the Health Bureau of Executive Yuan” for secondary data analysis. The effective sample size was 424 community-inhabited obese elderly and was investigated with structured questions. The analysis was done with cross-sectional.The instruments used for this study including “Activity of Daily Living Scale”, “Self-Perceived Health Status Scale”, “Taiwanese Depression Scale”, and “Self-Rated Co-morbidities”. We used the packet software of spss12.0 and arranged descriptive and collective analysis. The acceptive significant level was lower than 0.05.
The investigation result showed that (1) the average age was 72.38 years old, and women(56%) are more obese than men(44%); the most common co-morbidity was hypertension(62.7%), and the following was hyperlipidemia (36.6%); (2)The Activity of Daily Living Scale revealed most obese elder has some limitations on basic activity of daily living. At least one of difficult problems presented in daily life that accounted for 68.6%, and taking shower is the most difficult with the mean score of 2.27 points. The overall scores within community-inhabited obese elder was between 0~45, and most people were on or little depressive status which mean that most elders were under stable mood. (3)There was no difference betweeb different population characteristics The perceived health status was affected by education and income. The co-morbidity was affected by education, age, and income. The depression was affected by sex, religion, and education.The perceived health status was negative correlation to depression and co-morbidity, and the depression was positive to morbidity within community-inhabited obese elder.
This study supplied the reference to community-dwelling caregiver to order effective health policy and to reach the goal of preventive care.
Key word
Obese; elder; Activity of Daily Living; perceived health status; depression symdrome; co-morbidity; community-dwelling; bureau of health promotion

並列關鍵字

obese ； elder ； activity of daily living ； perceived health status ； depression symdrome ； co-morbidity ； community-dwelling ； bureau of health promotion

參考文獻

王耀輝、陳錦龍、陳春森 (1999)•肥胖症的藥物治療•中華民國內泌暨糖尿病 學會會訊，14，10-19。

問調查之調查設計、內容、執行方式與樣本人口特性•台灣公共衛生雜誌，

呂淑妤、林宗義（2000）•南部社區老人憂鬱症盛行率及其相關因素研究•中華公共衛生雜誌，19(1)，50-60。

李采娟、林正介、賴世偉、賴學洲（2005）•社區老人日常生活活動障礙之流 行病學研究•Mid- Taiwan Journal of Medicine，10(4)，165-170。

吳淑瓊、徐慧娟、莊瑛智、張明正（1996）•功能評估在估計台灣地區老人長 期照護需要之應用•中華衛誌，15(6)，533-545。