中文摘要 目的:本研究欲探討台灣地區中老年人憂鬱傾向之相關影響因素變動下對中老年人憂鬱傾向的影響。 方法:本研究採次級資料分析,利用行政院衛生署國民健康局人口與健康調查研究中心於1999年、2003年完成之「臺灣地區中老年身心社會生活狀況長期追蹤調查-長期研究」第四次、第五次調查兩次均完訪之有效樣本資料,扣除兩次調查中問卷有代答情況者、第四次調查有憂鬱傾向者,以及第五次調查抑鬱量表(CES-D量表)回答不完整者後,共2628人為研究樣本進行分析。 憂鬱傾向之測量是以問卷中抑鬱量表(CES-D量表)為研究工具,10題問題加總得分範圍介於0~30分之間,以10分為切割點(cut-off point)區分有無憂鬱傾向,10分以上者將之歸類為「有憂鬱傾向」,小於10分者將之歸類為「無憂鬱傾向」。 自變項中,主要分為人口學基本特性、居住環境、經濟收入、健康情形、社會互動情形五大類,其中除年齡、性別、省籍、教育程度無變動情況,以及前期慢性病罹患情況、前期惡性腫瘤罹患狀況未設變動情況外,其他自變項皆包括前期(1999年)狀況及變動情況(1999年到2003年間變動情況)。 結果:分析樣本2003年時有憂鬱傾向者占13.47%。羅吉斯迴歸分析結果中,在控制其它自變項的影響下,前期對自己經濟狀況不滿意者、居住安排從「與人同住」→「獨居」者、前期自覺健康狀況不好者以及自覺健康狀況變差者、前期罹患惡性腫瘤者、體能狀況變不好者、跌倒或摔倒情況從「有」→「有」者、疼痛或不舒服情況從「無」→「有」以及「有」→「有」者、生病或受傷情況從「無」→「有」者、情感性-授社會支持減少者,後期憂鬱傾向的發生機率較高,而婚姻狀況維持無偶者、經濟狀況滿意程度變好者、情感-授社會支持增加者,後期憂鬱傾向的發生機率較低。 結論:中老年人居住安排由與人同住變動為獨居者、個人收入及經濟滿意度較低者、健康情形較差者、情感性-授社會支持減少者,憂鬱傾向發生機率較高。故中老年人與親友間應多增加彼此心理支持之互動外,政府政策上可檢討各縣市政府實施關懷獨居老人措施之實施成效、加強促進中老年人健康狀態之措施,且加速中老年人經濟安全制度政策的施行,希望能讓中老年人有安適愉快的心情渡過晚年的生活。
ABSTRACT Objective: This study aimed to investigate the related influencing factors for the middle-aged and the elders depression. Method: This research using data from “The Longitudinal Sample Survey of Health and Living Status of the Elderly in Taiwan” conducted in 1999 and 2003 by the predecessor organization of the Bureau of Health Promotion, Department of Health, 2628 samples were analyzed without incomplete data. The measurement of depression we use “Center for Epidemiological Survey, Depression Scale”(CES-D). Depression index score (CES-D score) was constructed from ten items of depression measure to measure the level of depression. Score equal or higher than 10(CES-D≧10) classify into depression; less than 10 classify into no depression. Independent variable include Social demography’ living environment’ income’ health status’ social interaction , we investigate the change of variable( 1993:1996), except age’ sex’ birthplace’ education and earlier stage chronic disease or malignancy. Result: More than one-tenth(13.47%) of the elderly was found to have depression. In logistic regression, people who had no satisfied with circumstance’ Self-rated Health Status’ malignancy’ worth physical situation’ fall down ‘ pain from 「no」to「yes」’ sick or injured’ and less emotion social support in earlier stage, more higher probability depression in later stage;single’ circumstance satisfied’ and emotion social support raise, had low probability depression in later stage. Conclusion and Suggestion: Living arrangement from stay with others to single’ no satisfied with individual income and economic’ worth health status and less emotion social support, more easy to have depression. So middle-age can increase interaction of mental support between relatives and friends. In policy, government can review each city’s program of concerned about the elderly living along, improve middle-age health status, speed up elderly economic save policy, I hope that elderly have good mood to spend their late life.
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