獨居長者健康狀態、社會參與和生活滿意度之關係-以臺北市南港區為例

Abstract

本論文目的在探討獨居長者的健康狀態、社會參與和生活滿意度之相關性。本研究為橫斷式問卷調查，以臺北市南港區健康服務中心管理之獨居長者為研究對象，共發出172份問卷，由公共衛生護理人員採面對面訪談進行問卷調查，簽署同意書並完成問卷訪談者共計131份，完訪率為76.2%。問卷內容包括基本資料、健康狀態、社會參與以及生活滿意度情形。本研究使用電腦統計軟體SPSS 22.0版進行t檢定、變異數分析、皮爾森積差相關分析，以及多元迴歸分析。 本研究發現，研究對象偏高齡，平均年齡80.2歲（σ=0.87），確實有健康照顧方面的需求，自評健康狀況平均70.31分（σ=15），16.8%可能有憂鬱問題，14.5%有認知障礙、完全獨立者約71%、失能需協助者約34.4%、有衰弱者約28.2%。根據多元迴歸分析結果顯示，研究樣本之IADL、經濟情況及年齡為「社交活動」的顯著相關因子，有38.4%的解釋力；婚姻及年齡為「人際互動」的顯著相關因子，有31.3%的解釋力；教育程度為「活動參與」的顯著相關因子，有23.9%的解釋力；憂鬱程度及教育程度為「生活滿意度」的顯著相關因子，有32.8%的解釋力。 結論與建議：獨居長者之社會經濟地位、身心健康狀態、社會參與皆與生活滿意度有關。故因應人口急速老化，高齡獨居人數增加，政府及相關照護單位應依獨居長者年齡、健康狀態等，未來可規劃分齡、分眾，方便參加之活動，加強高齡友善基礎設施，或增加適當的誘因，來提升獨居長者社會參與與生活滿意度之情況。建議未來照護範圍宜擴及未列冊之獨居長者，並對獨居長者進行長期追蹤，探討社會參與對獨居長者身心健康之影響，提升其生活滿意度，進而達到活躍老化之目的。The purpose of the study was to explore the relationhips among health status, social participation and life satisfaction of the elderly living alone.This cross-sectional study employed a questionnaire survey of 172 older adults at the Health Service Center of the Nangang District. The survey was conducted face-to-face by public health nurses. A total of 131 older adults signed an informed consent and completed the questionnaire, resulting in a response rate of 76.2% . The questionnaire included questions regarding the respondent’s socio-demographic attributes, health status, social participation, and life satisfaction..The data was analyzed using SPSS 22.0 to conduct t-test, one way ANOVA, Pearson's product-moment correlation, and multiple regression analysis. According to the analysis, respondents were relatively old with an average age of 80.2. The average score of self-assessed health status was 70.31±15; 16.8% of respondents may have depression; 14.5% had cognitive impairment; 71% were totally independent; 34.4% were disabled; and 28.2% were frail. Results of the multiple regression analysis showed IADL, economic condition, and age were significant correlates of social engagement, explaining 38.4% of the variance of social enagement in the study respondents. Marital status and age were significant correlates of interpersonal interaction, explaining 31.3% by the variance. Education attainment was the only correlate of activity participation, explaining 23.9% by the varianace. Depression and education attainment were significant correlates of life satisfaction and explained 32.8% of the variance. In this group of older adults who lived alone, socioeconomic status, physical and mental health condition, social participation, and life satisfaction appeared to be inter-correlated. In response to the rapid aging of the population and an increase of older adults living alone, government and care institutions should design age-appropriate, education-specific, and easy-to-participate activities, increase the number of facilities that are friendly to the elderly, and use incentives to improve the social participation and life satisfaction of older adults living alone. Finally, it is recommended that care should be extended to unlisted elders and long-term assessment of the impact of social participation on physical and mental health of older adults living alone is needed in oder to improve the life satisfaction and achieve active aging in this vulnerable population.