台灣老人居住型態、社會支持與憂鬱程度關係之探討

Abstract

研究背景：隨著世界人口老化漸趨嚴重，老年健康越來越重要；世界衛生組織將憂鬱症列為二十一世紀三大疾病之一，也是唯一的精神疾病，足見憂鬱症的影響。台灣的大型資料庫研究中憂鬱程度相關研究多半針對比較獨居與非獨居民眾，鮮少將針對機構住民也列入考慮。而台灣目前因社會發展，居住型態亦隨改變，文獻指出居住型態會影響社會支持，社會支持會影響憂鬱程度，居住型態亦會影響憂鬱程度。因此，了解這三者之間的關係是相當重要的。 研究目的：藉由全國具代表性的固定追蹤樣本資料庫來探討社會支持對於不同居住型態老人與憂鬱程度的中介關係，並探社會支持的中介效果是否在性別間有所不同。 研究方法：本研究藉由分析臺灣地區中老年身心社會生活狀況長期追蹤調查2003年與2007年資料，以結構方程式來進行社會支持在居住型態與憂鬱程度間的中介效果分析。研究樣本的篩選條件為65歲以上且在兩個年度皆有資料者。納入研究的樣本數共有2074位。 研究結果：研究結果發現情緒性社會支持在居住型態與憂鬱程度間具有中介效果，居住在社區且與人同住的人相較於機構與獨居者會透過較高的給予情緒性社會支持與接受情緒性社會支持來降低憂鬱程度。但並未發現工具性社會支持在居住型態與憂鬱程度間具有中介效果。 討論：情緒性社會支持在居住型態與憂鬱程度間具有中介效果，本研究建議社會大眾可多提供情緒性社會支持給長者，或者長們本身也可主動提供他人情緒性社會支持，以來降低憂鬱程度。

Background：As global aging, older adults’ depression are getting more attention . WHO (World Health Organization) has included depression,the only mental disease considered as one of the three major diseases in 21th century. Most of the depression-related research in Taiwan using large database are focused on elderly living alone and living with others in communities? Very few of them took older adults’ living types into consideration. Given the change of modern family structure, older adutls’ living arrangements changed. Studies have shown that living arrangemgnt has impact on social support, and social support also have influences on older adults’ depression. Hence, it’s important to full these three factors on the same page and test the causal relationships among these three factors. . Objective：Using a population representative data, Taiwan Longitudinal Study in Aging (TLSA), this study tested the mediating effect of social support between older adults’ living arrangement and depression. This study explored wether the mediating effects of social support on living arrangement and depression would be different in male and female older adults. Method：The study analyzes Taiwan Longitudinal Study in Aging (TLSA) in 2003 and 2007. We used structural equation modeling (SEM) to test the mediation of different types of social support, including emotional social support and instrumental social support, in living arrangement and depression. Inclusion crirerias are age above 65 and have data in both 2003 and 2007. Study sample were 2074 older adults. Results：Emotional social support was a significant mediator of the relationship between older adults’ living arrangement and depression. Compared to older adults living in institution and living alone in communities, older adults living with others in communities have more emotional social support and therefore experienced a decrease depression status.Yet instrumental social support was not found as a mediator in living arrangement and depression. Disscussion：Emotional social support was a mediator in living arrangement and depression in older adults living in community and also living with others. This study suggested everyone offer more emotional social support to older adults. At the meantime, older adults can take the initiative to offer others emotional social support. By doing so, older adults’ might decrease their level of depression as well .