探討高齡者社會衰弱、孤獨感與健康生活品質之關係 ：中介調節模式的分析

Abstract

背景：衰弱在現代老年很常見且具多面向，然而社會衰弱為最少被提及的面向，但卻會對高齡者健康有其影響力。因此，本研究除了探討身體面向的衰弱，社會衰弱也被納入為本研究重點討論之一。首先，先確定社會衰弱是否會影響高齡者的健康生活品質；再者，觀察社會衰弱與孤獨感之間的關聯，探討孤獨感在社會衰弱與健康生活品質間是否扮演中介角色。第三，以身體衰弱作為調節變項，看是否會影響高齡者的身體狀況。最後，希望可以藉由此研究釐清社會衰弱、孤獨感與健康生活品質之間的關係，進而發現高齡者健康問題的影響因子。 方法：以次級資料分析，資料來自於：計畫主持人：陳端容博士【研究計畫：減緩老化衰弱的社會因素：「社會衰弱」(social frailty)的測量、變化趨勢及預測效果(109-2410-H-002-054-SS2)】於108年8月開始收案，收案地點擴及全台，包括健康活力中心、社區發展協會、健康服務中心，共1812位高齡者。透過描述性統計以及相關分析了解各變項，之後再利用路徑分析，釐清社會衰弱、孤獨感與健康生活品質的關係。 結果：年齡（p<0.01，與孤獨感p <0.05）、婚姻狀況（p<0.01）、教育程度（p<0.01）與社會衰弱、孤獨感、健康生活品質皆有相關。在模型四（以孤獨感為中介變項）觀察社會衰弱以及健康生活品質的關聯，結果發現孤獨感可作為中介變項，即社會衰弱會透過孤獨感影響健康生活品質。之後，再利用身體衰弱作為調節變項，調節孤獨感以及健康生活品質（即為模型十四）則結果達顯著效果，即身體衰弱可調節孤獨感對健康生活品質的影響效果：若高齡者身體衰弱，則孤獨感對於其健康生活品質的影響會小於無身體衰弱的高齡者。

Background: Frailty is common and multifaceted in modern aging. Social frailty is the least mentioned aspect, however, it has its influence on health-related quality of life of the elderly. In addition to exploring physical frailty in this study, social frailty is also included as one of the key discussions of this study. First, determine whether social frailty affects the health-related quality of life of the elderly. Second, observe the relationship between social frailty and loneliness, and explore whether loneliness plays a mediating role between social frailty and health-related quality of life. Third, take physical frailty as the moderating variable to see if it affects the physical condition of the elderly. Finally, it is hoped that this research can clarify the relationship between social frailty, loneliness and health-related quality of life, and then discover the influencing factors of the health problems of the elderly. Method: Analysis of secondary data, data from: Project host: Dr. Chen Duan-rung [Research Project: Slowing down the social factors of aging frailty: "social frailty" (social frailty) measurement, change trend and prediction effect (109- 2410-H-002-054-SS2)] began to accept the case in August 2018, and the location of the case has expanded to the whole Taiwan, including the Health and Vitality Center, the Community Development Association, and the Health Service Center, with a total of 1812 elderly people. Through descriptive statistics and correlation analysis to understand each variable, and then use path analysis to clarify the relationship between social frailty, loneliness and healthy quality of life. Results: Age (p<0.01, and loneliness p<0.05), marital status (p<0.01), education level (p<0.01) were all correlated with social frailty, loneliness, and health-related quality of life. In Model 4 (using loneliness as the mediating variable) to observe the relationship between social frailty and health-related quality of life, it was found that loneliness can be used as a mediating variable, that is, social frailty will affect the quality of healthy life through loneliness. Afterwards, using physical frailty as an adjustment variable to adjust loneliness and health-related quality of life (model 14), the result has a significant effect, that is, physical frailty can regulate the effect of loneliness on health-related quality of life: if the elderly If they are frail, the impact of loneliness on their quality of life will be smaller than that of the elderly without frailty.