影響臺灣民眾健康生活品質的因素探討

Abstract

隨著時代變化，社會、經濟發展及知識水準的提升，人們對於生活不再以物質層面為追求目標，轉而越來越重視生活品質的營造，因此測度生活品質及尋找其影響因子，著手改善生活品質，已然成為近年來之研究興趣。本研究目的為利用國家衛生研究院與國民健康局於2001所合作的國家健康訪問調查資料，找出影響一般民眾生活品質之重要因素，作為未來衛生政策決策者及醫療工作者制定醫療相關政策及治療策略發展方向的參考。 以往生活品質相關研究之分析方法著重於描述性分析、t檢定、皮爾森相關係數、單因子變異數分析及迴歸分析等方法，此研究套用基底類別羅吉斯迴歸模型分析生活品質問卷分數，但礙於目前尚未發展其配適指標及迴歸診斷技巧，改利用基底類別羅吉斯模型之概念，先以二元羅吉斯迴歸模型個別分析，進行共線性、相關性檢定、模型比較及迴歸診斷，取得最佳模型之解釋變數集後再作為基底類別羅吉斯迴歸模型之自變數，重新分析。 研究結果發現，生活品質之相關因子多為民眾健康狀況或健康行為相關變項，顯示生活品質與民眾身體健康狀況密切相關，其中又以民眾活動是否有困難相關最為顯著。而教育程度、婚姻狀況、信仰為基督教、天主教、居住於宜花東地區、過去一年之住院次數、過去一個月看中醫次數、運動次數、體重是否有明顯變化及目前是否增加體重等變項，相對於基底組之勝負比比率顯著地高或低，可將以上變數視為生活品質之重大相關因子。

In recent year, quality of life (QOL) has been heavily used in the evaluation of health care. This study used WHOQOL-BREF Taiwan version for assessing the QOL. The main purpose of this study was to identify factors affecting the QOL in the Taiwan general population. Data were obtained from the National Health Interview Survey (NHIS) in Taiwan which used a multi-staged stratified systematic sampling scheme in 2001. Each of the four domains of the questionnaire scores were to be fit with baseline-category logistic models, but the goodness-of-fit test and the technique for diagnostic have not been developed yet. We proposed to fit the questionnaire scale by two binary logistic models separately. After model diagnostics and comparison, we fit the questionnaire scale by baseline-category logistic model with the independent variables of the final selected models. The findings revealed that (1) the QOL was mostly affected by the physical state of individuals. The worse the physical state, the worse the QOL. This situation was most significant for the individuals with life activity difficult; (2) People aged 60-65 years had better QOL in the psychological and environmental domains; (3) Married people had the better QOL, especially for the social domain; (4) People lived in the eastern Taiwan had better QOL in overall domains, and People lived in the mountain region also had better QOL in the social domain; (5) In the past month, the people had gone see a doctor of traditional Chinese medicine between 4-5 times had worse QOL and (6) People have been gaining weight had worse QOL in the overall domains.