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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳端容(Duan-Rung Chen) | |
| dc.contributor.author | Yi-Yin Han | en |
| dc.contributor.author | 韓宜吟 | zh_TW |
| dc.date.accessioned | 2021-06-17T00:12:18Z | - |
| dc.date.available | 2017-09-17 | |
| dc.date.copyright | 2012-09-17 | |
| dc.date.issued | 2012 | |
| dc.date.submitted | 2012-07-11 | |
| dc.identifier.citation | 壹、中文文獻
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/65799 | - |
| dc.description.abstract | 研究背景：台灣老人自殺率相較於其他年齡層高出許多，過去自殺相關研究多針對年輕族群或全人口，為瞭解台灣老人自殺之狀況，本研究嘗試攫取一段時間的資料以時空分析方式來探究老人自殺是否存在時空變異，進一步探究鄉鎮因子包括社經發展或老人家庭支持與心理健康狀況在時空熱區與非熱區間之差異，並深入分析自殺時空熱區內老人的個人特質與死亡時間對自殺的影響。
研究方法：本研究資料來源為衛生署死因檔，對象為1999年至2007年65歲以上死亡老人，先分別進行空間群聚分析(pure space analysis)、時空群聚分析(time-spatial analysis )、校正時間序列後之時空群聚分析(non-parameter time-space analysis)，找出台灣老人自殺在空間與時間分布狀況，使用工具為SaTScan 9.1.1並以ArcGIS 9.3繪製地圖，爾後探究時空熱區與非熱區內自殺老人個人層次因子之差異，之後再藉由2000年台閩地區戶口住宅普查、2000年衛生統計資料與2005年國民健康調查取得鄉鎮環境因子資訊，以卡方獨立性檢定與變異數分析探究鄉鎮因子在時空熱區與非熱區之差異，並以多階層線性模式分析時空熱區內老人個人層次變項對於老人自殺之影響，納入自變項為年齡、性別、婚姻狀況、死亡季節、死亡年，依變項為老人自殺(ICD-9代碼為950至959)，使用工具為HLM 6.02，最後，以羅吉斯迴歸分析時空熱區內老人個人變項(人口學特質、死亡時間)對於老人暴力型自殺之影響，使用工具為SPSS 18.0。 研究結果：此九年期間，在時空分布上，在2003年至2006年台灣老人自殺產生兩個顯著(p<0.05)時空熱區(most likely clusters)，分別位於南台灣與北台灣，南台灣主要位於嘉南、高雄、屏東、花東地區，北台灣主要位於基隆市、部分台北縣與宜蘭縣，南、北時空熱區與非熱區內之鄉鎮因子以都市化程度、低學歷率、單親家庭率、離婚女家計率、喪偶女家計率、獨居老人率、家計未就業率、人均所得、隔代家庭率等變項存在顯著差異(p<0.05)，並深入發現在各時空熱區內初進入老年階段之年輕老人、男性老人、離婚老人以及夏季為時空熱區內自殺高風險族群(p<0.05)，再進一步探討各時空熱區內老人選擇的自殺方法，男性老人、年齡愈大之老老人(75歲以上)、季節為夏季時，選擇暴力型自殺風險較非暴力型自殺高(p<0.05)。 結論：整體而言，在1999年至2007年期間，台灣老人自殺於時空中分別產生南、北台灣兩個時空熱區，又以南台灣熱區鄉鎮數多於北台灣，但北台灣產生熱區之相對風險高於南台灣，在時空熱區與非熱區之間，老人選擇自殺方法與鄉鎮環境因子有顯著差異，時空熱區中老人的個人特質包括性別、年齡、婚姻狀況與死亡季節對於老人自殺有顯著正向影響，期將來可針對老人自殺高風險群聚地區內的人口特質、社經發展、家庭支持等方向進行自殺防治，使銀髮者能邁向健康老化。 | zh_TW |
| dc.description.abstract | Background: Suicide rose dramatically in Taiwan in the last decade, especially among elders. However, many studies conducted the relationship in the young people or all of the population. This study was to determine whether there are statistically significant geographical clusters of suicide among those aged above 65 years and whether these persist through time.
Method: Data from suicide (ICD-9 code from 950-959) among elders were obtained in the Death Certification data file from 1999 to 2007. The Time-Spatial Scan Statistic (SaTScan) in combination with GIS software was used to identify potential time-spatial clusters of suicide for each of the 359 Taiwanese districts, and Poisson regression was used to evaluate risk differences. Then, all of the data among the time-spatial clusters was analyzed using multileved logistic regression to adjust factors for different nested-level between elders and districts. Result: Two significant (p < 0.001) elders suicide time-spatial clusters were identified in southern (RR=1.226) and northern (RR=1.661) regions in Taiwan between 2003 and 2006. As shown in the results, the individual variables including elders who were male, younger (aged 65-74 year), divorced, and in the summertime were strongly associated with suicide in the sounthern cluster (n=103766). But, there were only seasonality of suicide in the northern cluster (n=11674), especially in spring and summer. Conclusion: The findings of the present study provide evidence for the existence of two time-spatial clusters, and show the geographic variations in risk. And this study also revealed that indivial character of elders including sex, age and marriage has impact on suicide and also demonstrate seasonality of suicide in the areas of time-spatial clusters. The public health interventions necessarily alleviate the social and personal problems among the elderly. And suicide prevention strategies could focus on unique local patterns. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T00:12:18Z (GMT). No. of bitstreams: 1 ntu-101-R99848010-1.pdf: 4365137 bytes, checksum: 2f98be86455d7046fa0e5bb90167a0ad (MD5) Previous issue date: 2012 | en |
| dc.description.tableofcontents | 致謝 I
中文摘要 II 英文摘要 IV 目錄 V 表目錄 VII 圖目錄 VIII 第一章 緒論 1 第一節、研究背景與動機 1 第二節、研究目的 4 第二章 文獻回顧 5 第一節、自殺理論 5 第二節、老人自殺之個人危險因子 8 第三節、老人自殺之區位環境因子 13 第四節、空間與時間群聚分析 15 第五節、綜括總體層次與個體層次應用於自殺之相關研究 17 第三章 研究方法 18 第一節、研究架構 18 第二節、研究假說 19 第三節、研究資料來源 22 第四節、研究對象與變項操作型定義 25 第四章 結果 44 第一節、研究流程 44 第二節、全部樣本描述性統計 46 第三節、時間與空間群聚分析 51 第四節、時空熱區與非熱區之間自殺老人特性之差異 59 第五節、時空熱區和非熱區之間鄉鎮環境因子的差異比較 64 第六節、時空熱區內老人自殺之個人危險因子分析 68 第七節、時空熱區內暴力型自殺之個人危險因子分析 71 第五章 討論 74 第一節、結果討論 74 第二節、研究貢獻 81 第三節、研究限制 83 第六章 結論與建議 85 第一節、結論 85 第二節、建議 86 參考文獻 88 附錄 98 附錄一、空間群聚分析(PURE SPATIAL ANALYSIS)結果對應鄉鎮名 98 附錄二、時空群聚分析(TIME-SPATIAL ANALYSIS)結果對應鄉鎮名100 附錄三、校正時間序列後(ADJUSTING FOR TIME NONPARAMETRICALLY)聚分析結果對應鄉鎮名102 | |
| dc.language.iso | zh-TW | |
| dc.subject | 自殺 | zh_TW |
| dc.subject | 多階層線性模式 | zh_TW |
| dc.subject | 老人 | zh_TW |
| dc.subject | 群聚 | zh_TW |
| dc.subject | 時空分析 | zh_TW |
| dc.subject | edlers | en |
| dc.subject | suicide | en |
| dc.subject | time-spatial analysis | en |
| dc.subject | cluster | en |
| dc.subject | SaTScan | en |
| dc.subject | Multilevel analysis | en |
| dc.title | 探討台灣老人自殺死亡之個人因素與地理變異(1999至2007年) | zh_TW |
| dc.title | The Evaluation of the Individual and Geographic Variations Associated with Suicide in the Elderly, Taiwan (1999-2007) | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 100-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 溫在弘(Tzai-Hung Wen),喬芷(Chi Chiao) | |
| dc.subject.keyword | 老人,自殺,時空分析,群聚,多階層線性模式, | zh_TW |
| dc.subject.keyword | edlers,suicide,time-spatial analysis,cluster,SaTScan,Multilevel analysis, | en |
| dc.relation.page | 103 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2012-07-12 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-101-1.pdf 未授權公開取用 | 4.26 MB | Adobe PDF |
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