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研究生:郭洺豪
研究生(外文):Ming-Hao, Kao
論文名稱:榮家內住榮民健康生活品質之探討
論文名稱(外文):A Study of Health Related Quality of Life Among Residents In Veterans Home
指導教授:高森永高森永引用關係魯學孟
指導教授(外文):Sen-Yeong KaoShyue-Meng Luu
學位類別:碩士
校院名稱:國防醫學院
系所名稱:公共衛生學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:中文
中文關鍵詞:健康相關生活品質健康效用榮家榮民
外文關鍵詞:Health-Related Quality of LifeHealth utilityveterans homeveteran
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有關老年人生活品質之研究隨著人口結構的改變和不同專業間的共同關懷已有相當豐富的發現,但是針對老榮民的研究卻不多見。就數量而言,民國90年底65歲以上榮民的人口數約佔全國老人的18.5﹪,而且對於居住於機構的老榮民通常又較其他的老榮民,在身體功能上更差,經濟安全、資源擁有或社會支持上都較弱勢。基於對老榮民的關心,本研究主要目的在於探討榮家榮民之健康相關生活品質及其影響因素,本研究設計屬於橫斷性研究,採用台灣簡明版世界衛生組織生活品質問卷,研究對象為台灣北部地區行政院退輔會所屬之榮家或自費安養中心之內住榮民,按照各榮家之內住榮民人數進行方便取樣,共面對面訪問約15﹪之內住榮民為研究樣本,完成692份有效問卷。主要的研究結果發現:
一、受訪榮家榮民之主要基本特質為:平均年齡77.82歲、平均軍中服務
時間21.45年、66.5﹪的榮民退伍階級為士官(含士官長)、平均住
榮家時間為8.99年、57.6﹪的榮民從未結婚、52.0﹪的榮民最高學歷
為識字或小學程度、84.1﹪的榮民主要經濟收入來源為榮民生活給
與。
二、受訪榮家榮民之主要健康狀況為:39.4﹪的榮民自覺健康狀況普通、
57.3﹪的榮民日常活動能力為能夠步行及維持輕度工作、37.6﹪的榮
民自覺快樂程度普通、88.2﹪的榮民有1種以上的慢性病、平均每位
榮民有2.07種慢性病、76.6﹪的榮民近三個月曾看門診、11.2﹪的榮
民近一年曾看急診、22.9﹪的榮民近一年曾住過院,81.0﹪的榮民曾
作過一年一次之老人健康檢查、9.8﹪的榮民近三個月曾跌倒過。
三、受訪榮家榮民自述慢性病種類,罹病率最高的前三種疾病為高血壓
(41.8﹪)、骨骼肌肉系統疾病(32.9﹪)、心臟血管疾病
(26.3﹪)。在榮家榮民健康習慣方面,每天都會從事的最高前兩種
生活習慣為:每天規律運動30分鐘以上(78.6﹪)、每天有抽煙的習
慣(41.2﹪);從來不會從事的前兩種生活習慣為:嚼食檳榔
(99.6﹪)、服用健康食品,例如中西醫或偏方等(74.9﹪)。
四、受訪榮家榮民之健康生活品質平均總分數為53.03分(
四個範疇總計80分),屬於中上程度。就四個範疇而言,平均得分最
高者為環境範疇生活品質,其次為生理範疇、社會關係範疇生活品
質,心理範疇最低。單項生活品質平均分數最低的前三種為「有享受
生活」、「覺得自己的生命有意義」及「能接受自己的外表」。
五、受訪榮家榮民自評健康平均分數(RS)為63.86分。在時間替代
(TTO)方面,如果在現在的健康狀況下假設可以生活10年的話,是否
願意在最健康的狀況下生活少於10年的時間?62.4﹪的榮民回答不願
意,僅21.7﹪的榮民回答願意,而願意替代的平均時間為8.8年。
六、經由逐步多元迴歸分析,整體範疇之健康相關生活品質,最佳的預測
變項為「自覺健康狀況」、「自覺快樂程度」、「日常活動能力」、
「規律運動30分鐘以上」、「休閒活動」,且此迴歸方程式已達統計
上顯著水準(p=.000),共可解釋整體範疇健康相關生活品質總變異
量的51.7﹪。
台灣簡明版世界衛生組織生活品質問卷經由再測信度、內部一致性及效標關聯效度之評估,發現對於榮家榮民具有不錯的信效度。本研究結果除了可以瞭解榮家榮民健康相關生活品質狀況外,還可以提供政府相關部會更多的訊息,協助榮家榮民提升其健康生活品質,以達成政府照顧榮民的美意。
The studies about the life quality of ageing people developed with the changes of the population structure and the concerns from a variety of professionals. However, there were few researches focused on the old veterans. At the end of 2001, the veterans who were over 65 accounted for 18.5% of the elder population of the country. Compared with their peers who lived on their own, those old veterans who lived in the institutions had worse physical functions and economical securities, and they also got less resources and social supports.
The objective of this study was exploring the Health-Related Quality of Life and connected influential factors of these veterans lived in veterans homes. This was a cross-sectional study, and the questionnaire was from WHOQOL-BREF Taiwan version. The study focused on these veterans who lived in veterans homes, which belonged to Veterans Affairs Commission of Executive Yuan in northern Taiwan, and those who lived in self-supporting nursing homes in the same area. We interviewed 15% of the veterans who lived in these institutions as our samples, and the process of convenient sampling was depended on the number of veterans in each institution. Totally 692 valid samples were collected. After analyzing these data, we found:
1.The property of these veteran participants: the average age was 77.82-year-old, and their mean service period was 21.45 years. 66.5%of them were sergeants (sergeant major included) when they left the army. These participants lived in the veteran-homes for 8.99 years on the average, 57.6%of them never got married. Regarding the highest level of education, 52.0%of these people either could only read characters or just graduated from elementary schools. 84.1% of them relied on the veteran subsidy.
2.The physical condition of these veteran participants: 39.4% of these participants considered that they were in general condition, and 57.3% of them could walk and did some easy work as their daily activities. The percentage of those who self-reported that they were on regular happiness level was 37.6%. 88.2% of these people had more than one chronic diseases, each man got 2.07 kind of chronic diseases on the average. The percentage of these veterans who went to clinics in 3 months, asked for emergency treatments in one year, hospitalized in one year are 76.6%, 11.2%, 22.9% respectively. 81.0%of them had gone to the health check for the old, which was hold once a year. In addition, 9.8% of them had stumbled in lately 3 months.
3.According to the information from the interviews, the first three chronic diseases these veterans diagnosed were hypertension (41.8%), musculoskeletal system disorders (32.9%), and cardiovascular diseases (26.3%). Concerning the healthy habits of these participants lived in veteran-homes, their two favorite day-by-day activities were smoking (41.2%) and regularly exercised more than 30 minutes everyday (78.6%). About the living habits they do not intend to do, they didn’t like chewing betel nuts (99.6%) nor taking “healthy food” such as Chinese traditional medicine, Western herbals, or other irregular prescriptions (74.9%).
4.The mean score of Health-Related Quality of Life of all participants was 53.03 (total 4 sections added up to 80). This was above average. The section that they got the highest point was the environmental life quality. The next one was physiological condition; these participants thought that they could “accept the appearances of themselves ”. Then the life quality of social relationship, these veterans felt that they ”had a meaningful life”. The lowest one was the psychological condition; they thought that they could “enjoy the life”.
5.The Rating Scale (RS) self-estimated by these participants was 63.86. We also investigated a Time Trade-Off (TTO) question: if you could live 10 more years in current physical condition, would you like to live less time but in the best condition? Only 21.7% answered yes, and 62.4% didn’t like this idea. The time they would like to trade off was 8.8 years on the average.
6.We analyzed these data by multi-stepwise regression, the best independent variables of integrated section in Health-Related Quality of Life were: self-reported physical condition, self-reported happiness level, abilities in daily activity, regular exercise more than 30 minutes, and leisure activities. The regression equation reached the level of obvious (p=.000), and we could utilize these data to explain 51.7% of total variance of the integrated section in Health-Related Quality of Life.
WHOQOL-BREF Taiwan version had estimated by Test-Retest Reliability, Internal Consistency, and Criterion-Related Validity, and the researchers found that it could reach good confidence to these veterans lived in veterans homes.This study could not only understand the Health-Related Quality of Life of these veterans, but also provide more messages to the related authorities. Moreover, it could help the government to reach the goal of taking care of these people, and to elevate their Health-Related Quality of Life.
正文目錄…………………………………………………………….Ⅰ
圖表目錄…………………………………………………………….Ⅲ
附錄目錄…………………………………………………………….Ⅵ
中文摘要…………………………………………………………….Ⅶ
英文摘要…………………………………………………………….Ⅸ
第一章 緒論
第一節 問題背景與研究重要性………………………………1
第二節 研究目的………………………………………………..3
第三節 名詞解釋………………………………………………..4
第二章 文獻探討
第一節 榮家榮民概況………………………………………….5
第二節 健康相關生活品質的定義與測量.…………………8
第三節 榮家榮民健康相關生活品質之影響因素………..12
第三章 研究架構與假設
第一節 研究架構………………………………………………16
第二節 研究假設………………………………………………17
第四章 研究工具與方法
第一節 研究工具與信效度檢定…………………………….18
第二節 研究方法與資料蒐集...…………………………….22
第三節 資料的處理與統計分析…………………………….23
第五章 研究結果與分析
第一節 榮家內住榮民訪問結果..…………………………..25
第二節 榮家內住榮民之描述性結果………………………26
第三節 健康相關生活品質(生理範疇)之影響因素…..29
第四節 健康相關生活品質(心理範疇)之影響因素…..32
第五節 健康相關生活品質(社會關係範疇)之影響因素.35
第六節 健康相關生活品質(環境範疇)之影響因素……38
第七節 健康相關生活品質(整體範疇)之影響因素…..41
第六章 討論
第一節 本研究資料代表性之探討………………………….45
第二節 基本資料與健康相關生活品質之探討…………..46
第三節 健康狀況、健康效用與健康相關生活品質之探討….49
第四節 健康相關生活品質評估之探討……………………51
第五節 研究限制………………………………………………53
第七章 討論與建議
第一節 結論…………………………………………………….54
第二節 建議…………………………………………………….58
參考文獻…………………………………………………………….61
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