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研究生:吳佳儀
研究生(外文):WU, CHIA-YI
論文名稱:社區老人睡眠品質與身體活動、憂鬱之相關性探討
論文名稱(外文):A Correlational Study among Sleep Quality, Physical Activity, and Depression of Community-dwelling Elders
指導教授:張媚張媚引用關係
指導教授(外文):Mei, Chang
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
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
論文頁數:121
中文關鍵詞:社區老人睡眠品質身體活動憂鬱
外文關鍵詞:Community-dwelling eldersSleep qualityPhysical activityDepression
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本橫斷式相關性研究主要目的在瞭解社區老人之睡眠品質現況,及個人屬性、身體活動與憂鬱和睡眠品質之間的關係。本研究以台北市大安區100位65歲以上的老年人為研究對象,由研究者面對面親自訪談的方式收案,個案之平均年齡為73.74±5.34歲,以匹茲堡睡眠品質量表(Pittsburgh Sleep Quality Index, PSQI)評估個案睡眠品質之平均得分為6.33±4.40分,其中49%社區老人屬於睡眠品質差者(PSQI>5分)。經本研究調查發現睡眠品質與相關因素的關係如下:
一、 個人屬性中以女性、罹患高血壓或骨骼肌肉疾病、自覺健康較差者睡眠品質較差;而於睡眠環境安排方面,個案之同睡者會吵到其睡眠者有顯著較差的睡眠品質。
二、 社區老人之身體活動以「老年人身體活動量表」(Physical Activity Scale for the Elderly, PASE)測得平均得分為60.14±41.36,年齡愈大、自覺健康愈差之個案其身體活動量愈少。而身體活動與睡眠品質之間則呈現顯著正相關性,即身體活動量愈大者,睡眠品質愈佳。
三、 社區老人之憂鬱情形以「台灣人憂鬱症篩檢問卷」(Taiwanese Depression Questionnaire, TDQ)測得平均得分為5.05±7.03分,研究顯示僅6%老人為具有憂鬱傾向者(按TDQ³19分),自覺健康愈差者憂鬱程度愈高。而憂鬱與睡眠品質之間呈顯著負相關性,即憂鬱程度愈高者,其睡眠品質愈差。
四、 以憂鬱、身體活動、性別、自覺健康情形等自變項置入多元迴歸模式(Multiple Regression Analysis)以預測相關變項對於睡眠品質的解釋情形,結果顯示四個自變項共可解釋睡眠品質30%的變異量,其中「憂鬱」是控制其他變項後唯一具顯著預測力的自變項,單獨可解釋睡眠品質28.5%的變異量。
本研究發現睡眠品質不佳是社區老人普遍存在的問題,睡眠品質與身體活動及憂鬱皆有顯著相關性存在,但「憂鬱」對於睡眠品質更具顯著的預測力。因此建議未來朝向社區老年族群的心理衛生防治著手,以促進老人心理健康、預防睡眠問題之發生,進而提昇睡眠品質及生活品質。
This cross-sectional study reports the sleep quality of community-dwelling elders, and the relationship of sleep quality with associated factors including demographic factors, physical activity and depression. A total of 100 elders living in one of Taipei municipal areas were purposive sampled and home-visited by the researcher. The average age of the subjects is 73.74±5.34 years old. It is found that the average PSQI (Pittsburgh Sleep Quality Index) global score is 6.33±4.40, and 49% community elders are poor sleepers whose scores are beyond the cutoff point of 5. Major findings of the study are listed below:
1. Female, hypertensive, having musculoskeletal diseases, poor perceived- health elders or people who were influenced by sleep accompanies are significantly poor sleepers. Less physical activity amount and more depression likelihood are also significantly associated with disturbed sleep.
2. Physical activity was assessed using PASE (Physical Activity Scale for the Elderly). The mean score of physical activity amount among community elders is 60.14±41.36. Bivariate statistics shows that older age and poorer perceived-health are significantly associated with less physical activity. Better sleep quality is positively correlated with more physical activity amount.
3. Using Taiwanese Depression Questionnaire (TDQ) to assess depressive disorder among subjects, the mean score is 5.05±7.03 and the prevalence of depression is 6% at the cutoff point of 19. The worse the elderly perceived their health, the higher their depressive degrees were. Better sleep quality is correlated with lower depressive degree.
4. Multiple regression analysis showed that the four independent variables of gender, perceived-health, physical activity, and depression account for 30% variances of sleep quality. Depression is the only significant variable explaining of 28.5% variances.
It is recommended that health professions detect elderly mental health and sleep problems at early stage to prevent conceived sleep quality. And more concentration should be put on to promote mental health of the community older persons.
章節目錄
第一章 緒論 1
第一節 研究動機………………………………………………….. 1
第二節 問題重要性……………………………………………….. 3
第三節 研究問題………………………………………………….. 5
第四節 研究目的………………………………………………….. 5
第五節 研究假設………………………………………………….. 6
第二章 文獻探討 7
第一節 睡眠品質的概念………………………………………….. 7
第二節 影響睡眠品質的相關因素探討………………………….. 9
第三節 身體活動與老年人睡眠………………………………….. 14
第四節 憂鬱症與老年人睡眠…………………………………….. 24
第三章 研究方法 33
第一節 研究架構………………………………………………….. 33
第二節 名詞界定………………………………………………….. 35
第三節 研究對象與場所…………………………………………. 38
第四節 研究工具………………………………………………….. 39
第五節 研究步驟………………………………………………….. 44
第六節 資料處理與分析………………………………………….. 48
第四章 研究結果 50
第一節 研究對象的基本資料………………………………………….50
第二節 社區老人之睡眠品質現況…………………………….………54
第三節 睡眠品質與個人屬性的關係…………………………….……63
第四節 睡眠品質與睡眠環境的關係…………………………….……69
第五節 社區老人之身體活動情形……………………………….……69
第六節 身體活動與個人屬性的關係…………………………….……75
第七節 睡眠品質與身體活動的關係…………………………….……77
第八節 社區老人的憂鬱情形…………………………………….……78
第九節 憂鬱與個人屬性的關係………………………………….……83
第十節 睡眠品質與憂鬱的關係………………………………….……85
第十一節 睡眠品質相關變項的預測情形……………………….……86
第五章 討論 89
第一節 社區老人睡眠品質現況…………………………………..89
第二節 社區老人個人屬性、睡眠環境安排與睡眠品質的關係探討95
第三節 睡眠品質與身體活動之相關性探討…………………….100
第四節 睡眠品質與憂鬱之相關性探討…………………………..101
第五節 預測睡眠品質的變項探討………………………………..103
第六章 結論與建議 105
第一節 結論……………………………………………………….105
第二節 研究限制……………………………. ……………………106
第三節 應用建議…………………………………………………..108
參考文獻
中文部分………………………………………………….…………...111
英文部分………………………………………………….…………...113
附錄
附錄一 研究問卷…………………………………………………..
附錄二 老人身體活動量表(PASE)同意書………………………
附錄三 老人身體活動類別一覽表………………………………..
附錄四 台灣人憂鬱篩檢問卷(TDQ)同意書…………………..
附錄五 SPMSQ認知障礙分類(按教育程度)…………………
附錄六 六分鐘步行測驗(6-Minute Walk Test)………………..
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