臺灣博碩士論文加值系統

隨著台灣地區人口的老化，長期照護機構的需求也隨之增加，在所有長期照護機構中，護理之家需要的護理以及生活照顧份量是最重的，護理之家老人有許多生理上及心理上的問題，但是護理之家老人憂鬱問題卻較常被忽視。
本研究的主要目的在於瞭解護理之家老人憂鬱的情形以及探討影響護理之家老人憂鬱的相關因素。採橫斷式相關研究設計，收案範圍包括北部地區總計12間護理之家，總計共收得個案人數111位。將所得資料以描述性統計、Logistic regression analysis進行結果分析。研究結果發現，護理之家老人憂鬱傾向發生的比率為44.1 %。教育程度較低、身體活動功能狀況較差、有疼痛情形、現在的疼痛程度較高、疼痛影響情緒的程度較嚴重、疼痛影響睡眠的程度較嚴重、社會支持網路的需求及參與程度較低、得到社會支持行為較少、各項社會支持滿意度較差者較易發生憂鬱傾向的情形。護理之家老人憂鬱傾向的預測因子為教育程度、身體活動功能狀況、以及有無疼痛情形。
本研究結果可以提供護理之家的相關醫護人員，瞭解護理之家老人憂鬱的情形，以及確認容易發生憂鬱傾向的高危險群老人，建議臨床上加強護理之家老人憂鬱問題的評估以及處理，以減少憂鬱傾向造成其它合併症的發生。

Along with the Taiwan area population aging, the demands of long-term care are also increasing. In all long-term care institutions, nursing home residents require the heaviest nursing care and the life attendance. Even thought nursing home elders have many physical and psychological problems, their depressive problems are often to be neglected.
The purposes of this study were to explore the prevalence and risk factors for depressive symptoms among elderly residents of nursing homes in Taiwan. A cross-sectional correlation design as used. Residents of 12 nursing homes in northern Taiwan were recruited. A total of 111 elders participated. Descriptive statistics analysis and logistic regression were used to analyze data.
The findings discovered that the prevalence of depressive symptoms was 44.1 %. Elders who had lower education level, worse functional status, had pain, had severe current pain, had pain to interfere with their mood and sleep, less demand of social support network and participated rate, received lower social support behaviors, less satisfied with all dimensions of social support were easier to have depressive symptoms. Significant predictors of depressive symptoms were the education level, the functional status, and the pain situation.
The findings may provide nursing home staffs to understand nursing home elders’ depressive symptoms and identify the high risk group of depressive symptom. We suggest strengthening nursing home elders’ depressive problems assessment and management in order to reduce the depressive symptoms creating other complications.

指導教授推薦書…………………………………………………………...
口試委員會審定書………………………………………………………...
博碩士論文授權書……………………………………………………...ⅲ
博碩士論文電子檔案上網授權書……………………………………...ⅳ
誌謝……………………………………………………………………...ⅴ
中文摘要………………………………………………………………...ⅵ
英文摘要………………………………………………………………...ⅷ
目錄……………………………………………………………………...ⅹ
圖表目錄……………………………………………………………...ⅹⅲ
附件目錄……………………………………………………………...ⅹⅴ

第壹章 緒論
第一節 研究動機….…………………………………….….…….....1
第二節 研究重要性….…………………………………………..….4
第三節 研究目的.……………………………………………….…..7
第四節 研究假設…..……………………………………….……….8
第五節 名詞界定…..……………………………………….……….8
第貳章 文獻查證
第一節 護理之家老人憂鬱的盛行率…………………..…………10
第二節 影響老人憂鬱的因素…………………………………..…14
第三節憂鬱傾向對於老人的影響……………………………....…25

第參章 研究方法
第一節 研究設計及研究對象……………………………….…….31
第二節 研究架構……………………………………………….….31
第三節 研究工具…………………………………………………..36
第四節 資料收集過程……………………………………………..46
第五節 倫理考量.………………………………………………….49
第六節 資料分析…………………………………………………..49

第肆章 研究結果
第一節 護理之家老人的基本資料及疾病狀態…………………..52
第二節 護理之家老人的身體活動功能及疼痛情形……………..53
第三節 護理之家老人的社會支持狀況………………………….55
第四節 影響護理之家老人憂鬱的相關因素及預測因子………..57

第伍章 討論
第一節 護理之家老人憂鬱的現況……………………………..…86
第二節 影響護理之家老人憂鬱的個人因素………………….….88
第三節 影響護理之家老人憂鬱的社會支持因素………………..90
第四節 影響護理之家老人憂鬱的健康相關因素………………..90
第五節 護理之家老人憂鬱的預測因子…………………………..92

第六章 結論、限制與建議
第一節 結論………………………………………………………95
第二節 研究限制…………………………………………………96
第三節 建議………………………………………………………97

參考資料
一 中文部分………………………………………………………99
二 英文部分………….………………………………………….103

圖表目錄
圖3-1 影響護理之家老人憂鬱相關因素之架構圖…………………...35
圖3-2資料收集過程……………………………………………………48
表2-1 護理之家老人憂鬱盛行率之相關研究………………………...11
表2-2 憂鬱傾向對於老人影響之相關研究…………………………...27
表3-1 實際收案護理之家基本資料…………………………………...47
表3-2 憂鬱傾向的發生與個人基本資料、身體活動功能、社會支持系統以及疼痛發生情形的研究假設與統計方法…………………….51
表4-1 有憂鬱傾向組及無憂鬱傾向組基本人口特性之比較………...61
表4-2 護理之家老人疾病罹患情形…………………………………...64
表4-3 有憂鬱傾向組及無憂鬱傾向組巴氏量表之比較……………...65
表4-4 有憂鬱傾向組及無憂鬱傾向組疼痛部位及疼痛對於生活影響程度的比較………………………………………………………….66
表4-5 有憂鬱傾向組及無憂鬱傾向組疼痛形容詞彙使用的比較…...68
表4-6 疼痛緩解的方式與緩解的程度………………………………...73
表4-7 有憂鬱傾向組及無憂鬱傾向組社會支持網路之比較………...74
表4-8 各項社會支持行為來源之分布情形…………………………...76
表4-9 各項社會支持行為頻率之分布情形…………………………...77
表4-10 有憂鬱傾向組及無憂鬱傾向組社會支持行為之比較……….78
表4-11 社會支持來源及頻率–來自子女、鄰居、及朋友部分………...79
表4-12 社會支持來源的來源及頻率–來自配偶、親戚、以及其他部分…………………………………………………………………….81
表4-13 項社會支持行為滿意度之分布情形………………………….83
表4-14 有憂鬱傾向組及無憂鬱傾向組社會支持滿意度之比較…….84
表4-15 護理之家老人憂鬱傾向的預測因子………………………….85
附件目錄
附件一 個人基本資料……………………………………………..….122
附件二 簡易智能量表……………………………………..………….123
附件三 老人憂鬱量表………………………………………………...124
附件四 巴氏量表……………………………………………………...125
附件五 社會支持量表………………………………….……………..129
附件六 簡明疼痛量表…………………...……..……………………..131
附件七 麥吉爾疼痛問卷…………………….………..…………..…..134
附件八 問卷同意書…………………………………………………...135

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