跳到主要內容

臺灣博碩士論文加值系統

(44.222.104.206) 您好!臺灣時間:2024/05/28 00:36
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:陳佩含
研究生(外文):Pei-Hang Chen
論文名稱:台灣老人精神抑鬱狀態變化及其影響因子-GEE模式及RES模式之應用
論文名稱(外文):A Panel Study of Changing Status and its Related Factors of Depression of the Elderly in Taiwan
指導教授:林正祥林正祥引用關係
指導教授(外文):Cheng-Hsiang Lin
口試委員:沈葆聖戴政
口試委員(外文):Pao-Sheng ShenJeng Tai
學位類別:碩士
校院名稱:東海大學
系所名稱:統計學系
學門:數學及統計學門
學類:統計學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:34
中文關鍵詞:長期追蹤老人精神抑鬱GEE模式復發事件存活分析模式
外文關鍵詞:panel studyold peopledepressionGEErecurrent survival model
相關次數:
  • 被引用被引用:1
  • 點閱點閱:904
  • 評分評分:
  • 下載下載:249
  • 收藏至我的研究室書目清單書目收藏:0
台灣六十五歲以上老人佔全國比例從1996年的7.9%至2005年提升到9.7%,至今已達二百萬以上,佔總人口比例10%以上,其中約12%~20%患有精神抑鬱,如果未來的老年人口不能更健康,則可預見將來家庭、社會及國家的負擔將會相當沉重。隨著年齡增長所累積的許多生活經驗,會增加老人心理健康的問題,抑鬱會影響老年人的生活品質,因此了解影響台灣老年人抑鬱狀況甚為重要。有鑒於此,本研究擬針對台灣地區影響老人精神抑鬱狀態變化趨勢相關因素作深入的探討研究,以十五年(1989-2003)台灣地區長期追蹤老人樣本探討台灣地區六十歲以上老人,其精神抑鬱(Depression)的變動趨勢。利用行政院衛生署國民健康局提供的1989-2003年五波『台灣地區老人保健與生活問題長期追蹤調查』資料進行分析探討,以抑鬱量表(CES-D)建構老人抑鬱程度指標,指標值10分或以上歸類為有抑鬱之老人,本研究兼具橫斷面暨縱斷面分析,利用迴歸模式及邏輯斯迴歸模式探討比較1989年至2003年五次調查之背景特徵、家庭狀況、社會經濟及健康狀況與老人抑鬱的關係,另將精神抑鬱狀態視為重覆變化事件以GEE模式及復發事件存活模式分析此一長期追蹤資料,探討影響老人抑鬱重要因子。研究結果顯示五次調查迴歸分析及邏輯斯迴歸分析,可看出各次調查中與抑鬱相關的因子的消長,從一開始多數因子的影響直至2003年時調查結果顯示配偶、經濟狀況、健康自評及體能狀況對老人抑鬱有顯著的相關,GEE模式除了失能狀況外背景特徵、家庭狀況、社會經濟及健康狀況相關因子大都與抑鬱有關,而復發事件模式(CP)則顯示在五次的調查期間開始無抑鬱的老人,經歷十四年,年齡、教育程度經濟狀況及健康自評和抑鬱的發生有密切的關係
During the past decades, many developed and developing countries experienced steady increase in their elderly population. With an increase in proportion of elderly population, the focus of public health also needs major adjustments in health policies in order to face challenges due to change in age composition. One such major problem in the elderly population is to deal with the problem of depression. This research used representative panel sample survey data collected in the five waves of “The Longitudinal Sample Survey of Health and Living Status of the Elder in Taiwan” conducted in 1989, 1993, 1996, 1999 and 2003 by the predecessor organization of the Bureau of Health Promotion, Department of Health. A panel sample of elderly who were 60 years old and over at the time of first interview in 1989 and re-interviewed in 1993, 1996, 1999 and 2003 with complete depression scale(CES-D)data was taken for this analysis. Depression index score(CES-D score)was constructed from ten items of depression measure(CES-D)to measure the level of depression and CES-D score equal or higher than 10(CES-D≧10)was used to
measure if the elderly has depression(depression status). The purposes of this study
is to discuss the status and level of depression, their changes following the factors
related to health status, home and environment, and social and economic situation in Taiwan aged 60 and above to find out the determinants of depression of the elderly in Taiwan. Generalized Estimating Equation(GEE) accounts for the correlation between repeated observations, and Recurrent survival model which combine the changing status of five survey are used for analyzing the depression data.

壹、 前言…………………………………………………………………………...1
貳、 研究方法……………………………………………………………………...6
一、 研究資料與架構………………………………………………………...6
二、 統計分析方法…………………………………………………………...7
參、 研究結果…………………………………………………………………….16
一、 五次調查抑鬱狀態變化趨勢………………………………………….16
二、 資料分析結果………………………………………………………….17
肆、 討論………………………………………………………………………….23
伍、 結論………………………………………………………………………….27
參考文獻……………………………………………………………………………..30

中文部分
王秀紅(2002)。老年人健康促進-護理的涵義。護理雜誌。47(1):19-25.
朱岑樓(1988)變遷社會與老年。第一版。台北市:巨流圖書公司。
張素紅、楊美賞(1999)老人寂寞與其個人因素、自覺健康狀況、社會支
持之關研究,高雄醫學科學雜誌,15:337- 347。
陳正生(2000)Validation of the Chinese Health Questionnaire(CHQ-12) in
Community Elders. 高雄醫學科學雜誌;16(11):559-565.
沙依仁(1996)高齡學。第一版,台北市:五南圖書出版有限公司。
行政院內政部主計處(1994)台灣地區老人狀況調查報告,台北。
行政院(2007)民國94年國民醫療保健支出。2007年9月10日,取自中華民
國行政院衛生署資訊網,衛生署資訊網http://www.doh.gov.tw/statistic/
張春興(2002)張氏心理學辭典,台北市:東華。
林正祥、林惠生(2006)台灣地區高齡人口存活之相關因素探討,台灣衛
誌,25(5):351-362。
楊景閔(2005)台灣地人精神抑鬱的狀況、改變及影響因子:10年長期追蹤研
究,中山醫學大學營養科學研究所碩士論文。
英文部分
Andersne, P. K., Borgan, O., Gill, R. D., and Keiding, N. 1993. Statistical Models Based on Counting Processes. New York :SpringerVerlag.
Beekman, A. T. 2002.“The natural history of late-life depression :A 6-year prospective study in the community.”Archives of general psychiatry 59(7): 605-611.
Bruce, M. L., K. Kim., P. J. Leaf, and S. Jacobs. 1990.“Depressive episodes and
dysphoria resulting from conjugal bereavement in a prospective community sample.”The American Journal of Psychiatry 147(5):608-611.
Cheng, A. T. 1995.“Mental illness and suicide. A case-control study in east
Taiwan.”Archives of General Psychiatry 52(7):594-603.
Chong, M. Y., Chen, C. C., Tsang, H. Y., Yeh, T. L., Chen, C. S., Lee, Y. H., Tang, T.
C., and Lo, H. Y. 2001.“Community study of depression in old age in Taiwan:
Prevalence, life Events and socio-demographic correlates.”The British Journal
of Psychiatry 178:29-35.
Gallagher, D. E., Thompson, L. W., and Peterson, J. A. 1981-1982.“Psychosocial factors affecting adaptation to bereavement in the elderly.”[Review] [54 refs] International Journal of Aging & Human Development 14(2):79-95.
Geerlings, S. W., Beekman A. T., Deeg, D. J., and Van, T. W. 2000.“Physical health
and the onset and persistence of depression in older adults: an eight-wave
prospective community-based study.”Psychological Medicine 30(2):369-380.
Hosmer, D. W., and S. Lemeshow. 2008. Applied survival analysis. John Wiley & Sons, Inc. New Jersey.
Jagger, C., Ritchie, K., Bronnum, H. H., Deeg, D., Gispert, R.,and Grimley, E. J.
1998.“Mental health expectancy-the European perspective: a synopsis of results presented at the Conference of Health Expectancies (Euro-REVES). Medical Resrarch Council Congnitive Function and Ageing Study Group.”Acta Psychiatrica Scandinavica 98(2):85-91.
Johnson, J., Weissman, M. M.,and Klerman, G. L. 1992.“Service utilization and
social morbidity associated with depressive symptoms in the community.”The
Journal of the American Medical Association 267(11):1478-1483.
Jorm, A. F. 2000.“Dose old age reduce the risk of anxiety and depression? A review
of epidemiological studies across the adult life span.”Psychological Medicine
30(1):11-22.
Judd, L. L., Paulus, M. P., Wells, K. B., and Rapaport, M. H. 1996.“Socioeconomic
burden of subsyndromal depressive symptoms and major depression in a sample
of the general population.”The American Journal of Psychiatry
153(11):1411-1417.
Kennedy, G. J., Kelman, H. R., and Thomas, C. 1990.“The emergence of depressive
symptoms in late life:the importance of declining health and increasing
disability.”Journal of Community Health 15(2):93-104.
Kleinbaum, D. G., and Klein, M. 2005. Survival Analysis 2nd ed. Springer-Veday. Inc.
New York.
Kohout, F. J., Berkman, L. F., Evans, D. A., and Cornoni, H. J. 1993.“Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index.”Journal of Aging & Health 5(2):179-93.
Kraaij, V. and Wilde, E. J. 2001.“Negative life events and depressive symptoms in
the elderly:a life span perspective.”Aging & Mental Health 5(1):84-91.
Krishnan, K. R. 2002.“Biological risk factors in late life depression.”[Review] [68
rfs] Biological Psychiatry 52(3):185-192.
Liang, K. Y. and Zeger, S. L. 1986.“Longitudinal data analysis using generalized linear models.”Biometrika:73(1):13-22.
iang, K. Y. and Zeger, S. L. 1988.“Models for Longitudinal Data: A Generalized
Estimating Equation Approach.”Biometrics: 44(4):1049-1060.
McCullagh, P., and Nelder, J. A. 1989. Generalized linear models. New York: Chapman and Hall.
McLeod, J. D., and Kessler, R. C. 1990. “Socioeconomic status differences in vulnerability to undesirable life events.”Journal of Health & Social Behavior 31(2):162-72.
Mazure, C. M., Maciejewski, P. K., Jacobs, S. C., and Bruce, M. L. 2002.“Stressful
life events Interacting with cognitive/personality styles to predict late-onset
major depression.”The American Journal of Geriatric Psychiatry
10(3):297-304.
Midanik, L. T., Soghikian, K., Ransom, L. J., and Tekawa, I. S. 1995.“The effect of
retirement on mental health and health behaviors: the Kaiser Permanente
Retirement Study.”The Journal of Gerontology Series B-Psychological
Sciences & Social Sciences 50(1):S59-S61.
Nicholas, J. H., and Stuart, R. L. 1999.“Review of software to fit generalized estimating equation regression models.”The American Statistician 53:160-169.
Oxman, T. E., Berkman, L. F., Kasl, S., Freeman, D. H., and Barrett, J. 1992.“Social
support and depressive symptoms in the elderly.”American Journal of
Epidemiology 135(4):356-368.
Prentice, R. L., Williams, B. J., and Peterson, A. V. 1981.“On the regression analysis
of multivariate failure time data.”Biometrika 68(2):373-379.
Prince, M. J., Harwood, R. H., Thomas, A., and Mann, A. H. 1998.“A prospective
population-based cohort study of the effects of disablement and social milieu on
the onset and maintenance of late-life depression.”The Gospel Oak Project VII.
Psychological Medicine 28(2):337-350.
Rapp, M. A., Gerstorf, D., Helmchen, H.,and Smith, J. 2008.“Depression predicts mortality in the young old, but not the oldest old:Results from the Berlin aging study.”America Journal of Geriatr Psychiatry 16(10):844-852.
Schoevers, R. A., Beekman, A. T., Deeg, D. J., Geerlings, M. I., Jonker, C., and Van, T. W. 2000.“Risk factors for depression in later life;results of a prospective community based study(AMSTEL).”Journal of Affective Disorders 59(2):127-137.
Schulz, R., Beach, S. R., Lind, B., Martire, L. M., Zdaniuk, B., Hirsch, C., Jackson,
S., and Burton, L. 2001.“Involvement in caregiving and adjustment to death of
a spouse:findings from the caregiver health effects study.”The Journal of the
American Medical Association 285(24):3123-3129.
Turvey, C. L., Carney, C., Arndt, S., Wallace, R. B., and Herzog, R. 1999.“Conjugal
loss and Syndromal depression in a sample of elders aged 70 years or older.”
The American Journal of Psychiatry 156(10):1596-1601.
Wang, J. J. 2001.“Prevalence and correlates of depressive symptoms in the elderly of
rural communities in southern Taiwan.”The Journal of Nursing Studies 9(3):1-12.
Wei, L. J., Lin, D. Y., and Weissfeld, L. 1989. Regression analysis of multivariate
incomplete failure time data by modeling marginal distributions. Journal of the
American Statistical Association 84:480.

連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top