臺灣嘉義縣鄉村地區接受日間照護服務老人之生活品質與相關因子研究

Health-related Quality of Life (HRQOL) and Related Factors for the Rural Community-dwelling Elderly in Taiwan

10.29461/TGG.201205.0004

余尚儒(Sang-Ju Yu)；林月娥(Yueh-Er Lin)；姚開屏(Grace Yao)；嚴元鴻(Yuan-Horng Yan)；劉文信(Wen-Hsin Liu)；林茂安(David Lin)；張育誠(Yu-Chen Chang)

鄉村地區 ； 老人 ； 健康相關生活品質 ； 相關因子 ； rural community ； the elderly ； health-related quality of life (HRQOL) ； related factors

台灣老年醫學暨老年學雜誌

7卷2期（2012 / 05 / 01）

105 - 119

繁體中文

背景：過去關於社區老人健康相關生活品質（health-related quality of life,HRQOL）之研究，在都市化社區和機構較多，對於鄉村地區老人健康相關生活品質仍然有許多未知的空間。本研究目的是探討臺灣嘉義縣鄉村地區社區老人健康相關生活品質，以及其相關因子。方法：2010年7月於嘉義縣提供日間照護服務之「長青活力站」中進行收案，318位接受服務老人中，有305 位完成問卷，回應率為95.9%，以臺語版世界衛生組織生活品質問卷臺灣簡明版（World Health Organization Quality ofLife-BREF Taiwan Version, WHOQOL-BREF）進行測量，與臺灣常模（norm）進行比較，同時收集其他社會人口學資料，以一般線性模型（generalized linear model）進行多變項分析。結果：平均年齡76.1 ± 5.2歲，女性佔72.1%，52.4%不識字，61.3%務農。WHOQOL-BREF各範疇分數分別為：生理範疇13.7 ± 3.8分（臺灣常模：15.1）、心理範疇13.6 ± 3.6分（臺灣常模：13.6）、社會關係範疇14.1 ± 3.0分（臺灣常模：14.1），以及環境範疇14.0 ± 3.4分（臺灣常模：13.3）。在WHOQOL-BREF社會範疇中，女性相較於男性（p=0.045），國小教育程度相較於不識字（國小者p=0.014），自評身體「健康或非常健康」相較於「不太好或非常不好」（p=0.007），老農福利津貼及政府補助兩者皆有相較於兩者皆無（p=0.006），以及「僅領取老農福利津貼」相較於兩者皆無（p=0.047），以上變項對社會範疇中生活品質影響有顯著相關。結論：臺灣鄉村地區接受日照服務之社區老人，WHOQOL-BREF生理範疇分數較臺灣常模低，環境範疇分數較臺灣常模高。性別、教育程度、自評身體健康狀況，以及有無領取老農福利津貼補助，為社會關係範疇之相關因子。除了其他人口學因素之外，尚需更多研究了解政府補助對於健康相關生活品質影響。

Background: Previous studies about health-related quality of life (HRQOL) of the elderly tend to focus on institutional or urban-dwelling participants, leaving us with very little knowledge about the HRQOL in rural elderly people. This study accordingly aims to investigate the HRQOL and its related factors for a group of rural-dwelling elderly in Taiwan.Methods: All 315 elderly rural community dwellers receiving day care service in Chiayi County, Taiwan in July, 2010 were invited to participate. HRQOL of 305 (95.9%) was measured using the brief Taiwanese version of World Health Organization Quality of Life questionnaire (WHOQOL-BREF). Socioeconomic and demographic data were collected for descriptive analysis. Generalized linear model was used to conduct multiple regression analysis to determine the association between HRQOL and its related variables.Results: Among the study subjects, the mean age was 76.1±5.2; 72.1% were women, 52.4% were illiterate, and 61.3% were farmers. Their WHOQOL-BREF scores were 13.7±3.8 in Physiological Domain (Taiwanese Norm 15.1), 13.6±3.6 in Psychological Domain (Taiwanese Norm 13.6), 14.1±3.0 in Social Relationship Domain (Taiwanese Norm 14.1), and 14.0±3.4 in Environmental Domain (Taiwanese Norm 13.3). Multiple regression analysis found higher Social Relationship Domain scores significantly associated with related factors, such as female (p=0.045), higher education level (p=0.014), and better self-rated health status (p=0.007). Moreover, recipients of the Old-Age Farmers' Welfare Allowance (p=0.047) and those of the Old-Age Farmers' Welfare Allowance and other allowances from the government (p=0.006) reported higher social relationship domain scores.Conclusions: Community-dwelling elderly people in Taiwan have lower Physiological Domain scores and higher Environmental Domain scores of the WHOQOL-BREF than the Taiwanese norms. Gender, education level, self-rated health status, and governmental financial support are significantly associated with their Social Relationship Domain scores. In addition to regular demographic factors, more studies need to be conducted to better understand the influence of governmental financial support on HRQOL.