Exercise Behavior and Depression among Hakka Adults: A Community-Based Cross-Sectional Study in Hakka, Miaoli County, Taiwan

客家成年人的運動行為與憂鬱情形：苗栗縣客家民族的橫斷式社區研究

10.3966/207010632017060047004

陳明坤(Ming-Kun Chen)；林昭光(Chao-Kuang Lin)

adults ； depression ； exercise behavior ； Hakka ； Miaoli County ； 成年人 ； 憂鬱 ； 運動行為 ； 客家 ； 苗栗縣

健康促進與衛生教育學報

47期（2017 / 06 / 30）

69 - 87

英文

Depression is a major health problem. Studies have suggested that exercise may serve as a valuable health promotion strategy in reducing the risk of developing depression. This study aims to investigate the predictability of depression in relation to exercise habits among Hakka adults living in Hakka communities in Miaoli County. A cross-sectional design was adopted and structured questionnaires (incorporating demographic variables, an exercise behavior questionnaire and the Taiwanese Depression Questionnaire) were used for data collection. Purposeful sampling was employed and 533 Hakka adults living in Hakka communities in Miaoli County volunteered to participate in this study. Ten trained Hakka interviewers interviewed the subjects individually to collect data. The response rate was 100%. The data was analyzed by hierarchical Poisson multiple regression. After controlling for gender, age, religious beliefs, marital status and socioeconomic status, an increase in exercise behavior lowers depression (β = -.041, Wald X^2 = 14.372, p ＜ .001). It is found that exercise behavior predicted severity of depression in Hakka adults living in Hakka communities in central Taiwan. Thus, exercise behavior can serve as depression preventing or buffering strategy in planning health promotion and health education for Hakka adults in the future.

憂鬱是一項主要的健康議題，過去的研究發現運動是降低罹患憂鬱風險且有價值的健康促進策略。本研究旨在調查居住於苗栗縣客家社區客家成年人的運動行為對於其憂鬱情形的預測力。本研究採橫斷式研究，以結構式問卷（包含社會人口學變項、運動行為問卷及臺灣人量表）蒐集資料。立意取樣533名居住於苗栗縣客家社區中的客家成年人為研究對象，由10名受過訓的訪員對研究對象進行個別訪談以蒐集資料，問卷回收率為100%。回收的資料以卜瓦松迴歸進行分析。本研究於控制性別、年齡、宗教信仰、婚姻狀況與社經地位後，發現運動行為的得分愈高，憂鬱的得分就愈低（β = -.041, Wald X^2 = 14.372, p ＜ .001）。研究結果發現居住於苗栗縣客家社區中的客家成年研究對象的運動行為可以預測其憂鬱情形，因此，未來規劃客家成年人的健康促進與臨床衛生教育時，運動行為可作為憂鬱的預防或緩衝策略。

1. Chang, C.-M. (2009). EQ killer-understanding depression. Retrieved from http://www.depression.org.tw/knowledge/know_info_part.asp?paper_id=64
   連結：
2. Chen, H.-S.,Huang, I.-W.(2014).Association between leisure physical activity and anxiety: A cluster-analytical approach.Xing Da Ti Yu Xiao Kan,13,71-82.
   連結：
3. Blake, H.,Mo, P.,Malik, S.,Thomas, S.(2009).How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review.Clinical Rehabilitation,23(10),873-887.
4. Chen, C.-Y.(2001).Study on the healthy lifestyle and its related factors among the students in Taiwan.Chinese Journal of School Health,40,22-49.
5. Cooney, G. M.,Dwan, K.,Greig, C. A.,Lawlor, D. A.,Rimer, J.,Waugh, F. R.,Mead, G. E.(2013).Exercise for depression.Cochrane Database Systematic Reviews,9,1-142.
6. Craft, L. L.,Pema, F. F.(2004).The benefits of exercise for the clinically depressed.Prim Care Companion to the Journal of Clinical Psychiatry,6(3),104-111.
7. Davydow, D. S.,Russo, J. E.,Ludman, E.,Ciechanowski, P.,Lin, E. H.-B.,Von Korff,Katon, W. J.(2011).The association of comorbid depression with intensive care unit admission in patients with diabetes: A prospective cohort study.Psychosomatics,52(2),117-126.
8. Dlugaj, M.,Winkler, A.,Dragano, N.,Moebus, S.,Jöckel, K. H.,Erbel, R.,Heinz Nixdorf Recall Study Investigative Group(2015).Depression and mild cognitive impairment in the general population: Results of the Heinz Nixdorf recall study.Journal of Alzheimer's Disease,45(1),159-174.
9. Fu, T. S.-T.,Lee, C.-S.,Gunnell, D.,Lee, W.-C.,Cheng, A. T.-A.(2013).Changing trends in the prevalence of common mental disorders in Taiwan: A 20-year repeated cross-sectional survey.The Lancet,381,235-241.
10. Hakka Affair Council. (2013). Distribution of the Hakka population in Taiwan. Retrieved from http://web3.hakka.gov.tw/ct.asp?xItem=131009&ctNode=2931&mp=4&ps= posed on 2013-08-12
11. Hollingshead, A. B.(1957).Two factors index of social position.New Haven, CT:Private Print.
12. Huang, H.,Russo, J.,Von Korff, M.,Ciechanowski, P.,Lin, E.,Ludman, E.,Katon, W.(2012).The effect of changes in depressive symptoms on disability status in patients with diabetes.Psychosomatics,53(1),21-29.
13. Jin, H.,Wu, S.,Vidyanti, I.,Di Capua, P.,Wu, B.(2015).Predicting depression among patients with diabetes using longitudinal data. A multilevel regression model.Methods of Information in Medicine,54(6),553-559.
14. Kato, P. M.(Ed.),Mann, T.(Ed.)(1996).Handbook of diversity issues in health psychology.New York, NY:Plenum.
15. Lee, Y.,Yang, M.-J.,Lai, T.-J.,Chiou, N.-M.,Chau, T.-T.(2000).Development of Taiwanese depression questionnaire.The Chang Gung Medical Journal,23,688-694.
16. Lorant, V.,Deliege, D.,Eaton, W.,Robert, A.,Philippot, P.,Ansseau, M.(2003).Socioeconomic inequalities in depression: A meta-analysis.American Journal of Epidemiology,157(2),98-112.
17. Mammen, G.,Faulkner, G.(2013).Physical activity and the prevention of depression: A sustematic review of prospective studies.American Journal of Preventive Medicine,45(5),649-657.
18. Martinsen, E. W.,Strand, J.,Paulsson, G.,Kaggestad, J.(1989).Physical fitness levels in patients with anxiety and depressive disorders.International Journal Sports Medicine,10(1),58-61.
19. Martinsen, E.W.,Medhus, A.,Sandvik, L.(1985).Effects of aerobic exercise on depression: A controlled study.British Medical Journal,291,109.
20. Mead, G. E.,Morley, W.,Campbell, P.,Greig, C. A.,McMurdo, M.,Lawlor, D. A.(2009).Exercise for depression.Cochrane Database Systematic Reviews,3,CD004366.
21. Mead, G. E.,Morley, W.,Campbell, P.,Greig, C. A.,McMurdo, M.,Lawlor, D. A.(2008).Exercise for depression.Cochrane Database Systematic Reviews,4,CD004366.
22. Morgan, W. P.(1969).A pilot investigation of physical working capacity in depressed and nondepressed males.Research Quarterly for Exercise and Sport,40,859-861.
23. Morgan, W. P.(1968).Selected physiological and psychomotor correlates of depression in psychiatric patients.Research Quarterly for Exercise and Sport,30,1037-1043.
24. Piccinelli, M.,Wilkinson, G.(2000).Gender differences in depression.The British Journal of Psychiatry,177(6),486-492.
25. Reddy, M. S.(2010).Depression: The disorder and the burden.Indian Journal of Psychological Medicine,32(1),1-2.
26. Rimer, J.,Dwan, K.,Lawlor, D. A.,Greig, C. A.,McMurdo, M.,Morley, W.,Mead, G. E.(2012).Exercise for depression.Cochrane Database Systematic Reviews,7,CD004366.
27. Rovner, B. W.,Casten, R. J.(2002).Activity loss and depression in age-related macular degeneration.The American Journal of Geriatric Psychiatry,10(3),305-310.
28. Salguero, J. M.,Extremera, N.,Fernández-Berrocal, P.(2012).Emotional intelligence and depression: The moderator role of gender.Personality and Individual Differences,53(1),29-32.
29. Salguero, J. M.,Palomera, R. Y,Fernández-Berrocal, P.(2012).Perceived emotional intelligence as predictor of psychological adjustment in adloescents: A 1-year prospective study.European Journal of Psychology of Education,27(1),21-34.
30. Shang, C.-Y.,Liao, S.-C.,Lee, M.-B.(2003).Trends of visiting rate of depressive outpatients in psychiatric clinic.Formosa Journal of Medicine,7,502-509.
31. Tanenbaum, A. S.,van Steen, M.(2002).Distributed systems: Principles and paradigms.New Jersey, NJ:Prentince Hall.
32. Twenge, J. M.,Nolen-Hoeksema, S.(2002).Age, gender, race, socioeconomic status, and birth cohort difference on the children's depression inventory: A meta-analysis.Journal of Abnormal Psychology,111(4),578-588.
33. Wink, P.,Dillon, M.,Larsen, B.(2005).Religion as moderator of the depression-health connection findings from a longitudinal study.Research on Aging,27(2),197-220.
34. World Health Organization. (2015). Depression. Retrieved from http://www.who.int/mediacentre/factsheets/fs369/en/