高齡者憂鬱傾向、健康狀況與跌倒經驗之相關研究-以臺北市中山區為例

Abstract

本研究為探討高齡者社會人口學變項、健康狀況、憂鬱傾向及跌倒經驗之現況，進一步分析社會人口學特質、健康狀況、憂鬱傾向與跌倒經驗的相互影響情形及預測力。 本研究探討臺北市中山區高齡者的憂鬱傾向、健康狀況與跌倒經驗之關聯，並分析其預測力。研究方法採取分層比例集束抽樣法，以面對面問卷調查方式收集資料，有效樣本共382份，再進行卡方檢定及二元羅吉特迴歸分析。研究結果發現（一）性別、年齡、婚姻狀況及教育程度等社會人口學變項與跌倒經驗皆未達顯著差異，顯示沒有關聯。自覺健康狀況、走路平穩度、使用輔助器走路、視力（近）（遠）、聽力、慢性疾病等健康狀況與跌倒經驗皆達顯著差異，與跌倒經驗存有關聯性。慢性疾病中又以高血壓、糖尿病、關節炎或風濕痛及眩暈症/現象與跌倒經驗之間有關聯。憂鬱傾向有達顯著差異，與跌倒經驗存有關聯性。（二）走路平穩度、聽力、慢性疾病、用藥行為及憂鬱傾向可有效地預測跌倒經驗。走路平穩度「普通」及「非常不平穩與不平穩」的高齡者，較「平穩與非常平穩」跌倒機率多出6.150倍及3.388倍。聽力「普通」的高齡者，較「非常清楚與清楚」跌倒機率多出2.468倍。「有」慢性疾病的高齡者較「無」慢性疾病的跌倒機率多出10.139倍。「有」用藥行為的高齡者較「無」用藥行為的跌倒機率多出5.122倍。「有」憂鬱傾向的高齡者較「無」憂鬱傾向的跌倒機率多出2.343倍。 最後根據上述研究結果，建議政府相關單位可從相關法令或公共衛生政策來介入，並藉由專業醫療人員的努力，提早發現高齡者健康狀況及憂鬱情形。另外可建立高齡者社區支持性網絡，加強健康促進及憂鬱正確觀念宣導，提高社會大眾對於高齡者跌倒防治及跌倒傷害的認知。This study explores the current situation of depression tendency and fall experience of the elder people, and analyzes the associations between sociodemographic characteristics, health status, depression tendency, and fall experience. Study participants were selected from the senior citizens in Zhongshan District of Taipei City, using the stratified proportional cluster sampling method. Data were collected by a face-to-face questionnaire survey and 382 participants completed the survey. Study findings revealed that gender, age, marital status, and education level were not associated with fall experience. Self-reported health status, walking smoothness, walking with aids, vision, and hearing were associated with fall experience. Chronic diseases that related to fall experience included hypertension, diabetes, arthritis or rheumatic pain and vertigo/phenomena. There was a significant association between the tendency to depression and the experience of falling. Walking stability, hearing, chronic diseases, medication and depression tendency were significant predictors of the fall experience. Participants with "normal" and "very unstable or unstable" walking ability were 6.150 times and 3.388 times more likely to fall than those with "stable or very stable" walking ability. Those who are "normal" in hearing are 2.668 times more likely to fall than those with "very clear or clear" hearing. Those who have chronic diseases are 10.139 times more likely to fall than those without chronic diseases. Those with medication were 5.122 times more likely to fall than their counterparts. Those with depression tendency were 2.343 times more likely to fall than their counterparts. Based on the findings, the relevant government units could intervene from making laws or public health policies, and early detection of health status and depression among the elder people through the efforts of professional personnel. In addition, a community support network for the elder people could be established to strengthen health promotion, and to raise the awareness of fall prevention among the elder people.