| Summary: | 碩士 === 慈濟大學 === 公共衛生研究所 === 96 === The present study is to investigate the impact of depression on quality of life（WHOQOL）among the elderly in Veteran’s Home. This research attempts to clarify the role of depression, physical status, physical activity and social support in determining WHOQOL. Study subjects were collected from a Veteran’s home in eastern Taiwan. Those aged younger than 65 years old, and whose scores of Activities of Daily Living (ADL) lower than 60, and with cognition, language and communication difficulties were excluded. Seven cross-sectional questionnaires were conducted: socio-demographic information, WHOQOL-BREF Taiwan Version, Taiwan Geriatric Depression Scale (TGDS), Barthal index (ADL), Chronic medical conditions checklist, Health-related behaviors questionnaire, and Social support Questionnaire. Two-stage hierarchical multiple regression analysis was performed to examine the potential predictors of WHOQOL. First, socio-demographic status, physical conditions, physical activity and social support were used to predict both WHOQOL and TGDS. Second, TGDS was further added into the WHOQOL model derived from the first stage to study the net effects of the other predictors on WHOQOL after controlling for TGDS.
One hundred and eighty-two veterans with mean age 82 years completed all the 7 surveys. The average score of WHOQOL was 96.34 (range: 28-140). The average TGDS score was 8.47 (range: 0-30); there were 32 (17.58%) subjects with TGDS greater or equal to 15. The correlation analysis showed that higher depression levels poorer physical conditions, and lack of physical activity and social support were associated with poorer quality of life. In the first stage regression analysis, ADL, number of chronic medical conditions, exercises time and emotional support accounted for 29.85% of variation in WHOQOL. In the second stage of regression analysis, adding TGDS alone increased the accounted variation by 24.03% to 53.88%. Thus, TGDS was the most important predictor of overall WHOQOL.
Further analysis of the four WHOQOL domains showed that depression was also the most significant determinants of the WHOQOL physical, psychological, social and environment domains. After controlling for TGDS, the impacts of physical conditions and physical activity on WHOQOL physical domain were diminished but still significant. In psychological domain, only depression could predict QOL, but physical conditions and physical activity became non-significant. In social relationships domain, only TGDS and social support became significant predictors. In environment domain, only TGDS and physical activity were significant. Therefore, depression was the most important predictor of QOL total score and 4 domains of QOL. To promote QOL in the elderly, the first key thing needs to be done is to control of their depression symptoms; furthermore, encouraging the elderly to exercise with 30-minitue duration and regularly, and increasing their social support can also improve their QOL.
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