Study on quality of life and related factors among the elderly in Hunei

• Main Authors: Wen-Jung Sun, 孫文榮
• Other Authors: Pesus Chou
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/25052427547328670763

博士 === 國立陽明大學 === 公共衛生研究所 === 96 === The main purpose of this thesis in 1. explored separately about the quality of life and related factors among the elderly in 2000 and in 2002. 2. Choices the more suitable one questionnaire of the quality of life for the community-dwelling elderly 3.To determinate the factors of the change of quality of life among the elderly from 2000 to 2002 4. Perform the survival analysis about the quality of life among the elderly. Method: This research divides into four major parts: The first part was in 2000 about the quality of life and the related factors among elderly, not only the demographic data, but also the disease correlation data and quality of life. The elders who lived alone also be the target population we focus on. We make the discussion in both Short Form-36 (SF-36) and the brief edition of the World Health Organization quality of life questionnaire, Taiwan version (World Health Organization Quality of Life-Brief version, Taiwan version) about which one is more suitable for the Taiwan community-dwelling elderly. Second part: In 2002 about the quality of life and the related factors among elderly, not only the demographic data, but also the disease correlation data and quality of life. Third part: Trace 409 elders, who had participated both survey in 2000 and 2002, about the demography, the disease correlation data as well as with the quality of life relations, and discovered the factors which influence the improvement of quality of life, better or worse. Simultaneously discusses the death old persons, has not been visited old persons and is visited old person's similarities and differences. Fourth part: Traced the elders who took part in the survey in 2000, until the June in 2008, to explore the related factors about the surval. The obtained data carries on the statistics by the SPSS 11.5 Chinese version statistics software. Result: In 2000 above 65 years old the old person altogether had 2,133 people to accept the interview, the responds rate is 92%. The male is more than the female, the widowed ratio for widowered more than one time (36.8% vs 16.0%). Is not literate the old person to surpass half number of, the female reaches as high as most likely above. Will be near a tenth old person to live alone, in which female will be more than the male slightly (8.9% vs 8.1%).The feminine body weight overweight and the obese ratio are more than the male, masculine too thin is more than the female. Three-quarters elderl have the waist-wide question, the female have been more serious. The female attracts the tobacco, drinks and chews betel nut the ratio below 1%. From the self-reported chronic illness by cataract, hypertension and the respiratory tract illness are most. The prevalence rate of the self-reported major illness, female rate is higher than the male, besides stroke and respiratory tract illness. The feminine total numbers of chronic illness also is higher than the male. Simultaneously the female dementia symptom and the depression symptom ratio all is also higher than the male. The factor about good quality of life is the male, the husbands and wives lives together, BMI is big, the education level is higher, the less of chronic illness number, who the tobacco, drinks and chews the betel nut few, less dementia symptom or the depression symptom old person. The wide waist worse the physical component of quality of life, but better the mental or psychological component did. The related factors of quality of life among the community-dwelling elderly include: the age, the depression symptom, the dementia symptom, the sex, live alone, the waist-width, the education level, each chronic illness and the total numbers. By the correlation coefficient about various domains, the power of discrimination, the partial r square value among the domain and the demographic datas and between the domains, as well as the construction validity,we think the SF-36, especially the physical domain, is more suitable one in compared to WHOQOL-BREF for the Taiwan community elderly. The female elders, who are living alone, reported poor quality of life than the man and non living alone did. The male alone report the best quality of life. After multiple linear regression analysis may discover the sex and the live status has the interaction phenomenon, even if after the control age and the numbers of chronic illness, the mental scale of SF-36 (Mental Component Summary, MCS) still demonstrated the difference significantly. In 2002 altogether had 557 old people to participate in the home visit, the male still slightly is more than the female, the female wifeless widowed is more than the male.Is not literate the old person to surpass one half, the female reaches as high as 3/4. Lives alone in old person's, the female still was more than the male. The female overweight and the obese ratio is higher than the male (59.8% vs 45.5%), and the masculine too thin ratio is higher than the female slightly. The waist-width ratio nearly 70%, the female far has been higher than the male. Same as in 2000, the female who attracts the tobacco, drinks and chews the betel nut not to 1%. Suffers from the chronic illness the old person are most by the chronic obstructed pulmonary disease, next for diabetes and heart failure. The female dementia symptom in old person's the ratio still to be higher than the male, but male in depression symptom then was more than the female slightly. The quality of life of the masculine still surpassed the female, live alone, widowed and too thin in BMI reported the poorer quality of life. The education level is higher, the quality of life is better. The waist-wide elders, who reported poorer quality of life in physical scale, had better quality of life in mental scale or psychological domains. Has the chronic illness old person, the more total numbers of chronic illness, has dementia symptom or the depression symptom old person, its quality of life is bad. The factors affects quality of life of community dwelling elderly are to have the chronic illness, the more total numbes of chronic illness, the depression symptom, the dementia symptom and the sex. In 2000, 2,133 visited elders to have 592 to live in the vallages which 2002 sampled, including 409 people to accept 2002 inquiring. Died besides 80 old people, and some 103 people have not been able to receive visit. Discovered compared with these three group of old person's data, death old person's characteristic for male, old, widowed and many chronic illness total. The quality of life is also bad, besides the psychological domains and the mental scale, the depression symptom and dementia symptom to be also obvious. But the 409 old people who two times survey all participation, its education level is high, wifeless widowed, lives together with son and other family, and the too thin ratio increases slightly. The quality of life is better, the less of depression symptom and the dementia symptom. The factors influence the quality of life improvement has the less of depression symptom, no gout, no cataract and not living alone, the physical component summary (PCS) of SF-36 to be able to improve; But the less of depression symptom, the mental component summary (MCS) of SF-36 and the Environment domains of WHOQOL-BREF can improve on the tendency; If adds on again the dementia symptom, the waist is wider, and the poorer education level, then the Psychological domains of WHOQOL-BREF also can improve. As for affects the physical domain of the WHOQOL-BREF improvement factor to include: less numbers of chronic illness, has not lived alone, no gout and cannot too be thin. The results revealed the dementia symptom were significant predictor of 2 more years PCS scale of SF-36 deterioration; If accompany by BMI-non overweight and have cardiovascular disease, the MCS scale will also be deteriorated. The smoking and age were the predictor for the physical domains of WHOQOL-BREF deteriorated, the dementia symptom, dementia symptom, wide waist, drinking and having cardiovascular disease for the psychological domain of WHOQOL-BREF deteriorated, the obesity, cardiovascular disease and the educational level for the social domains of WHOQOL-BREF deteriorated, and the wide waist and the BMI non-obesity for the environment domain of WHOQOL-BREF deteriorated. The male, the advanced age, has not been educated, wifeless widowed, lives alone, BMI is smaller than 18.5, the waist width, has not attracted the tobacco or chews the betel nut and abstains the tobacco and stopping drinking old person its mortality rate is obviously high. The poorer quality of life, suffers from each kind of chronic illness or merges many kinds of illness, the depression symptom high, the dementia symptom high old person, the mortality rate is also high. The survival factor affects the old person to live is: The age, the PCS scale of SF-36, the female, diabetes, dementia symptom, BMI are smaller than 18.5, heart disease, BMI are bigger than 25, the environment domain of WHOQL-BREF and chew the betel nut. Conclusion: 1. this research uses SF-36 and the WHOQOL-BREF two kind of quality of life questionnaire at the same time, discovered all has the good validity, but seems the SF-36 is more suitable for community-dwelling elderly, especially in PCS scale. 2. This research discoveries the female who lives alone, havd poorer quality of life, the more numbers of chronic illness, is in the life weak trend tribal group, is worth reminding the govement concerned attention and intervention. 3. The research discoveries the related factors about quality of life among elderly, the related factors about the quality of life improved and deteriorated, and the related about the surval of the quality of life among the community-dwelling elderly, may provide as the reference for the health politics unit administration strategy.