61 探討四川地震災後組合屋社區之老年人生存質量的影響因素 1 郭紅霞陳紅 2* 3 錢黃碧君 4 陳茜 5 區美蘭 6 李芸 1 四川大學華西醫院暨華西護理學院護理學系講師教授暨副主任 3 香港理工大學應用社會科學系高級臨床導師老年科副教授 2 四川大學華西臨床醫學院護理學系 5 香港理工

Size: px

Start display at page:

Download "61 探討四川地震災後組合屋社區之老年人生存質量的影響因素 1 郭紅霞陳紅 2* 3 錢黃碧君 4 陳茜 5 區美蘭 6 李芸 1 四川大學華西醫院暨華西護理學院護理學系講師教授暨副主任 3 香港理工大學應用社會科學系高級臨床導師老年科副教授 2 四川大學華西臨床醫學院護理學系 5 香港理工"

彦群家
5 years ago
Views:

1 61 探討四川地震災後組合屋社區之老年人生存質量的影響因素 1 郭紅霞陳紅 2* 3 錢黃碧君 4 陳茜 5 區美蘭 6 李芸 1 四川大學華西醫院暨華西護理學院護理學系講師教授暨副主任 3 香港理工大學應用社會科學系高級臨床導師老年科副教授 2 四川大學華西臨床醫學院護理學系 5 香港理工大學應用社會科學系副教授 6 四川大學華西醫院國際醫院講師 4 四川大學華西醫院四川 512 地震造成了巨大的環境破壞和財產損失, 災後大量的居民被迫暫時居住於組合屋社區呈現四川地震災後, 居住於組合屋社區之老年人的生存質量狀況 ; 並探討其相關影響因素, 以作為提高組合屋社區之老年人生存質量的依據採立意取樣, 針對居住在四川綿竹市組合屋社區的 191 名老人, 以 WHOQOL-BREF 量表進行問卷調查研究資料以 t 檢驗單因子變異數分析和逐步複回歸來進行統計分析本研究結果顯示老人生存品質自評較好, 但在生理範疇 ( 平均分 56.2) 心理範疇 ( 平均分 45.7) 之得分顯著低於中國大陸研究中心提供的數據單因子分析顯示, 有無配偶物質受災狀況子女數有無壓力家庭平均月收入興趣家庭磨擦, 上述因素與生存質量呈顯著相關進一步的逐步複回歸分析發現 : 興趣嗜好家庭摩擦影響生活程度家庭平均月收入有無壓力共可解釋生存質量之生理範疇 13.8% 的變異量 ; 家庭摩擦對生活影響程度興趣嗜好共可以解釋心理範疇 15.3% 的變異量 ; 有無壓力有無配偶家庭摩擦影響生活程度受災狀況子女數興趣嗜好共可以解釋社會範疇 19.5% 的變異量 ; 有無壓力家庭摩擦影響生活程度興趣嗜好共可以解釋環境範疇的 16.5% 的變異量對生存質量四個範疇均有影響的變項為 : 家庭摩擦對生活影響程度興趣嗜好本研究結果呈現 512 四川地震災後組合屋之社區老年人的生存質量概況研究結果建議醫護工作者在未來關懷災區組合屋社區方面, 應以家庭為單位, 除老年人外, 應包括其他家庭成員親友, 以及構成其社會支援網路的人員和機構另建議在組合屋社區建立多元化育樂設施, 培養老年人多方面興趣嗜好, 適宜的補助以減輕老人經濟方面的壓力, 並定期提供必要之醫療服務與心理諮商服務, 以提高老人生存質量關鍵詞 : 組合屋社區生存質量老年人災後調查 , ,643 17, , *

2 62 QOL of Prefab House-Dwelling Elderly 2009 ㈠ quality of life, QOL ㈡ WHOQOL-100 World Health Organization Quality of Life Survey; Bowden & Fox-Rushby, 2003 WHO World Health Organization 15 Bowden & Fox-Rushby, 2003 WHO, 1998 WHOQOL domains 24 facets100 WHOQOL-100 WHO WHOQOL-100 WHOQOL-BREFWHOQOL-BREF WHOQOL general facet, facet G 2 overall QOL 26 WHOQOL-BREF Skevington, Lotfy, & O Conntell, ,830 Cronbach s α WHOQOL-BREF WHOQOL-BREF well illiness p <.01 overall QOL overall health R Pearson p <.0001 WHOQOL-BREF internal consistency discriminant validity construct validity; Skevington et al., 2004 WHOQOL-BREF WHOQOL-100 Cronbach s α.9 WHO, 1998 WHOQOL-BREF 20% 6 Skevington et al., 2004

3 63 ㈢ (2009) 2009 post-traumatic stress disorder, PTSD 2009 ㈠ 60 ㈡㈢ % % WHOQOL-BREF, Chinese WHOQOL-BREF WHO, n.d. WHOQOL-BREF 8 WHOQOL-BREF WHOQOL-BREF Cronbach s α WHOQOL-BREF WHOQOL-100 Person WHOQOL-BREF

4 64 QOL of Prefab House-Dwelling Elderly 3 8 overall QOL2 26 Likert s 5 = SPSS 11.0 t one-way ANOVA stepwise multiple regressionα.05 p < ± % 18.0% 3.2%0.5% 5.8% 49.2% 36.0% 12.2% 3.7% 45.5% 43.4%11.6% 10.6% 10.6% 6.9% 2.1% 9.0% 36.5% 39.7% 12.7% WHO- QOL-BREF 56.2 ± ± ± ± 14.0 WHOQOL- BREF Power 2006 t 13 Mean = 67.5 vs Mean = 62.3 vs 53.6 vs 46.4 Mean = 64.1 vs 53.8 vs 52.2 Bonferroni 52.4 vs Mean = Mean = M ± SD N = ± ± * 45.7 ± ± <.00* 64.2 ± ± ± ± *p <.05. t p

5 65 N = 189 n M ± SD t/f (p) M ± SD t/f (p) M ± SD t/f (p) M ± SD t/f (p) 1.04(.36) 0.57(.56) 0.51(.60) 0.36(.70) ± ± ± ± ± ± ± ± ± ± ± ± (.23) 1.36(.18) -1.54(.13) 1.05(.29) ± ± ± ± ± ± ± ± (.50) 0.73(.46) -3.09(.00*) 0.26(.80) ± ± ± ± ± ± ± ± (.65) 0.82(.44) 2.23(.11) 1.37(.26) ± ± ± ± ± ± ± ± ± ± ± ± (.69) -0.44(.66) -1.96(.04*) -1.27(.21) ± ± ± ± ± ± ± ± (.48) 0.13(.90) -0.80(.43) -1.07(.28) ± ± ± ± ± ± ± ± (.87) 0.22(.88) 2.97(.03*) 0.05(.99) ± ± ± ± ± ± ± ± ± ± ± ± 13.1 > ± ± ± ± (.01*) 2.58(.01*) 3.10(.00*) 4.35(.00*) ± ± ± ± ± ± ± ± (.05) -0.31(.76) -0.98(.32) -1.12(.26) ± ± ± ± 13.7 > ± ± ± ± (.00*) 5.33(.01*) 2.57(.08) 3.31(.04*) ± ± ± ± ± ± ± ± ± ± ± ± (.69) 1.12(.90) -0.09(.93) -1.11(.27) ± ± ± ± ± ± ± ± (.69) 0.60(.58) 0.39(.70) -0.50(.62) ± ± ± ± ± ± ± ± (.00*) 15.90(.00*) 4.46(.01*) 10.37(.00*) ± ± ± ± ± ± ± ± ± ± ± ± 13.2 LSD Bonferroni *p <.05.

6 66 QOL of Prefab House-Dwelling Elderly N = 189 B SE t p ** ** * ** ** ** ** ** ** * * * ** ** ** *p <.05. **p < stepwise multiple regression analysis R 2 = 13.8, F = 7.353, p <.001 R 2 = 15.3, F = , p <.001 R 2 = 19.5, F = 7.336, p <.001 R 2 = 16.5, F = , p < % Myers, 1994

7 Myers, Loma Prieta let down Myers, % Wu Hartsugh Mayers % 71.4% Gandee Knierim McLittle-Marino % 36.0% Gandee et al., 1998

8 68 QOL of Prefab House-Dwelling Elderly Kaniasty & Norris, % 31.2% 16.9% Bolin & Klenow, % Myers & David, 2005; Yeung & Fung, , Bonanno, Galea, Bucciarelli, & Vlahov, 2007 Deeg, Huizink, Comijs, & Smid, [Yu, P. L., & Yuan, H. J. (2000). Geriatrics (2nd., pp ). Beijing City, China: People s Medical Publishing House.] newscenter/ /11/content_ htm [Information Office of the State Council, PRC. (2008, September 11). Update on disaster relief work following the earthquake in Wenchuan Country, Sichuan Province. Retrieved from [Wang, K., He, G. X., Zhu, Y. Y., & Hu, Y. S. (2004). Introduction of therapeutic recreation. Chinese Journal of Clinical Rehabilitation, 8(28), ] [Wang, L. J. (2009). A study on influence factors of quality of life of 315 suburban left-behind old people in Jining city of Shan dong, province. Journal of Jining Medical College, 30(1), ]

9 [Wang, P. Y., Han, B. X., Li, H. F., Liu, S. L., Huang, H. Q.,... Li, C. (2009). Mental health of elderly victims in relocation sites four months after the 5.12 earthquake. Chinese Journal of Gerontology, 29(6), ] [Fu, R. K., Jiang, R. S., Chen, C., Wang, Y. L., & Sheng, Q. M. (2007). Study status quo of the quality of life for elderly. Chinese Journal of Gerontology, 27(8), ] [Li, J., Jang, S. F., Su, X. B., Zhang, Y., & Li, K. (2001). The assessment of quality of life and the analysis of it s influencing factors for the elderly in the second farm of country. Modern Rehabilitation, 5(2), ] [Li, H. F., Kuang, W. H., Yang, H. Q., Fu, C. S., Chen, T. Y., & Han, B. X. (2009). Subjective well-being in elderly survivors after the 5.12 Wenchuan earthquake. Chinese Journal of Gerontology, 29(5), ] [Hao, Y. T., & Fang, J. Q. (2000). The introduce and usage of WHOQOL instrument in Chinese. Modern Rehabilitation, 4(8), ] Power, M. J.2006 WHO [Hao, Y. T., Fang, J. Q., Power, M. J., Wu, S. M., & Zhu, S. M. (2006). The equivalence of WHOQOL-BREF among 13culture versions. Chinese Mental Health Journal, 20(2), ] [Hao, Y. T., Fang, J. Q., Li, C. X., & Shi, M. L. (1999). WHOQOL instrument in Chinese. Foreign Medical Sciences. Social Medicine Section, 16(3), ] [Xu, B. Y., Wang, Z. Q., Wang, G. H., & Wang, H. L. (2009). Investigate and analysis on the quality of life of old people in Taiwan. China Journal of Health Psychology, 17(9), ] [Xu, H. L. (1994). Life satisfaction and its influential factors in the elderly. Chinese Mental Health Journal, 8(4), ] [Jia, S. M., Feng, Z. Y., Hu, Y., & Wang, J. (2004). Investigate on quality of life and the analysis of It s influencing factors for the elderly living in communities of Shanghai city. Journal of Nurses Training, 19(5), ] [Lei, M., Dong, L. P., & Du, R. H. (2009). Quality of life and it s influencing factors for the elderly living in nursing house. Chinese Journal of Gerontology, 2(6), ] [Ouyang, Y., Hu, S. K., & Zhao, Z. Y. (2009). The quality of life of the elderly living in communities of Xi an City. Journal of Xi an Jiaotong University (Medical Sciences), 30(3), ] [Liu, R. G., & Gong, Y. (2000). The subjective well-being of the elderly and its influential factors. Chinese Journal of Clinical Psychology, 8(2), ] (12) [Han, B. X., Wang, T., Huang, H. Q., & Wang, X. M. (2009). Advance of studying the mental health status of the elderly after catastrophe. Chinese Journal of Gerontology, 29(12), ] Bolin, R., & Klenow, D. J. (1988). Older people in disaster: A comparison of black and white victims. The International Journal of Aging and Human Development, 26(1), doi: /rhk2-416v-mgxh-hykl

10 70 QOL of Prefab House-Dwelling Elderly Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007). What predicts psychological resilience after disaster? The role of demographics resources and life stress. Journal of Consulting and Clinical Psychology, 75(5), doi: / x Bowden, A., & Fox-Rushby, J. A. (2003). A systematic and critical review of the process of translation and adaptation of generic health-related quality of life measures in Africa, Asia, Eastern Europe, the Middle East, South America. Social Science & Medicine, 57(7), doi: / S (02) Deeg, D. J. H., Huizink, A. C., Comijs, H. C., & Smid, T. (2005). Disaster and associated changes in physical and mental health in older residents. European Journal of Public Health, 15(2), doi: /eurpub/cki126 Gandee, R. N., & Knierim, H., & McLittle-Marino, D. (1998). Stress and older adults: A mind-body relationship. The Journal of Physical Education, Recreation & Dance, 69(9), Hartsough, D. M., & Mayers, D. G. (1987). Disaster work and mental: Health prevention and control of stress among workers (pp ). Rockville, MD: National Institute of Mental Health. Kaniasty, K., & Norris, F. H. (1995). In search of altruistic community patterns of social support mobilization following Hurricane Hugo. American Journal of Community Psychology, 23(4), Myers, D. (1994). Disaster response and recovery: A handbook for mental health professionals. Rockville, MD: Center for Mental Health Services. Myers, D., & David, F. (2005). Special populations in disaster. In Disaster Mental Health services (pp ). New York, NY: Routledge. Skevington, S., M., Lotfy, M., & O Conntell, K. A. (2004). The World Health Organization s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL Group. Quality of Life Research, 13(2), World Health Orgniztion Quality of Life Group. (1998). Development of the World Health Organization WHOQOL- BREF Quality of life assessment. Psychological Medicine, 28(3), World Health Organization. (n.d.). WHO-quality of life-brief (WHOQOL-BREF). Retrieved from substance_abuse/research_tools/whoqolbref/en/ Wu, H. C., Chou, P., Chou, F. H., Su, C. Y., Tsai, K. Y., Ou- Yang, W. C.,... Chen, M. C. (2006). Survey of quality of life and related risk factors for a Taiwanese village population 3years post-earthquake. The Australian and New Zealand Journal of Psychiatry, 40(4), doi: / j x Yeung, D. Y. L., & Fung, H. H. (2007). Age differences in coping and emotional responses toward SARS: A longitudinal study of Hong Kong Chinese. Aging Mental Health, 11(5), doi: /

11 71 Factors Influencing the Quality of Life of Elderly Living in a Pre-Fabricated Housing Complex in the Sichuan Earthquake Area Hong-Xia Guo 1 Hong Chen 2 * Teresa Bik-Kwan Tsien Wong 3 Qian Chen 4 May-Lan Au 5 Yun Li 6 1 RN, MSN, Lecturer, Department of Nursing, West China Hospital & Sichuan University; 2 RN, MSN, Vice Director & Professor, Department of Nursing, West China School of Medicine, Sichuan University; 3 Senior Clinical Associate Programme Director, Department of Applied Social Sciences, The Hong Kong Polytechnic University; 4 RN, MSN, Associate Professor, Department of Geriatrics, West China Hospital, Sichuan University; 5 PhD, Associate Professor, Department of Applied Social Sciences, The Hong Kong Polytechnic University; 6 RN, MSN, Lecturer, International Hospital, West China Hospital, Sichuan University. Abstract Background: The 2008 Sichuan Earthquake caused great damage to the environment and property. In the aftermath, many citizens were relocated to live in newly constructed prefabricated (prefab) communities. Purpose: This paper explored the current quality of life (QOL) of elderly residents living in prefabricated communities in areas damaged by the Sichuan earthquake and identified factors of influence on QOL values. The ultimate objective was to provide evidence-based guidance for heath improvement measures. Methods: The authors used the short form WHOQOL-BREF to assess the quality of life of 191 elderly residents of prefabricated communities in the Sichuan Province 2008 earthquake zone. A Student s t-test, variance analysis, and stepwise multivariate regression methods were used to test the impact of various factors on QOL. Results: Results indicate the self-assessed QOL of participants as good, although scores in the physical (average 56.2) and psychological (average 45.7) domains were significantly lower than the norm in China. Marital status, capital loss in the earthquake, number of children, level of perceived stress, income, interest, and family harmony each correlated with at least one of the short form WHOQOL-BREF domains in t-test and one-way analyses. After excluding for factor interaction effects using multivariate regression, we found interest, family harmony, monthly income and stress to be significant predictors of physical domain QOL, explaining 13.8% of total variance. Family harmony and interest explained 15.3% of total variance for psychological domain QOL; stress, marital status, family harmony, capital loss in the earthquake, number of children and interest explained 19.5% of total variance for social domain QOL; and stress, family harmony and interest explained 16.5% of total variance for environmental domain QOL. Family harmony and interest were significant factors across all domains, while others influenced a smaller proportion. Conclusions: Quality of life for elderly living in prefab communities should be improved. The authors hope study findings will increase awareness among healthcare providers regarding the quality of life of this vulnerable population. Study results suggest that key steps to promoting QOL in this population include improving family harmony, helping to cultivate well-rounded interests, alleviating economic stresses, providing necessary medical and psychological counseling services, and affording more social support. Key Words: prefabricated community, quality of life, the elderly, investigation after earthquake disaster. Accepted for publication: December 14, 2011 *Address correspondence to: Hong Chen, No. 37, Guo Xue Xiang, Wu Hou District, Chengdu City, Sichuan P.R. of China. Tel: +86(28) ; Calch@sohu.com

P. C Evelyn. M. Duvall 2 quality of life cabana

P. C Evelyn. M. Duvall 2 quality of life cabana 2012 3 193 POPULATION JOURNAL No. 3. 2012 Tot. No. 193 100871 2008 Logit C913. 6 A doi 10. 3969 /j. issn. 1004-129X. 2012. 03. 004 1004-129X 2012 03-0031 - 11 2011-12 - 10 10JJD840001 1962-2010 1% 60 1.