| 摘要: | 背景：社會參與作為個人與社會彼此連結的概念，能夠體現出在老化影響下，彼此之間的交互反應，並帶來許多健康的益處。然而，社會參與會因高齡者老化過程而產生動態變化，鮮少研究討論高齡者社會參與改變時的相關因素。
目的：探討高齡者社會參與改變以及社會參與狀況之相關因素。
方法：採用「台灣地區中老年身心社會生活狀況長期追蹤調查」進行次級資料庫分析，進行兩部份分析，第一部份以2011年、2015年度資料探討高齡者社會參與改變之相關因素（N=1,728）；第二部份以2015年度資料探討高齡者社會參與狀況之相關因素（N=2,399）。
結果：本研究第一部份發現有偶的組別，其社會參與減少機率為無偶組別的0.719倍（OR=0.719，p =0.002）；自評健康變好的組別，其社會參與減少機率為自評健康變差組別的1.306倍（OR=1.306，p =0.049）；活動功能不變的組別，其社會參與減少機率為活動功能變差組別的1.520倍（OR=1.520，p =0.004）。第二部份發現無偶的社會參與狀況（M = 3.23, SD = 3.18）較有偶來得差（M = 4.83, SD = 3.89）；65-69歲的組別社會參與狀況（SD = 5.63）顯著高於其他年齡組別；不識字組別的社會參與狀況（SD = 3.06）顯著低於其他教育程度組別；直轄市的組別社會參與狀況（SD = 4.08）顯著低於鄉的組別（SD = 5.03）；沒有感受到什麼壓力或煩惱組別的社會參與狀況（SD = 4.91）顯著高於中等程度的壓力或煩惱以及有很大的壓力或煩惱的組別（SD = 2.73、3.22）；自評健康狀況很好、好以及普通的組別社會參與狀況（SD = 5.38、5.03、4.65）顯著高於不太好以及很不好的組別（SD = 3.20、1.74）；1項慢性病的組別社會參與狀況（SD = 4.62）顯著高於2項以上慢性病的組別（SD = 4.04）；活動功能（r = -.30, p = .000）、憂鬱狀況（r = -.16, p = .000）與社會參與狀況呈現顯著負相關；認知功能（r = .17, p = .000）與社會參與狀況呈現顯著正相關。
結論：婚姻、自評健康狀況改變、活動功能改變與社會參與改變有關，此三個因素與社會參與狀況相關的因素相似。建議高齡者宜與能夠給予較多支持及陪伴的伴侶一同從事社會參與，並積極避免身體健康惡化，以免落入社會參與逐步減少的困境。
Background: Social engagement, as a concept of the interconnection between individuals and society, can reflect the interaction between each other under the influence of aging, and bring many health benefits. However, social engagement will have dynamic changes due to the aging process of the elderly, and there are few studies discussing the factors related to the changes in social engagement in elderly.
Objective: To explore the factors related to changes in social engagement in elderly and the status of social engagement.
Method: Using "Taiwan Longitudinal Study on Aging" to conduct a two-part analysis of the secondary database, the first part uses the data from 2011 and 2015 to explore the factors related to changes in social engagement in elderly ( N=1,728); The second part uses the 2015 data to explore the relevant factors of the social engagement status of the elderly (N=2,399).
Results: In the first part of this study, in the group with a spouse, the probability of reducing social engagement is 0.719 times that of the group with no spouse (OR=0.719, p=0.002). In the group with better self-rated health, the probability of reducing social engagement is 1.306 times that of the self-rated health deterioration group (OR=1.306, p =0.049). In the group with constant activity function, the probability of social engagement reduction is 1.520 times that of the activity function deterioration group (OR=1.520) , P = 0.004). In the second part, in the group with no spouse(M = 3.23, SD = 3.18), the social engagement status is worse than that of the group with a spouse (M = 4.83, SD = 3.89). In the group with 65-69-year-old group (SD = 5.63), the social engagement status is significantly higher than other age groups. In the group with the illiterate group (SD = 3.06), the social engagement status is significantly lower than that of other education level groups. In the group with the municipality (SD = 4.08), the social engagement status is significantly lower than the township ( SD = 5.03). In the group that does not feel any pressure or trouble (SD = 4.91), the social engagement status is significantly higher than that of the group with moderate pressure or trouble and the group with great pressure or trouble (SD = 2.73, 3.22). In the group with self-rated health very good, good and ordinary (SD = 5.38, 5.03, 4.65), the social engagement status is significantly higher than that of the self-rated health not very good and very bad (SD = 3.20, 1.74). In the group with 1 chronic disease (SD = 4.62), the social engagement status is significantly higher than the group with more than 2 chronic diseases (SD = 4.04). Activity function (r = -.30, p = .000), melancholy status (r = -.16, p =. 000) are significant negative correlation with social engagement status. Cognitive function (r = .17, p = .000) is significant positive correlation with social engagement status.
Conclusion: Marriage, self-rated health status changes, and activity functions changes are related to changes in social engagement. These three factors are similar to those related to social engagement status. It is recommended that the elderly should engage in social engagement with a partner who can provide more support and companionship, and avoid the deterioration of their physical health, to prevent from declining in social engagement. |
