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

Factors Influencing the Quality of Life of Elderly Living in a Pre-Fabricated Housing Complex in the Sichuan Earthquake Area

背景：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。目的：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。方法：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。結果：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」。結論：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。

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.