老人社會資本對健康生活品質的影響：以台中市老人為例

Effects of social capital on health-related quality of life among older adults in Taichung City

本研究旨在探討老人社會資本及健康生活品質的現況，進一步探討老人社會資本對健康生活品質的影響。方法：本研究為一探索性的橫斷式研究，以結構式問卷調查台中市12個C據點的212位居住在家中的老人。社會資本包含社區參與、信任與安全感、鄰居的連結三個構面、共計15題，健康生活品質則以EQ-5D5個面向（行動能力、自我照顧、一般活動、疼痛／不適與焦慮／沮喪）共5道題項進行測量，各題項計分介於1分至3分之間，3分代表沒有問題、1分代表無法自理／有極度問題。統計分析方法包含描述性統計及推論性統計，多變項分析則以等級機率迴歸探討老人社會資本對健康生活品質的影響。結果：鄉區老人增加一等級EQ-5D的勝算比為2.052（95％ C.I.＝1.070；3.939）；高社會資本老人增加一等級EQ-5D的勝算比為低社會資本老人的3.662倍（95％ C.I.＝1.917；7.001）；老人年齡每增加1歲增加一等級EQ-5D的勝算比下降6.9％（OR＝0.931，95％ CI＝0.889；0.977）；有慢性病的老人增加一等級EQ-5D的勝算比下降62.8％（OR＝0.372，95％ CI＝0.165；0.840）；衰弱前期的老人（OR＝0.261，95％ CI＝0.129；0.530）與衰弱期的老人（OR＝0.121，95％ CI＝0.050；0.289）增加一等級EQ-5D的勝算比分別下降73.9％及87.9％。結論：老人的社會資本對老人健康生活品質具有顯著影響，建議政府提出各項面對超高齡社會政策時，應納入如何提高老人社會資本的相關措施。

Objectives: This study explored the effects of social capital on health-related quality of life among older adults in Taiwan. Methods: This exploratory cross-sectional study used a self-administered structured questionnaire to collect data from 212 older adults from 12 community care centers in Taichung City. Social capital was measured using a 15-item scale, which included items on community participation, trust/ safety, and neighborhood linkage. The EQ-5D descriptive system is a preference-based health-related quality of life measure with one question for each of its five dimensions: mobility, self-care, usual activities, pain/ discomfort, and anxiety/ depression. The responses are coded from 1 to 3, with 3 indicating ''no problems,'' 2 indicating ''some problems,'' and 1 indicating ''many problems.'' Ordered probit regression was used to explore the effect of social capital on health-related quality of life. Results: The results of ordered probit regression revealed that living in rural areas (odds ratio [OR] = 2.0052, 95% confidence interval [CI] = 1.070-3.939) and having high social capital (OR = 3.662, 95% CI = 1.917-7.001) supported high self-rated health-related quality of life. Low assessment of health-related quality of life increased with age (OR = 0.931, 95% CI = 0.889-0.977), growing number of chronic diseases (OR = 0.372, 95% CI = 0.165-0.840), and Study of Osteoporotic Fractures frailty index (OR = 0.261, 95% CI = 0.129–0.530 vs. OR = 0.121, 95% CI = 0.050-0.289). Conclusions: Social capital played a relatively strong role in determining the health-related quality of life of older adults in Taichung City. Policymakers should implement social capital-related policies when facing a super-aged society.