健康促進計畫對社區防治老人憂鬱症狀之成效探討

The Effects of Health Promotion Program on Depressive Emotion Among the Community Dwelling Elderly

目的：憂鬱是老人常見之心理困擾，文獻指出可透過活動而達到預防憂鬱活躍老化之目標，故本研究目的旨在探討健康促進計劃對社區老人憂鬱症狀防治之成效。方法：採單組前後測實驗法，以立意取樣針對雲林縣三個社區共126位老人提供健康促進方案，介入內容包括：健康飲食與運動、心理健康及老人防跌，每2星期上ㄧ次課程、每次課程100分鐘，持續進行3.5個月。測量工具為結構式問卷，內容包括：人口學概況與老人憂鬱量表（GDS），問卷經過專家效度與內部一致性檢測後進行施測。最後將所得資料以SPSS 12.0建檔後，進行配對t檢定與McNemar分析其成效。結果：研究顯示計畫介入前社區老人憂鬱平均為3.71±2.53分，介入後為3.02±2.79分，經配對t檢定後顯示具顯著性改善（p <0.05），即社區老人健康促進計劃可有效降低老人憂鬱症狀之平均分數。而以Mc N e m ar分析檢定則發現介入前GDS≧5分之憂鬱症狀人數（百分比）雖有下降，但未達顯著差異（p =0.175），進一步分析前測時有憂鬱症狀之老人其介入後之GDS改變情形，結果發現分數有顯著下降，即此介入計劃對社區憂鬱症狀老人有顯著改善。結論：本研究結果可提供基層健康照護人員對社區老人憂鬱狀況之了解與以社區為基礎的健康促進計劃對老人憂鬱之改善成效。

Purposes: Estimate the rate of suicide (including ideation, attempts, and completions) among adolescents and young adults (10-24 years old) in northern Taiwan in 2010. (2) Determine the factors affecting those who did these acts. (3) Determine the factors affecting lethality. Methods: Perform secondary data analysis utilizing the suicide reporting system and the death registry. Results: A total of 742 cases were identified. The total suicide rate was 94.2 per 100 000 (95% confidence interval: 87.7-101.2). The rates of suicidal ideation, attempted suicide, and completed suicide were 10.9, 79.1, and 4.2, respectively. The rates of suicidal ideation and attempted suicide in females were higher than those in males; however, the rate of completed suicide in males was higher than that in females. The rates of all three types of suicide increased consistently with age. Affection/inter-personal relationship was the main reason for suicide (61.6%). On multivariate analysis, age was the most important factor determining completed suicide. Among those who completed suicide, the means was the most important factor in determining lethality. Hanging/suffocating had the highest odds ratio (27.83) for lethality. Ingesting solid/liquid material or cutting was less fatal (0.02). Conclusions: Among 10-24 year olds in northern Taiwan, the rates of suicidal ideation and attempted suicide were higher in females than in males. The rate of completed suicide was higher in males than in females. Among those who completed suicide, the means was the most important factor in determining lethality.