背景：
過去研究指出，退休者若能維持活躍，持續投入有意義的志工參與，與他人持續建立親密的關係，保持心智與生理上的活躍，其生活品質分數比沒持續參與的人都還要高分。然而，在國際上，探討中老年人志工參與對生活品質之影響的研究較少，且少有對志工參與的細部進行分析，例如沒有深入討論一個人參與幾個志工單位，或是將志工參與頻率及參與單位總數，一起納入研究分析，因此，本研究目的旨在補足上述之缺憾，以台灣中老年退休者為例，探討志工參與的數量和頻率對其生活品質之影響。
目的：
針對有無志工參與、志工參與頻率以及參與單位總數，來探討台灣中老年退休者之志工參與對其三年後之生活品質(SF-12)變化之影響。
方法：
本研究使用國民健康署委託成大健康城市研究中心完成的兩波追蹤研究資料進行分析，基線年為2015-2016年，追蹤年為2018-2019年，為間隔三年的追蹤調查。其中，完成兩波調查的退休者為2448人，排除生活品質題目漏答者12人以及日常生活活動(ADL)大於等於1的個案41人，共得有效樣本2395人。自變項為有無志工參與、志工參與的頻率、志工參與的單位總數對兩波生活品質的分數變化之影響。生活品質量表採用SF-12，分為兩個分數：身體構面總分（Physical Component Summary, PCS）和心理構面總分(Mental Component Summary, MCS)，分數越高表示生活品質越好。統計分析方法則使用線性迴歸模型進行分析。
結果：
在身體構面(PCS)方面，有無志工參與、志工參與時數、志工參與單位數對生活品質之身體構面分數(PCS)變化，在調整干擾因子後，皆未達統計上顯著意義。
對於心理構面(MCS)方面，擔任志工比起沒有擔任志工的人，增加1.31分；若以志工時數為0的人當作對照組，本研究發現參與志工時數4-6小時增加分數最多達2.20分(P=<.001)，即便調整干擾因子後，志工時數4-6小時仍然增加最多有1.57分(P=0.015)；在志工單位數部分，本研究發現參與的單位數愈多，其第二波MCS分數有增加的趨勢，達劑量反應效應，其中參加3個單位以上的人比起參與0個單位的人，調整後仍多了2.81分。
討論：
本研究發現每周志工參與頻率4-6小時對MCS效果最好，適量的時間致力於志願服務對心理幸福感(psychological well-being)產生積極影響。參加三個以上的單位對MCS有顯著增加，這一結果也與先前研究觀點相似。然而，有無志工參與、志工參與時數、志工參與單位數對於生活品質之身體構面分數(PCS)，皆未達統計上顯著意義，這一結果跟先前研究結果略有不同，先前研究指出女性一個月參加數次志工比起從未參與的人，身體構面分數有些微的增加。
結論：
台灣中老年退休者當中，女性有較高的比例會有志工參與。志工參與有助於提高生活品質的分數，其中在心理構面的部分，最為明顯，而且當志工參與時數達到4小時以上，效果變得很好。還有，當志工參與的單位數達到3個的時候，效果變得最好，能使生活品質之心理構面分數提高許多。

The purposes of the study are to explore the impacts of the number and frequency of volunteer participation on the quality of life, using the retired people as an example. The independent variables included the presence or absence of volunteer participation, the frequency of volunteer participation, and the total number of volunteering units. The dependent variable was the changes of the scores of the two waves of quality of life (using SF-12). SF-12 is defined as two scores, physical component summary (PCS) and mental component summary (MCS). The linear regression model was used for analysis.
We found that volunteer participation, the participation hours, and the number of volunteering units had no significant impact on the changes in the physical score (PCS). However, the presence of volunteer participation, the 4-6 hours of volunteering, and volunteering for more than 3 units had the best effects on the mental score (MCS). Thus, this study concluded that volunteering can help improve the score of quality of life of retired people.

Bayliss, E. A., Ellis, J. L., & Steiner, J. F. (2007). Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. The Annals of Family Medicine, 5(5), 395-402.
Bilotta, C., Bowling, A., Casè, A., Nicolini, P., Mauri, S., Castelli, M., & Vergani, C. (2010). Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health and quality of life outcomes, 8(1), 56.
Borgonovi, F. (2008). Doing well by doing good. The relationship between formal volunteering and self-reported health and happiness. Social science & medicine, 66(11), 2321-2334.
Bowling, A. (1995). The most important things in life. Comparisons between older and younger population age groups by gender. Results from a national survey of the public's judgements. International Journal of Health Sciences, 6, 169-176.
Boyd, C. M., Xue, Q. L., Simpson, C. F., Guralnik, J. M., & Fried, L. P. (2005). Frailty, hospitalization, and progression of disability in a cohort of disabled older women. The American journal of medicine, 118(11), 1225-1231.
Bukov, A., Maas, I., & Lampert, T. (2002). Social participation in very old age: Cross-sectional and longitudinal findings from BASE. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(6), P510-P517.
Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and personality psychology compass, 8(2), 58-72.
Camfield, L., & Skevington, S. M. (2008). On subjective well-being and quality of life. Journal of health psychology, 13(6), 764-775.
Cattan, M., Hogg, E., & Hardill, I. (2011). Improving quality of life in ageing populations: What can volunteering do?. Maturitas, 70(4), 328-332.
Cattan, M., Newell, C., Bond, J., & White, M. (2003). Alleviating social isolation and loneliness among older people. International Journal of Mental Health Promotion, 5(3), 20-30.
Chen, P. L., Tsai, Y. L., Lin, M. H., & Wang, J. (2018). Gender differences in health promotion behaviors and quality of life among community-dwelling elderly. Journal of women & aging, 30(3), 259-274.
Choi, N. G., & Kim, J. (2011). The effect of time volunteering and charitable donations in later life on psychological wellbeing. Ageing and society, 31(4), 590.
Choi, Y., Lee, K. S., Shin, J., Kwon, J. A., & Park, E. C. (2017). Effects of a change in social activity on quality of life among middle‐aged and elderly K oreans: Analysis of the K orean longitudinal study of aging (2006–2012). Geriatrics & gerontology international, 17(1), 132-141.
Cohen, S. (2004). Social relationships and health. American psychologist, 59(8), 676.
Cumming, E., & Henry, W. E. (1961). Growing old, the process of disengagement. Basic books.
Cunillera, O., Tresserras, R., Rajmil, L., Vilagut, G., Brugulat, P., Herdman, M., ... & Brazier, J. (2010). Discriminative capacity of the EQ-5D, SF-6D, and SF-12 as measures of health status in population health survey. Quality of Life Research, 19(6), 853-864.
De Vaus, D., Wells, Y., Kendig, H., & Quine, S. (2007). Does gradual retirement have better outcomes than abrupt retirement? Results from an Australian panel study. Ageing & Society, 27(5), 667-682.
Fiori, K. L., Brown, E. E., Cortina, K. S., & Antonucci, T. C. (2006). Locus of control as a mediator of the relationship between religiosity and life satisfaction: Age, race, and gender differences. Mental Health, Religion and Culture, 9(03), 239-263.
Mein, G., Martikainen, P., Hemingway, H., Stansfeld, S., & Marmot, M. (2003). Is retirement good or bad for mental and physical health functioning? Whitehall II longitudinal study of civil servants. Journal of Epidemiology & Community Health, 57(1), 46-49.
Gabriel, Z., & Bowling, A. (2004). Quality of life from the perspectives of older people. Ageing and Society, 24(5), 675-691.
Gillespie, A. A., Gottlieb, B. H., & Maitland, S. B. (2011). Goals and personal resources that contribute to the development and agency attachment of older adult volunteers. Canadian Journal on Aging/La Revue canadienne du vieillissement, 30(1), 101-111.
Glass, T. A., De Leon, C. F. M., Bassuk, S. S., & Berkman, L. F. (2006). Social
engagement and depressive symptoms in late life: longitudinal findings. Journal of aging and health, 18(4), 604-628.
Gottlieb, B. H., & Gillespie, A. A. (2008). Volunteerism, health, and civic engagement among older adults. Canadian Journal on Aging/La Revue canadienne du vieillissement, 27(4), 399-406.
Group, T. E. (1990). EuroQol-a new facility for the measurement of health-related quality of life. Health policy, 16(3), 199-208.
Hajek, A., Brettschneider, C., Mallon, T., Ernst, A., Mamone, S., Wiese, B., ... & Stein, J. (2017). The impact of social engagement on health-related quality of life and depressive symptoms in old age-evidence from a multicenter prospective cohort study in Germany. Health and quality of life outcomes, 15(1), 1-8.
Halvorsrud L, Kalfoss M: The conceptualization and measurement of quality of life in older adults: a review of empirical studies published during 1944-2006. EJA 2007; 4: 229-46.
Hao, Y. (2008). Productive activities and psychological well-being among older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(2), S64-S72.
Hsu, H. C. (2007). Does social participation by the elderly reduce mortality and cognitive impairment?. Aging & mental health, 11(6), 699-707.
Hsu, H. C., Liang, J., Luh, D. L., Chen, C. F., & Lin, L. J. (2019). Constructing Taiwan’s Active Aging Index and Applications for International Comparison. Social Indicators Research, 146(3), 727-756.
Huang, J. J., Wu, T. E. G., Chen, Y. C., Chiu, J. Y., Chou, P., & Chou, F. H. C. (2018). A preliminary report on psychiatric impairments and quality of life among Kaohsiung gas explosion victims 6 months after the event. Quality of life research, 27(3), 631-638.
Hyde, M., Wiggins, R. D., Higgs, P., & Blane, D. B. (2003). A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Aging & mental health, 7(3), 186-194.
Olesen, K., Rugulies, R., Rod, N. H., & Bonde, J. P. (2014). Does retirement reduce the risk of myocardial infarction? A prospective registry linkage study of 617 511 Danish workers. International journal of epidemiology, 43(1), 160-167.
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban health, 78(3), 458-467.
Kim, J. H., Lee, S. G., Kim, T. H., Choi, Y., Lee, Y., & Park, E. C. (2016). Influence of social engagement on mortality in Korea: analysis of the Korean longitudinal study of aging (2006–2012). Journal of Korean medical science, 31(7), 1020-1026.
Kim, S., & Feldman, D. C. (2000). Working in retirement: The antecedents of bridge employment and its consequences for quality of life in retirement. Academy of management Journal, 43(6), 1195-1210.
Klumb, P. L., & Baltes, M. M. (1999). Time use of old and very old Berliners: Productive and consumptive activities as functions of resources. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54(5), S271-S278.
Kondo, N. (2012). Socioeconomic disparities and health: impacts and pathways. Journal of Epidemiology, 22(1), 2-6.
Krägeloh, C. U., & Shepherd, G. S. (2015). Quality of life of community-dwelling retirement-aged New Zealanders: The effects of volunteering, income, and being part of a religious community. VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, 26(6), 2462-2478.
Krause, N., Herzog, A. R., & Baker, E. (1992). Providing support to others and well-being
in later life. Journal of gerontology, 47(5), P300-P311.
Lai, K. L., Tzeng, R. J., Wang, B. L., Lee, H. S., Amidon, R. L., & Kao, S. (2005). Health-related quality of life and health utility for the institutional elderly in Taiwan. Quality of Life Research, 14(4), 1169-1180.
Lam, C. L., Eileen, Y. Y., & Gandek, B. (2005). Is the standard SF-12 health survey valid and equivalent for a Chinese population?. Quality of life Research, 14(2), 539-547.
Lee, I. C., Chiu, Y. H., & Lee, C. Y. (2016). Exploration of the importance of geriatric frailty on health‐related quality of life. Psychogeriatrics, 16(6), 368-375.
Liang, Y. W., Hsieh, Y., Lin, Y. H., & Chen, W. Y. (2014). The impact of job stressors on health-related quality of life of nursing assistants in long-term care settings. Geriatric Nursing, 35(2), 114-119.
Lu, P., & Liang, Y. (2016). Health-related quality of life of young Chinese civil servants working in local government: comparison of SF-12 and EQ5D. Applied Research in Quality of Life, 11(4), 1445-1464.
Luoh, M. C., & Herzog, A. R. (2002). Individual consequences of volunteer and paid work in old age: Health and mortality. Journal of health and social behavior, 490-509.
Lum, T. Y., & Lightfoot, E. (2005). The effects of volunteering on the physical and mental health of older people. Research on aging, 27(1), 31-55.
MacKeigan, L. D., & Pathak, D. S. (1992). Overview of health-related quality-of-life measures. American journal of hospital pharmacy, 49(9), 2236-2245.
Maddox, G. L. (1963). Activity and morale: A longitudinal study of selected elderly subjects. Social forces, 42(2), 195-204.
Mahadeva, S., Wee, H. L., Goh, K. L., & Thumboo, J. (2009). The EQ-5D (Euroqol) is a valid generic instrument for measuring quality of life in patients with dyspepsia. BMC gastroenterology, 9(1), 20.
Maaravi, Y., Berry, E. M., Ginsberg, G., Cohen, A., & Stessman, J. (2000). Nutrition and quality of life in the aged: the Jerusalem 70-year olds longitudinal study. Aging (Milan, Italy), 12(3), 173-179.
McMunn, A., Nazroo, J., Wahrendorf, M., Breeze, E., & Zaninotto, P. (2009). Participation in socially-productive activities, reciprocity and wellbeing in later life: baseline results in England. Ageing and society, 29(5), 765-782.
Musick, M. A., Herzog, A. R., & House, J. S. (1999). Volunteering and mortality among older adults: Findings from a national sample. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54(3), S173-S180.
Narushima, M. (2005). 'Payback time': community volunteering among older adults as a transformative mechanism. Ageing and Society, 25, 567.
Park, H. K., Chun, S. Y., Choi, Y., Lee, S. Y., Kim, S. J., & Park, E. C. (2015). Effects of social activity on health-related quality of life according to age and gender: an observational study. Health and quality of life outcomes, 13(1), 140.
Piliavin, J. A., & Siegl, E. (2007). Health benefits of volunteering in the Wisconsin longitudinal study. Journal of Health and Social Behavior, 48(4), 450-464.
Rabin, R., & Charro, F. D. (2001). EQ-SD: a measure of health status from the EuroQol Group. Annals of medicine, 33(5), 337-343.
Parkinson, L., Warburton, J., Sibbritt, D., & Byles, J. (2010). Volunteering and older
women: Psychosocial and health predictors of participation. Aging and Mental Health, 14(8), 917-927.
Rietschlin, J. (1998). Voluntary association membership and psychological distress. Journal of health and social behavior, 348-355.
Rong, J. (2002). Perceived stress, learned resourcefulness, and adaptive functioning among older adults.
South, J., Meah, A., Bagnall, A. M., Kinsella, K., Branney, P., White, J., & Gamsu, M. (2010). People in Public Health–a study of approaches to develop and support people in public health roles.
Strain, L. A., Grabusic, C. C., Searle, M. S., & Dunn, N. J. (2002). Continuing and ceasing leisure activities in later life: A longitudinal study. The Gerontologist, 42(2), 217-223.
Sugihara, Y., Sugisawa, H., Shibata, H., & Harada, K. (2008). Productive roles, gender, and depressive symptoms: evidence from a national longitudinal study of late-middle-aged Japanese. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63(4), P227-P234.
Takagi, D., Kondo, K., & Kawachi, I. (2013). Social participation and mental health: moderating effects of gender, social role and rurality. BMC public health, 13(1), 701.
Tang, F., Choi, E., & Morrow-Howell, N. (2010). Organizational support and volunteering benefits for older adults. The Gerontologist, 50(5), 603-612.
Tang, F. (2016). Retirement patterns and their relationship to volunteering. Nonprofit and Voluntary Sector Quarterly, 45(5), 910-930.
Thoits, P. A., & Hewitt, L. N. (2001). Volunteer work and well-being. Journal of health and social behavior, 115-131.
Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of aging and health, 18(3), 359-384.
Tomioka, K., Kurumatani, N., & Hosoi, H. (2017). Positive and negative influences of social participation on physical and mental health among community-dwelling elderly aged 65–70 years: a cross-sectional study in Japan. BMC geriatrics, 17(1), 111.
Tung, H. H., Wei, J., & Chang, C. Y. (2007). Gender differences in quality of life for post coronary artery bypass grafting patients in Taiwan. The journal of nursing research: JNR, 15(4), 275-284.
Umberson, D., & Karas Montez, J. (2010). Social relationships and health: A flashpoint for health policy. Journal of health and social behavior, 51(1_suppl), S54-S66.
Unger, J. B., Johnson, C. A., & Marks, G. (1997). Functional decline in the elderly: evidence for direct and stress-buffering protective effects of social interactions and physical activity. Annals of Behavioral Medicine, 19(2), 152-160.
Uphoff, E. P., Pickett, K. E., Cabieses, B., Small, N., & Wright, J. (2013). A systematic review of the relationships between social capital and socioeconomic inequalities in health: a contribution to understanding the psychosocial pathway of health inequalities. International journal for equity in health, 12(1), 54.
Vanhoutte, B. (2012). Measuring subjective well-being: a review. CCSR Woking Paper.
Van Willigen, M. (2000). Differential benefits of volunteering across the life course. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55(5), S308-S318.
Vetta, F., Ronzoni, S., Taglieri, G., & Bollea, M. R. (1999). The impact of malnutrition on the quality of life in the elderly. Clinical nutrition, 18(5), 259-267.
Wanchai, A., & Phrompayak, D. (2019). A systematic review of factors influencing social participation of older adults. Pacific Rim International Journal of Nursing Research, 23(2), 131-141.
Wang, H. M., Beyer, M., Gensichen, J., & Gerlach, F. M. (2008). Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health, 8(1), 246.
Warburton, J. (2006). Volunteering in later life: Is it good for your health. Voluntary Action, 8(2), 3-15.
Ware JE, Kosinski M, Dewey JE, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Incorporated; 2001.
Ware, J. E., Kosinski, M., & Keller, S. D. (1998). How to score the SF-12 physical and mental health summary scales . Lincoln, RI: Quality Metric.
Ware, P., & Todd, M. J. (2002). British statutory sector partnerships with the voluntary sector: exploring rhetoric and reality. The Social Policy Journal, 1(3), 5-20.
Wilson, J., & Musick, M. A. (1999, June). Attachment to volunteering. In Sociological Forum (Vol. 14, No. 2, pp. 243-272). Kluwer Academic Publishers-Plenum Publishers.
World Health Organization. (2002). Active ageing: A policy framework (No.WHO/NMH/NPH/02.8). Geneva: World Health Organization.
Bortz, W. M. (2002). A conceptual framework of frailty: a review. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(5), M283-M288.
Zappalà, G. (2000). How many people volunteer in Australia and why do they do it?. Sydney, Australia: Smith Family.
Zhan, L. (1992). Quality of life: conceptual and measurement issues. Journal of Advanced Nursing, 17(7), 795-800.
厚生勞動省。(2014)。第10回中高年者縦断調査（中高年者の生活に関する継続調査）の概況。日本勞動厚生省報告。取自https://www.mhlw.go.jp/toukei/saikin/hw/judan/chukou15/
厚生勞動省。(2018)。第14回中高年者縦断調査（中高年者の生活に関する継続調査）の概況。日本勞動厚生省報告。取自https://www.mhlw.go.jp/toukei/saikin/hw/judan/chukou19/
呂寶靜。(1997)。台灣地區民眾從事老年準備之初探。社會工作學刊，(4)，27-53。
江亮演。(1992)。社區福利與志願服務。社區發展季刊，(57)，54-60。
李月萍、黃惠子。(2014)。老年生活品質概念與測量應用。台灣老年醫學暨老年學雜誌， 9(3)，57-67。
姚開屏。(2002a)。健康相關生活品質概念與測量原理之簡介。台灣醫學，6(2)， 183-192。
姚開屏。(2002b)。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6(2)，193-200。
姚開屏。(2005)。台灣版世界衛生組織生活品質問卷之發展及使用手冊。台北世界衛生組織生活品質問卷台灣版發展小組，台大心理系。
蔡承家、阮惠玉、陳依卿、劉秀華(2010)。社區老人的志願服務老人服務事業管理系會議論文，高齡志工與社區學習。
衛生福利部統計處。(2017)。106老人狀況調查。取自
https://dep.mohw.gov.tw/DOS/cp-1767-38429-113.html
盧瑞芬、曾旭民、蔡益堅。(2003)。國人生活品質評量(Ⅰ)：SF-36台灣版的發展及心理計量特質分析。台灣公共衛生雜誌，22(6)，501-511。