目的：探討台灣地區老人的罹病嚴重度、自覺健康及社會支持與憂鬱之關係，並探討工具性社會支持與情感性社會支持的角色。方法：參與本研究之對象為台灣省家庭計畫研究所於1989年調查中所抽樣之4049位老人樣本，過去曾於1993年、1996年，陸續進行二次追蹤調查，本研究乃於2002年再度調查，共完成訪問2,125人。在調查問卷中，以罹病嚴重度、自覺健康、社會支持、憂鬱程度等四種量表為測量工具，進行面訪。結果：以憂鬱程度為依變項之階層回歸分析發現，罹病嚴重度、自覺健康、工具性社會支持、情感性社會支持，都可直接預測憂鬱程度；但罹病嚴重度與工具性社會支持產生交互作用而影響憂鬱程度。2.進一步將罹病嚴重度分為高、低分組，再以憂鬱程度為依變項進行階層回歸分析，結果顯示，針對罹病嚴重度高分組而言，工具性社會支持愈多，憂鬱程度愈高；針對罹病嚴重度低分組而言，則工具性社會支持不能顯著預測憂鬱程度。結論：對台灣地區的老人而言，自覺健康與情感性社會支持直接影響憂鬱程度；而工具性社會支持對憂鬱程度的影響，會因罹病嚴重度高低而有所不同。

　　Objectives: The study was designed to exam the relationships of the severity of chronic disease, perceived health, and social support to depression as well as the differential roles of instrumental and social support among the elderly in Taiwan .
　　Subjects: During 2002,we conducted a cross-sectional survey by interview in a random sample of 4049 elderly subjects enrolled in 1989 and followed up in 1993 and 1996. The present study successfully completed the follow up of 2125 subjects.
　　Results: The results illustrated, (1) with depression as dependent variable, by performing hierarchical regression analyses, severity of chronic disease, perceived health , affective social support would directly predict the level of depression. However , the interaction between the severity of chronic disease and instrumental social support would influence the degree of depression. (2) Furthermore, we separate the subjects by severity of chronic disease into high and low groups, and performed hierarchical regression analyses again. The results showed that as to the group with high chronic disease, the more instrumental social support and the higher degree of depression. Regarding the group with lower severity of chronic disease, instrumental social support would not significantly predict the level of depression.
　　Conclusions: The results of the present study suggested that perceived health and affective social support directly influenced the degree of depression but the severity of chronic disease would buffer the impact
of the instrumental social support on depression among the elderly in Taiwan .

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