Persons In Thailand Research Articles

State of household need for caregivers and determinants of psychological burden among caregivers of older people in Thailand: An analysis from national surveys on older persons.

ObjectivesTo explore the levels and trends of household need for caregivers of older people and to explore the impact of potential determinants of psychological burden among caregivers of older people in Thailand.MethodsThe secondary data analysis was performed using the Survey of Older Persons in Thailand 2007, 2011, and 2014 datasets which conducted by the National Statistical Office of Thailand. The household need for caregivers of older persons refers to having at least one older person in the household who needs a caregiver for assistance with activities of daily living. Caregiver mental health, which is confined to the available 2011 data, is defined as a state of psychological burden. Ordinal logistic regression models were used to explore the impact of potential determinants of psychological caregiver burden.ResultsThe household need for caregivers in Thailand tends to be increasing, from 5.0% in 2007 to 6.6% in 2014. The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households. In terms of psychological caregiver burden, the Thai Mental Health Indicators in 2011 produced, on average, a fair level of mental health, but one-fourth of caregivers had poor mental health. Duration of care for older people, household wealth, and functional dependency significantly predict total caregiver burden. Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high (odds ratio = 2.34; 95% confidence interval = 1.47–3.73).ConclusionThe increasing need for caregiving in households with an older person can lead to a higher caregiver burden, particularly among those caregivers who care for dependent older people in poor households. Longer duration of caregiving is a factor that mitigates this burden.

Health Utility Scores of Hearing-Impaired Thais

Objective: To assess the health utility scores of Thais with hearing loss, which can be used as a reference value for assessing health-related quality of life and economic evaluations in any interventions among hearing-impaired persons in Thailand. Material and Methods: All hearing-impaired persons who visited Songklanagarind Hospital between January and June 2019 were recruited for the study. The demographic and clinical data of the participants including gender, age, and type and degree of hearing loss were collected. A health-related quality of life interview was conducted using the EuroQoL five-dimensional questionnaire, Thai version. Independent t-test and multiple linear regression analysis were performed to assess which factors were associated independently with the health utility scores. Results: One hundred and eleven participants, 46 males and 65 females, ranging in age from 22 to 92 years, were recruited for the study. The average health utility scores were 0.81 and 0.86 for subjects not using and using hearing aids, respectively, similar to the results from other nations. The average health utility score of subjects with underlying diseases (0.79) was lower than the average health utility score of subjects without underlying diseases (0.87) with statistical significance (p-value=0.038). Additionally, the pure tone average in the better ear was the only variable significantly associated with the health utility scores (regression coefficient: -0.004, p-value=0.002). Conclusion: The average health utility scores among hearing-impaired Thais were 0.81 and 0.86 for subjects not using and using hearing aids, respectively.

Rural-urban gaps in health care utilization among older Thais: The role of family support

This study examined rural-urban differences in health visits among older Thais utilizing Andersen’s model. Data were drawn from the 2011 Survey of Older Persons in Thailand of adults 50 years and older (N = 56,435). Logistic regression models examine individuals’ predisposing, enabling, and health need factors for explaining older adults’ health care use. Approximately 50% of older adults sought health care but urban dwellers were more likely than rural dwellers to seek health care (54.8% vs. 49.7%). Predisposing factors and health needs narrow the rural-urban gap while enabling factors widened the gap in health visits. The receipt of financial support from children presented a significant moderating effect in the rural-urban divide of health care use. Despite Thailand’s universal access to health care, geographic inequity in health care utilization withstands. Findings suggest investments in education, income security, social participation, and healthy lifestyle promotion can improve health care utilization. Furthermore, results suggest a need for continued investigation of the role of family support in bridging the rural-urban divide in the health of older Thais.

Caring for Thai Older Persons With Long-Term Care Needs.

To provide a situation analysis of recent long-term care (LTC) needs among older persons in Thailand. The 2014 Survey of Older Persons in Thailand (SOPT) provides data to assess patterns of caregiving, whether care needs are met, and who are main caregivers for older Thais. We examine how types of familial and nonfamilial caregivers are associated with the well-being of older persons. The need for LTC increases sharply with age and is more common among women than men. Spouses and children constitute approximately 90% of main caregivers. The association of a family member as the main caregiver and education or value of assets is quite weak underscoring the general normative prescription for family members to serve as care providers. Thailand is experiencing acute population aging but empirical evidence to support LTC needs remains lacking. This analysis helps close the gap.

Health prospects of older persons in Thailand: the role of education

ABSTRACTThailand’s population is aging rapidly and the number of older adults suffering from health limitations is expected to increase. Making use of several rounds of the Survey of Older Persons, we look at the education-specific prevalences of three health indicators over time and find a positive education gradient for difficulties with ADLs and poor self-rated health, but not for functional limitations. Combining these age-, sex- and education-specific prevalences for each indicator with population projections up to 2050, we see a lower projected number of persons with difficulties with ADLs or bad health as compared to an approach when we only account for differences by age and sex. Still, irrespective of the approach taken, we project a significant increase in the number of persons 50+ that have at least one ADL difficulty, at least one functional limitation or suffer from poor health. Our results provide estimates for future care needs and illustrate the possibly preventive effect of education.

Healthy behaviours and productive activities among Thai older adults: A repeated cross-sectional analysis

Based on a nationally representative repeated cross-sectional sample of older individuals from the 2007 and 2011 Surveys of Older Persons in Thailand (n = 50,138, with the participation rate of 95.79%), this study investigates the extent to which healthy behaviours are interrelated with productive activities in old age. Healthy behaviours were represented by alcohol abstinence, tobacco abstinence, physical exercise, and consumption of a nutritious diet, encompassing all major lifestyle choices that could lower mortality risks among the general population. Productive activities were represented by social participation and labour participation, consistent with the paradigms of Active and Productive Ageing promoted by the World Health Organization. A multivariate probit model, whereby all six behaviours were jointly estimated, was explored. Conditional on pairwise combinations of the two productive activities, the probabilities of contemporaneously undertaking all four healthy behaviours were calculated. The results illustrate that the relationships among productive activities and health behaviours are inextricable and complex. Considering each of the four healthy behaviours separately, social participation and labour participation are associated with lower probabilities of abstaining from alcohol and tobacco but higher probabilities of exercising and keeping a nutritious diet among older adults. Considering all four healthy behaviours together, the productive activities are associated with a significant increase in the probability that a Thai older adult would simultaneously abstain from alcohol, abstain from tobacco, exercise, and eat healthily, compared to if the same individual undertakes neither social participation nor labour participation. This study calls for a consistent set of multiple-behaviour interventions to promote healthy and productive ageing.

Parental status and psychological distress among older Thais

This study examines whether childless older Thais are more vulnerable to psychological distress relative to older adults with children. Drawing from the 2011 Survey of Older Persons in Thailand (n = 37,936), zero‐inflated negative binomial regression methods examine psychological distress of childless older adults relative to coresident and noncoresident parents. Analyses further explore how gender and marital status moderate this relationship. Results show that 40% of older Thais did not experience any symptoms of psychological distress in the past month. Compared to coresident parents, noncoresident parents showed a higher likelihood of experiencing psychological distress but being childless was associated with increased symptoms of psychological distress. While the relationship between parental status and psychological distress did not significantly differ by gender, marital status presents a significant moderating effect. Specifically, widowed childless older adults and widowed noncoresident parents experienced more symptoms of psychological distress relative to their married counterparts. In collectivistic societies, where the family unit is highly valued, and institutional support is weak, being childless and unmarried may negatively affect one's psychological well‐being in later life. Children and marriage are protective for older Thais’ psychological well‐being. The implications for social welfare policies are discussed.

Providing regular care for grandchildren in Thailand: An analysis of the impact on grandparents’ health

One of the many roles of grandparents is the role as caretaker for their grandchildren. Studies looking into the situation of older adults providing care for their grandchildren have found that care responsibilities can have beneficial effects but can also pose challenges to those providing it, depending on individual and societal circumstances. The objective of our study is to shed light on the health effects of providing care for grandchildren younger than 10 years of age on grandparents. Whether this experience has positive or negative effects on the caretaker's health depends on a range of factors that we explore here in the context of Thailand.The study is based on the quantitative analysis of the 2011 round of the National Survey of Older Persons in Thailand. In order to control for endogeneity between health status and the provision of care, we apply several instrumental variable (IV) approaches in addition to regular regressions. In terms of health status, we make use of four health-related variables: self-reported health status, functional limitations, happiness level and information about negative feelings. The observed positive impact of grandparenting on three health outcomes that we find with non-endogeneity-controlled OLS analyses is likely due to reverse causality or self-selection into becoming a grandparent who provides care. The unbiased results imply that regularly taking care of young grandchildren does not provide any physical health benefits; to the contrary, it seems to have a negative impact on self-rated health, functional limitations and psychological well-being, supporting the role strain theory.

Memory and the Reporting of Remittance in a Sample of Elderly Persons in Thailand

Accurate reporting of sources of income is needed in studies of intergenerational transfers and welfare of the elderly. The objective of this paper is to investigate how memory in the elderly is related to the reporting of remittances received from their children in Thailand. Using data from a longitudinal study of 1036 persons age 60 to 93 in a province in Thailand, the influence of a word recall (verbal learning and recall), and nickname recall (verbal learning and recall) on reporting of remittance was assessed. Initially, both measures were positively and significantly related to the reporting of remittance. The results remained significant only for the nickname task after controlling for education, wealth, living arrangements and disability. The results highlight the importance of cognitive issues in the quality of data and the need for attention to memory in questionnaire design.

Active Ageing Level of Older Persons: Regional Comparison in Thailand.

Active ageing level and its discrepancy in different regions (Bangkok, Central, North, Northeast, and South) of Thailand have been examined for prioritizing the policy agenda to be implemented. Attempt has been made to test preliminary active ageing models for Thai older persons and hence active ageing index (AAI, ranges from 0 to 1) has been estimated. Using nationally representative data and confirmatory factor analysis approach, this study justified active ageing models for female and male older persons in Thailand. Results revealed that active ageing level of Thai older persons is not high (mean AAIs for female and male older persons are 0.64 and 0.61, resp., and those are significantly different (p < 0.001)). Mean AAI in Central region is lower than North, Northeast, and South regions but there is no significant difference in the latter three regions of Thailand. Special emphasis should be given to Central region and policy should be undertaken for increasing active ageing level. Implementation of an Integrated Active Ageing Package (IAAP), containing policies for older persons to improve their health and economic security, to promote participation in social groups and longer working lives, and to arrange learning programs, would be helpful for increasing older persons' active ageing level in Thailand.

The relationship between upstream intergenerational transfers and wealth of older adults: evidence from Thailand

This paper examines the relationship between the wealth of older parents and the receipt of in-kind and monetary transfers from non-resident adult children. Based on a nationally representative sample from the 2007 and 2011 Surveys of Older Persons in Thailand (N = 46,216), a sample-selected bivariate ordered probit model is employed. Different measures of wealth are explored, including home ownership, income and savings. The results show that the relationships between each measure of wealth and the receipt of in-kind as well as monetary transfers are positive and statistically significant. Nonlinearities are observed with regard to income but not home ownership and savings. The fact that wealthier parents receive larger transfers implies that, to promote old-age financial security, the government should not only devise a strategy to incentivise adult children to make larger upstream transfers, but also target and provide additional support for financially vulnerable older adults.

How Much Do Student Loan Sizes Affect Returns on Tertiary Education for Thai Persons with Disabilities?

This paper is motivated by the fact that there were about 1.5 million disabled persons in Thailand in 2011. A year later, 234,390 of them had died; many of the deaths were premature. The major causes of their deaths could be traced back to deprived socioeconomic conditions. At present, registered disabled persons are entitled to a monthly payment of 500 Baht (17 USD), and have access to low cost medical services. It is inevitable that a new initiative is needed to promote better quality of life. Access to tertiary education is one of the viable options. Disabled persons are usually credit constrained; access to sufficient student loans is, therefore, a pre-requisite to access tertiary education. Using a unique health literacy data set of Thai persons with disabilities, this paper examines how different student loan sizes affect returns on tertiary education. Propensity Score Matching is used to estimate the differences in the log of earnings between disabled persons with tertiary degrees, and disabled persons with basic education qualifications. A subsequent exercise on the effects of different loan sizes is conducted using the Thai Student Loans Fund (SLF) arrangement. The exercise reveals that rates of returns do not vary significantly with loan sizes. These findings suggest that promoting greater access to tertiary education for disabled persons will be beneficial to individuals, as well as the society at large. Supplementary in-depth interviews highlight the importance of post-graduation placement services.

Associations between social inequality and tooth loss in a household sample of elderly Thai people aged ≥60 years old.

To assess the relationship between social inequality and the number of remaining teeth in an elderly Thai population. Having twenty or more remaining teeth is an important indicator of optimal oral health in the elderly. The data for this study were derived from the Survey of Older Persons in Thailand, conducted by the National Statistical Office, based on face-to-face interviews with people aged ≥60. The total sample was 30 427. The oral health measure was self-reported remaining number of teeth. Income, education and possession of durable goods were utilised as measures of social inequality. More than half of the sample (57.0%) was women. The majority (73.2%) was in the age range 60-74 years old. Less than a fifth (15.5%) had 7 or more years of education. A third earned <20 000 Thai Baht (THB) per annum (defined as poor). More than half (52.8%) of the sample had <20 remaining teeth. There was a link between social inequalities and tooth loss. In the adjusted model, elderly people, who were older than 75, who were not under a married status, had a lower level of education, had a lower income, and who did not own luxury goods, were 2.84 (CI 95% 2.66-3.03), 1.31 (CI 95% 1.21-1.41), 1.44 (CI 95% 1.34-1.56), 1.12 (CI 95% 1.13-1.29) and 1.21 (CI 95% 1.13-1.29) times more likely to have 19 or fewer teeth remaining, respectively. Social inequality is related to the number of remaining teeth in elderly Thai people.

New insights from the 7th World Melioidosis Congress 2013.

New insights from the 7th World Melioidosis Congress 2013.

Field evaluation of a real-time fluorescence loop-mediated isothermal amplification assay, RealAmp, for the diagnosis of malaria in Thailand and India.

To eliminate malaria, surveillance for submicroscopic infections is needed. Molecular methods can detect submicroscopic infections but have not hitherto been amenable to implementation in surveillance programs. A portable loop-mediated isothermal amplification assay called RealAmp was assessed in 2 areas of low malaria transmission. RealAmp was evaluated in 141 patients from health clinics in India (passive surveillance) and in 127 asymptomatic persons in Thailand (active surveillance). The diagnostic validity, precision, and predictive value of RealAmp were determined using polymerase chain reaction (PCR) as the reference method. A pilot study of RealAmp was also performed on samples from patients presenting at a Thai health center. A total of 96 and 7 positive cases were detected in India and Thailand, respectively, via PCR. In comparison with nested PCR, the sensitivity and specificity of RealAmp in India were 94.8% (95% confidence interval [CI], 88.3%-98.3%) and 100% (95% CI, 92.1%-100%), respectively, with correct identification of all 5 Plasmodium vivax cases. In Thailand, compared with pooled real-time PCR, RealAmp demonstrated 100% sensitivity (95% CI, 59.0%-100%) and 96.7% specificity (95% CI, 91.7%-99.1%). Testing at the health center demonstrated RealAmp's potential to serve as a point-of-care test with results available in 30-75 minutes. RealAmp was comparable to PCR in detecting malaria parasites and shows promise as a tool to detect submicroscopic infections in malaria control and elimination programs worldwide.

Inter‐generational family care for and by older people in Thailand

PurposeThe purpose of this study is to examine inter‐generational arrangements in Thailand for personal care provided to older members and provided by them as grandparents to young children.Design/methodology/approachResults are based on analysis of the 2007 Survey of Older Persons in Thailand. Consideration focuses on persons aged 60 and older.FindingsThe results document the primary role of the family, especially adult children and spouses, in providing personal care to older members. For those with only one or two adult children compared to those with four or more, spouses are considerably more likely and children less likely to be the main care provider. At the same time, older family members, as grandparents, make significant contributions to the care of young children, especially for those whose parents migrated. In most such situations, however, the grandchild's parents cover the main financial support.Social implicationsTrends towards smaller family size and increased migration of adult children have already contributed to a steady decline in coresidence with adult children and increased proportions of older persons living alone or only with a spouse. How this will affect elder and grandchild care requires careful monitoring to guide social policy in relation to the roles of family, state, and voluntary sector.Originality/valueThe availability of representative data on the older population in Thailand provides an unusual opportunity to highlight the challenges posed by the changing demographic context of inter‐generational family care in a context of rapid population ageing in a developing country setting.

Impact of children's migration on health and health care-seeking behavior of elderly left behind.

BackgroundMany countries are facing the burden of accelerated population aging and a lack of institutional support to meet the needs of older individuals. In developing countries, adult children are primarily responsible for the care of their elderly parents. However, out-migration of adult children is common in these countries. This study aims to explore the impact of migration on the health of the elderly left behind and their health care-seeking behavior.MethodsThis paper uses data from a national survey of older persons in Thailand conducted in 2007. The analysis is confined to those who were aged 60 years or above and who had at least one child (biological or step/adopted) (n = 28,677). Logistic regression was used to assess the net effect of migration of adult children on the health of the elderly left behind and their health care-seeking behavior, after controlling for other socio-demographic and economic variables.ResultsMore than two-thirds of the elderly (67%) had at least one migrant child. About three-fifths (58%) reported that they had at least one symptom of poor mental health. Almost three in five elderly (56%) rated their health as poor, and 44% had experienced at least one chronic disease. About two-thirds of the elderly (65%) got sick during the 5 years preceding the survey. An overwhelming majority of elderly (88%) who got sick during the five years preceding the survey had sought treatment for their last illness.After controlling for socio-demographic and economic variables, our study found that those elderly who had a migrant child were more likely (OR = 1.10; 95% CI 1.05-1.17) to have symptoms of poor mental health than those whose children had not migrated. However, no significant association was observed among physical health, such as experience of chronic disease, perceived poor health, and illness of the elderly left behind. Interestingly, however, out-migration of adult children was independently associated with higher utilization of health services. The elderly who had migrant children were more likely (odds ratio = 1.22, CI 1.11-1.33) than those whose children had not migrated to seek treatment for their most recent illness, after controlling for socio-demographic and economic variables.ConclusionOur study provides novel evidence on an issue of special importance to countries affected by heavy out-migration of adult children, an issue that has received little attention. Out-migration of adult children was highly associated with poor mental health but it was not associated with the physical health of the elderly left behind. Out-migration of children was also highly associated with higher utilization of health facilities by the elderly. Thus, in order to decrease morbidity among the elderly as well as to maintain and enhance the well-being of families, programs should focus on alleviating the symptoms of poor mental health among the elderly left behind and aim to reduce the differences in utilization of health care-seeking behavior among elderly with children present in the community and elderly left behind.

HIV Prevalence, Risk Behavior, Hormone Use and Surgical History Among Transgender Persons in Thailand

While Male-to-female transgender persons (TG) are believed to often engage in sex work and have high HIV infection risk, little is known about demographics, surgical and hormone use history, risk behaviors and HIV prevalence. Between March and October 2005, 474 TG from Bangkok, Chiangmai, and Phuket were surveyed using venue-day-time sampling. Of 474 participants, overall HIV prevalence was 13.5%. Most participants had completed at least secondary or vocational education (79.2%), gender self-identified as female (89.0%), had received money, gifts or valuables for sex (60.8%), and reported hormone use (88.6%). Surgical history was taken from 325 participants. Of these, 68.6% reported some form of surgery and 11.1% had undergone penile-vaginal reconstructive surgery. In multivariate analysis, being recruited from a park/street; older age, anal sex role identification as "versatile" and anal sex debut before age 13 were independently associated with HIV prevalence. The development, implementation and evaluation of culturally appropriate sexual health interventions for Thai TG is urgently needed.

Immunologic Markers as Predictors of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome in HIV and Tuberculosis Coinfected Persons in Thailand

This study analyzes immunologic markers to predict and diagnose tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in HIV and TB coinfected adults who initiated antiretroviral therapy (ART) in Thailand. T helper 1 cytokines interleukin (IL)-2, IL-12, and interferon-gamma (IFN-gamma) levels in response to PPD and RD1 antigens were assessed prior to ART, at weeks 6, 12, and 24 of treatment, and at time of TB-IRIS. Of 126 subjects, 22 (17.5%) developed TB-IRIS; 14 (64%) subjects received steroid treatment and 3 (14%) received NSAIDs; none of the subjects died. Median interval between ART initiation and TB-IRIS development was 14 days. IFN-gamma, IL-2, and IL-12 responses did not differ between TB-IRIS and no TB-IRIS subjects (p > 0.05). More research into the immunopathogenesis of TB-IRIS and diagnostic potential of cytokine markers is warranted.

Older Persons in Thailand: A Demographic, Social and Economic Profile

Population aging is proceeding at a rapid pace in Thailand posing important challenges for the government and society as a whole. On the positive side, the material well-being of older persons in Thailand has been improving. Older Thais live in better quality houses with far more appliances and amenities compared to a decades or two ago. The recent spread of telephones improves their ability to maintain contact with children and relatives who live elsewhere. Still, a large rural and urban gap in material well-being remains. Also of concern, given current widespread reliance on children for material support, is that future elderly will have far fewer children to depend on. Hopefully efforts by family and state will complement each other and allow Thailand to adapt constructively to the inevitable ageing of its population.