Thai Elders Research Articles

Does social participation make Thai psychologically abused elders happier? a stress-buffering effect hypothesis

ABSTRACT This study investigates the influence of psychological elder abuse on life satisfaction levels in Thailand. This study also analyses the stress-buffering effect of social participation on the life satisfaction levels of Thai mentally abused elderly. Elder abuse has been proven to dramatically reduce Thai elders’ levels of life satisfaction as their function in society shrinks owing to ageism. As a result, individuals are more likely to lose their independence and status and be forced to rely on others, increasing the danger of abuse. Elder abuse has a more significant negative impact on life satisfaction levels among Thai older women. Nonetheless, the mentally abused elderly who participate in social activities are happier than those who do not. Thai elders who live with their daughters are more satisfied in life than those who do not, but living with adult offspring does not assist psychologically abused elders in escaping their psychological suffering.

Home-based end-of-life care for Thai elders: Family caregivers’ perspectives

Home-based end-of-life care for Thai elders: Family caregivers’ perspectives

The Factors of the Holistic Health Status of Thai Elders in the 21st Century

Holistic health is important for life, perhaps especially for elders. Focus should not only be placed on illness or the physical part of their lives, but the person as a whole should also be considered, emphasizing the connection of their mind, body, and the environment. ; Objective: The aims of this research were to study the factors of the Holistic Health Status (HHS) of the Thai elderly in the 21st century, and to predict the factors affecting the development of HHS from 3 aspects; physical health status, mental and emotional health status, and the social and environmental health status. ; Methods: The data were collected from 928 Thai elderly aged 60 and over in the central part of Thailand. The research instrument was a questionnaire whose reliability was confirmed using a Cronbach alpha coefficient of .904. Multiple regression analysis was used for predicting the factors of HHS. ; Results: The results indicated that stress, increased age, gender, and social participation can predict the HHS of Thai elders, and stress can predict each of the 3 aspects. Therefore, stress prevention activities are very important for enhancing the HHS of Thai elders. ; Conclusion: The findings of this research can be used to improve the quality of life of elders in the 21st century.

Thai Elder Abuse Problems and Prevention

The present qualitative research aimed to study: 1) the nature of abuse experienced by Thai elders, 2) the causes of elder abuse, and 3) the prevention of elder abuse. The key informants were the Thai elders and directors of 9 Social Welfare Development Centers for Older Persons and old age homes in Buriram, Chiang Mai, Nakhon Pathom, Pathum Thani, Chonburi, Lopburi, Bangkok, Kanchanaburi, and Phra Nakhon Si Ayutthaya. The in-depth interview technique was applied to collect data. The results suggested that the abuse of older people in Thailand could be categorized into 4 main groups, which were neglect, financial abuse, verbal abuse, and physical assault. The occurrence of elder abuse resulted from the individual factors of elders and abusers such as sons and daughters, sons-in-law, husband’s brothers, and grandchildren. The preventive measures to reduce elder abuse included driving Thai local administrative organizations to play a role in caring the elderly in each community, formulating a specific law on elder abuse, strictly complying with the elder abuse law, and encouraging community volunteers such as care-forthe- elderly-at-home volunteers and village health volunteers to pay attention to and look out for the elderly in communities.

Hearing and Balance Survey in Thai Elders

Objective: To survey hearing and balance problems of a sampling group of Thai elders in the central region of Thailand. Methods: A population study was people aged 60 and over who agreed to join the survey at the 14 elderly social associations. The questionnaires were used as a self-report for hearing and balance problems. After ears examination by ENT specialists, the participants underwent air-conduction audiometry for hearing screening. Results: 828 participants (259 (31.3%) males and 569 (68.7%) females, age ranged from 60 to 97 (median=68, mean ± SD = 69.65 ± 6.89 years), had completed screening program for hearing and balance problems using both questionnaires and examinations. There was a statistically significant correlation between self-report hearing loss and severe or profound hearing loss in both ears (P 70 years old especially in those with underlying diseases. Hearing and balance screening will provide early detection and primary intervention to minimize the negative impact in the elderly’s daily life.

HEALTH LITERACY AMONG THAI ELDERLY POPULATION WITH TYPE-2 DIABETES LIVING IN RURAL AREA OF THAILAND

Background: According to the World Health Organization, health literacy represents the cognitive and social skills, which determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health with positive impact on health outcome. Objective: This study aimed to describe the situation of health literacy among Thai elders with type-2 diabetes in a rural Thai community. Methods: We conducted this mix-method study including quantitative and qualitative research approach was used through validated and reliable questionnaire adapted from Ishikawa. We did purposive sampling of 277 participants for quantitative, and conducted 12 in-depth interviews. Study was ethically approved from Chulalongkorn University Thailand. Results: The average age of the participants was 68.62 years. The majority of them had income less than 5,001 Bath, and highest education level at elementary school. Most of them had been diagnosed with DM more than one year (ranged 1-56 years, average 10.05 years). The respondents had fair overall health literacy. Upon consideration as an aspect basis, the mean score of functional health literacy was 3.07 from 4.00, the interactive health literacy was 2.28, and the critical health literacy was 2.41. From the perspective of patients and caregivers, most patients received health-related information from public health officials. They do not like to talk to other diabetes patients about their diabetes. Most patients wanted to have someone who was willing to listen to their problem and help them solve it. Conclusion: Study has concluded that the health literacy among Thai population suffering with diabetes was very poor and not found as per standards that need to be intervened.

Effects of a Physical Activity and Brain Exercise Program on Cognitive Ability of Healthy Thai Elders

This study used a quasi-experimental single-group time series design to compare the effects of a physical activity and brain exercise program on the cognitive ability of healthy Thai elders. It was conducted from December 2015 to May 2016. A purposive sample of 23 people of over 60 years of age was used. The research instruments consisted of 1) the Mini-Mental State Examination Thai 2002 (MMSE-Thai 2002), 2) the Montreal Cognitive Assessment (MoCA, Thai version), and 3) the physical activity and brain exercise program devised for this research. The program components were validated and reviewed by 3 experts and yielded a content validity index (CVI) of 0.96. Participants attended the program 8 times (3 h each) over 5 consecutive weeks. Subsequently, participant follow-up progress reviews were done in weeks 10, 14, and 18. Data were analyzed using descriptive statistics and ANOVA with Wilcoxon matched-pairs signed-rank test and repeated measures ANOVA. Results revealed that the average score for cognitive ability (Mental State and cognitive function) in weeks 10 and 14 and at follow-up in week 18 were statistically significantly higher (p < .05) than the baseline. Recommendation: the physical activity and brain exercise program could improve cognitive ability and should be included in health promoting activities in elders’ clubs or senior schools in the future.

Views and Expectations of Community-Dwelling Thai Elderly in Reporting Falls to Their Primary Care Physicians.

Fall among older adults is a concern in Thailand. The challenge for primary care physicians is to deliver effective interventions potentially adhered to by older people. This research employed a mixed-methods design to understand factors leading to fall reporting by community-dwelling Thai elders and their expectations regarding fall prevention education. Participants ( N = 305) who had fallen in the last year completed a questionnaire in the quantitative phase, and 50 of these were interviewed in-depth in the qualitative phase. Results revealed that only 39% reported their fall. Participants with comorbidities were 1.6 times more likely to report falling than those without (odds ratio = 1.61, confidence interval = [1.01, 2.58]). Post-fall pain (84%) was the strongest reason for reporting. Some participants believed that falling is an inevitable life event. It is crucial to encourage older adults to report falling, to provide targeted education, and to focus on improving the overall health status of older adults.

How do living arrangements and intergenerational support matter for psychological health of elderly parents? Evidence from Myanmar, Vietnam, and Thailand

Living arrangements and family support for older persons have become an increasingly important policy concern in developing and rapidly aging Asia. Formulating a sound elderly care policy for the region will benefit from empirically examining how living arrangements, particularly coresidence, and intergenerational exchanges of financial, instrumental, and emotional support are associated with old-age psychological health. This study analyzes data from nationally representative aging surveys in Myanmar, Vietnam, and Thailand for 2011–2012 to offer a comparative perspective from Southeast Asia where various kinship systems coexist. Results suggest that coresidence with a child of culturally preferred gender significantly improves the emotional health of Vietnamese and Thai elders but with different implications. In Vietnam, living with a married son is more beneficial to parents' psychological wellbeing than living with other children. In Thailand, coresidence regardless of the child's gender improves old-age psychological wellbeing but living with a daughter brings greater benefits than living only with son. Evidence points to the importance of understanding the dominant kinship system that may shape normative filial expectations and gender role expectations within the family. In Vietnam and Thailand, the positive association holds even after intergenerational support is controlled, suggesting that the value of culturally preferred coresidence goes beyond practical functions. In Myanmar, there are almost no significant differences in psychological wellbeing among elderly across various living arrangements, except between coresidence and network living arrangements. For all settings, we do not find evidence in support of network family arrangements as a complete substitute for coresidence in terms of promoting old-age psychological wellbeing after filial support is controlled. Our study highlights important cultural nuances for theorizing the nature of the relationship between living arrangements and old-age psychological health, and presents the important need for more rigorous investigation of the causal links between these two phenomena in future research.

The effect of asset-based wealth inequality on problem drinking among rural Thai elders: A prospective population-based cohort study

Evidence on the link between income inequality and alcohol-related problems is scarce, inconclusive and dominated by studies from the developed world. The use of income as a proxy measure for wealth is also questionable, particularly in developing countries. The goal of the present study is to explore the contextual influence of asset-based wealth inequality on problem drinking among Thai older adults. A population-based cohort study with a one-year follow-up was nested in a Demographic Surveillance System (DSS) of 100 villages in western Thailand. Data were drawn from a random sample of 1104 older residents, aged 60 or over (one per household) drawn from all 100 villages, of whom 982 (89%) provided problem drinking data at follow-up. The primary outcome measure was a validated Thai version of the Alcohol-Used Disorder Identification Test for problem drinking. Living in areas of high wealth inequality was prospectively associated with a greater risk for problem drinking among older people (adjusted odds ratio 2.30, 95% confidence intervals 1.02–5.22), after adjusting for individual-level and village-level factors. A rise in wealth inequality over the year was also independently associated with an increased risk of problem drinking (adjusted odds ratio 2.89, 95% confidence intervals 1.24–6.65). The associations were not explained by the social capital, status anxiety or psychosocial stress variables. The data suggest that wealth inequality and an increase in inequality across time lead to a greater risk of problem drinking. Efforts should be directed towards reducing gaps and preventing large jumps in inequality in the communities. Further research should investigate the effect of asset-based inequality on various health risk behaviors and its specific mediating pathways.

Effectiveness of a behavior modification program for older people with uncontrolled Type 2 Diabetes

This quasi-experimental study examined the effectiveness of a behavior modification program for diabetic control in Thai elders with uncontrolled Type 2 Diabetes. Purposive sampling was used to select 30 elders from one community as an intervention group, and 30 from a neighboring community as a control group. The intervention group participated in a program of 12 weeks' duration involving activities related to group counseling, group discussion, and an empowerment process that enhanced appropriate consumption of healthy diet, medication taking, and exercise. Data were collected by interviews using a questionnaire to assess knowledge of diabetes, perceived self-efficacy, and diabetes control behavior, including fasting blood glucose and glycosylated hemoglobin, were examined at the baseline and three months thereafter. At program completion, the intervention group had significantly higher scores of knowledge, self-efficacy, and health behaviors than those in the control group, but blood glucose and glycosylated hemoglobin were not significantly different. Although nurses can use aspects of this program to benefit elders with diabetes who require support and education, further research is required to provide improved health outcomes such as better glycemic control.

The dementia and disability project in Thai elderly: rational, design, methodology and early results

BackgroundA strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly.MethodsThe Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004–2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline.ResultsThe mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap (indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white matter lesions.ConclusionThe large and comprehensive set of measurements in DDP allows a wide-ranging explanation of the functional and clinical features to be investigated in relation to white matter lesions or cortical atrophy of the brain in Thai elderly population. An almost 2 year follow up was made available to those with MCI and dementia and some of the cognitively normal elderly. The longitudinal design will provide great understanding of the possible contributors to disability in the elderly and to the progression of cognitive decline in Thai elders.

The relationships among family, friends, and psychological well-being for Thai elderly

Objectives: The extent to which family and friends contribute to psychological well-being (PWB) may be subject to cultural variability. This study examines the mechanisms by which relationships with family and friends contribute to PWB among Thai elders. Method: Interviews were conducted with 469 men and women aged 60 and older in Nan Province, Thailand. The data were analyzed using structural equation modeling, controlling for age, gender, education, income, marital status, and health status. Results: Family and friendship networks have a significant direct effect on family and friendship support. However, family and friendship networks do not have a significant direct effect on PWB, but rather an indirect effect via social support. Similarly, friendship support mediates the relationship between friendship networks and family support. Both family support and friendship support are significantly related to PWB but family support is the stronger predictor. Conclusion: Using an adapting theoretical framework developed by Berkman, Glass, Brissette, & Seeman (2000) allows researchers to map the various pathways by which relationships with family and friends may contribute to PWB among older Thai adults.

Intergenerational Relationships and Family Care and Support for Thai Elderly

Intergenerational relations between older age parents and their children remain pervasive in Thailand. Over 70% of older persons live with or next to a child. Material assistance from children remains substantial. Desertion of elderly parents is quite rare. Family members, particularly children, are the main persons providing assistance to frail older persons. Nevertheless, co-residence with children has declined and living alone or only with a spouse has increased. Given projected smaller family sizes of future cohorts of older persons and the increasing migration of their children, these trends are certain to continue. Widespread access to telephones helps elderly parents to maintain social contact with distant children. Still, reduced numbers of adult children and their increased migration pose challenges for personal care of the elderly. Clearly adaptations by family and state are needed if the quality of life of Thai elders is to continue to improve.

Effectiveness of a Behavioral Change Intervention in Thai Elders After Knee Replacement

After total knee replacement, elders need an effective intervention to change exercise and physical activity behavior. This study examined the effects of a behavioral change intervention (BCI) on self-efficacy and outcome expectations for exercise and functional activity, physical activity participation, and physical performance of older adults. The study was based on the social cognitive theory (SCT), with a longitudinal quasi-experimental, pretest-posttest control group design. Sixty-three Thai elders undergoing knee replacement surgery were studied. The experimental group received a BCI based on SCT given by the investigator. Outcome measures were the Self-Efficacy for Exercise Scale (SEES) and Self-Efficacy for Functional Activity Scale (SEFAS), the Outcome Expectations for Exercise Scale (OEES) and Outcome Expectations for Functional Activity Scale (OEFAS), the Physical Performance Test (PPT), and the Physical Activity Diary (PAD). The experimental group had significantly greater improvements in self-efficacy for exercise, outcome expectations for exercise, and functional activity, significantly more participation in exercise and walking, and significantly greater improvement in physical performance than did the control group at postoperative weeks 2 and 6. The BCI based on SCT was effective in changing the outcomes in the expected direction. This BCI may be applicable, with modifications, to elders in other situations in which changing behavior is the key to recovery.

Psychological well-being Asian style: the perspective of Thai elders.

Psychological well-being is an important aspect of life quality for older adults. Asian elders may have a distinctly different perspective from Westerners concerning the meaning of psychological well-being. Using qualitative research methods, this study focused on the views of Thai elders. In-depth interviews and focus group discussions were conducted with 67 Thai people aged 60 and over. Transcripts were content analyzed resulting in the identification of five dimensions of well-being: harmony, interdependence, acceptance, respect and enjoyment. When compared to research in the United States, some of the dimensions of psychological well-being were distinct while others were overlapping. Implications are discussed in relation to the development of culturally-relevant measures of well-being.

The essential elements of spirituality among rural Thai elders

The essential elements of spirituality among rural Thai elders

The essential elements of spirituality among rural Thai elders.

The purpose of the study reported here was to understand and describe the essential elements of spirituality among rural Thai elders. The research question that guided the study was: How do rural Thai elders experience and describe spirituality in their daily lives? This question was explored through in-depth, audio-taped, face-to-face interviews with 12 rural Thai elders living in the Nakhorn Prathom Province in the central part of Thailand during the period from January to March 1998. Prior to implementing the study, approval to conduct this study was granted from the Institutional Review Broad of the University of Alabama at Birmingham. Through the process of hermeneutic phenomenological data analysis, three categories and nine themes emerged. The findings of the study provide a knowledge base for Thai nurses to explore and explain spirituality to enhance nursing science and provide holistic nursing care. Further research should be conducted throughout the health and illness continuum with all age groups and with individuals of different cultures and belief systems.

A national survey of health-service use in Thai elders.

To examine the pattern of health-service use and associated factors among elderly people in Thailand. A cross-sectional multi-stage random sampling household survey. 4480 People aged 60 and over. Responses to illness among elderly Thai subjects and health-service utilization. Of 1954 elderly Thai subjects who reported that they had had an illness without hospitalization during the last month, 93% had sought treatment and 7% did nothing. Just over a half (52.8%) used health services. Subjects who had self-limiting symptoms or diseases tended to not use health services, while subjects with chronic conditions did. Sixty-two percent paid for treatment themselves while 28% of them had their bills paid by their children. Independent determinants of health-service use included living in a rural area, being well-educated and better off, not drinking alcohol and the severity of illness identified. We found a low rate of state health-service use. Children had an important role in taking care of parents.