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Understanding healthy aging in Isan-Thai culture
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand . (NMP)ORCID iD: 0000-0003-4027-7939
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The older population in Thailand is growing, and the number of older people who suffer from health problems is increasing as well. The health situation of the older population challenges healthcare providers to care for older people. Healthy aging is key to promoting the health of older people and sustaining their well-being. However, little is known about healthy aging in Thailand, especially in northeastern Thailand, or the Isan region, where the number of older people is increasing. Thus, this thesis aims to understand the factors associated with perceived health and healthy aging and how older people and their relatives in the Isan region conceptualize healthy aging. This thesis also focuses on how community nurses experience the meaning and promotion of healthy aging in this region.

This thesis includes four studies. The first is a quantitative cross-sectional study with 453 participants aged 60 years or older. The second and third studies are qualitative with a phenomenographic approach that is based on lifeworld theory. Participants in the second and third studies include 17 older people and 14 relatives who are responsible for caring for older people, respectively. The fourth study is a qualitative study that involves focus group interviews with 36 community nurses who work with older people in the Isan region.

The findings of the first study show a variance (24.3%) in perceived health and healthy aging based on residential area, marital status and disability status. The meaning of healthy aging, which was derived from the second, third and fourth studies, was divided into three domains: being interconnected; being able to do something good and feeling strong; and thinking beyond the capacity and functions of body and mind. The promotion of healthy aging was described as “providing health assessments”, “sharing knowledge”, and “having limited resources”.

The findings of the first study revealed the key factors that will help healthcare providers promote healthy aging. The findings of the second, third and fourth studies revealed that older people, their children and grandchildren, and community nurses attach different meanings to healthy aging. The finding regarding promotion of healthy aging emphasizes that the person-centredness should be integrated in practice when promoting healthy aging. The results of this thesis will be useful to policymakers, who can apply this enhanced understanding of healthy aging to develop healthcare practices that promote healthy aging.

 

Place, publisher, year, edition, pages
Stockholm: E-Print AB , 2017.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 220
Keywords [en]
cross-sectional study, focus group interviews, healthy aging, lifeworld theory, nursing, person-centred care, phenomenography, relatives, Thai nurses
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-34559ISBN: 978-91-7485-307-0 (print)OAI: oai:DiVA.org:mdh-34559DiVA, id: diva2:1060402
Public defence
2017-02-17, Filen, Mälardalen university, Eskilstuna Campus, Eskilstuna, 10:00 (English)
Opponent
Supervisors
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2017-01-20Bibliographically approved
List of papers
1. Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand
Open this publication in new window or tab >>Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand
Show others...
2016 (English)In: Journal of Cross-Cultural Gerontology, ISSN 0169-3816, E-ISSN 1573-0719, Vol. 31, no 4, p. 369-384Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand’s aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthy aging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors. 

Keywords
Cross-sectional study, Healthy aging, Northeastern Thailand, Older persons
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-32517 (URN)10.1007/s10823-016-9296-y (DOI)000408865400003 ()27432370 (PubMedID)2-s2.0-84978718906 (Scopus ID)
Available from: 2016-08-18 Created: 2016-08-18 Last updated: 2017-09-14Bibliographically approved
2. Healthy ageing in Isan-Thai culture-A phenomenographic study based on older persons' lived experiences
Open this publication in new window or tab >>Healthy ageing in Isan-Thai culture-A phenomenographic study based on older persons' lived experiences
2016 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 29463Article in journal (Refereed) Published
Abstract [sv]

Healthy ageing is a concept that concerns older persons' quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons' experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons' qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: "being independent in dependence,'' "being at peace,'' and "being a valuable person.'' This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-31430 (URN)10.3402/qhw.v11.29463 (DOI)000372205200001 ()26960686 (PubMedID)2-s2.0-84962295859 (Scopus ID)
Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2017-11-30Bibliographically approved
3. Conceptions of healthy ageing held by relatives of older people in Isan-Thai culture: A phenomenographic study
Open this publication in new window or tab >>Conceptions of healthy ageing held by relatives of older people in Isan-Thai culture: A phenomenographic study
2018 (English)In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, article id 3734645Article in journal (Refereed) Published
Abstract [en]

Healthy ageing has been studied in various contexts. However, no studies have focused on healthy ageing from the perspective of children or grandchildren, who are the main informal caregivers for older people in northeast Thailand, also referred to as the Isan region. Therefore, this study aimed to describe the conceptions of healthy ageing harboured by children and grandchildren caring for older people in northeast Thailand. A qualitative descriptive design was performed using a phenomenographic approach with an epistemological basis in the lifeworld theory to understand the varying conceptions of healthy ageing based on participants’ lived experience. We conducted in-depth interviews comprising open-ended questions to gain an understanding of the conceptions of healthy ageing held by 14 children and grandchildren of older persons in northeast Thailand. The data collected during these interviews were analysed using the phenomenographic analysis method. The results of our analysis indicated that the conceptions of healthy ageing can be categorized into the following four descriptive categories: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. These findings highlight that healthy ageing entails autonomy, interdependence and wisdom and emphasize the importance of holistic view on the meaning of healthy ageing. Healthcare providers should understand the different meanings of healthy ageing from the perspectives of children and grandchildren of older people and integrate their perspectives when collaborating with them to promote healthy ageing. The findings of this study may facilitate further research and ensure the provision of support to the relatives of older people to promote healthy ageing in northeast Thailand. 

Keywords
healthy ageing, health promotion, older people, qualitative research, relatives
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-34557 (URN)10.1155/2018/3734645 (DOI)2-s2.0-85045911896 (Scopus ID)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2018-05-11Bibliographically approved
4. Community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand
Open this publication in new window or tab >>Community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand
2018 (English)In: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, no 36, p. 54-67Article in journal (Refereed) Published
Abstract [en]

Purpose: Describe community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. Method: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. Findings: Healthy aging was characterized by the interconnection of older persons, older persons’ family members and the community. Healthy aging was associated with two themes: “being strong” and “being a supporter and feeling supported”. The nurses’ experiences in promoting healthy aging were described by the themes “providing health assessment”, “sharing knowledge” and “having limited resources”. Conclusions: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy-aging strategies in Thailand.

Keywords
healthy aging; health promotion; holistic care; older people; person-centredness; qualitative research; Thai nurses
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-34558 (URN)000425058800007 ()2-s2.0-85042162448 (Scopus ID)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2018-03-01Bibliographically approved

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