Kattika Thanakwang

Mechanisms by Which Social Support Networks Influence Healthy Aging Among Thai Community-Dwelling Elderly

Objective: To examine the relationships among family, friendship networks and supports, health-promoting behaviors, and healthy aging. Method: A sample of 469 Thai elderly persons was recruited using multistage random sampling. A structural equation model based on Berkman’s conceptual model was performed. Results: Family networks did not directly influence health-promoting behaviors but rather had an indirect effect through family support. Friendship networks had both a significant direct effect on the elderly health-promoting behaviors and an indirect effect via friendship support. Interestingly, friendships had both direct and indirect influences on family support to the elderly. Health-promoting behaviors had a powerful influence on healthy aging and play a significant role in mediating the relationship between family and friendship supports and healthy aging. Discussion: Findings demonstrate the importance of family and friendship roles on health-promoting behaviors and healthy aging. Intervention programs should be designed to include a collaborative approach involving family members and friends.

Perspectives on healthy aging among Thai elderly: a qualitative study.

In this qualitative study, we provide an in-depth understanding of the views of healthy aging among Thai elderly and explore the ways that contribute to healthy aging. Data were collected using focus groups and in-depth interviews in four selected provinces of Thailand, and were analyzed using content analysis. The results revealed that Thai elderly described being healthy as the result of multiple components involving physical, mental, and social well-being. Healthy aging was viewed as an absence of serious diseases, having functional independence, a positive psycho-emotional outlook, and making a social contribution. The factors considered to contribute to healthy aging included activities promoting physical and psychological health, as well as active engagement in social activities. Understanding how the elderly define healthy aging and identifying the most important components and factors that contribute to being healthy provides insight into possible policy implications and interventions to promote health and well-being among Thai elderly.

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.

Productive engagement in older adults: A concept analysis

This study aimed to clarify the concept of productive engagement as it applies to older adults. The concept analysis was based on Walker and Avants eight-step method. A literature review of articles published in English between 1990 and 2011 (n = 37) was conducted, using an electronic search of multiple sources. Results revealed that four defining attributes for productive engagement include continuing to work either paid or unpaid, caring for others, engaging in social activities, and growing spirituality. The antecedents of productive engagement are sociocultural factors as well as individual and institutional capacities. Meanwhile, the consequences are increased feelings of usefulness, improved health and well-being, aged successfully, and enhanced quality of life. Model, borderline, and contrary cases are presented to illustrate the concepts defining attributes. Defining the concept of productive engagement provides a basis for nurses and other health professionals to better understand productive engagement in older adults, thus effective strategic plans or programs for promoting productive roles among older adults can be further developed.

Psychometric properties of the Thai version of the Diabetes Distress Scale in diabetic seniors.

Background The Diabetes Distress Scale (DDS) is an important measure of diabetes-related emotional distress that has been widely used in the Western world. In Thailand, there is a lack of reliable and valid scales for assessing distress levels in diabetes patients, specifically in older adults. Objectives The main objectives of this study were to adapt the DDS for use in Thai diabetic elderly and to evaluate its psychometric properties. Methods The 17-item DDS was linguistically adapted using forward–backward translation and administered to 170 diabetic patients ≥60 years selected from diabetes outpatient clinics of four hospitals in Buriram, Thailand. Statistical analyses included exploratory factor analysis, internal consistency, convergent validity, and test–retest reliability. Results During factor analysis, a three-factor solution was found to be reasonable for the sub-dimensions of emotional and regimen-related burden (ten items), physician- and nurse-related distress (four items), and diabetes-related interpersonal distress (three items). The Cronbach’s alpha coefficient for the total score was 0.95 and varied between 0.85 and 0.96 in the three subscales. The results provided evidence that supports the convergent validity of the Thai version of the DDS as well as its stability. Conclusion The Thai version of the DDS has acceptable psychometric properties. It enables assessment of diabetes-specific distress in elderly patients and has the advantage of being easy to use in both clinical and research settings.

Development and psychometric testing of the active aging scale for Thai adults.

Background Active aging is central to enhancing the quality of life for older adults, but its conceptualization is not often made explicit for Asian elderly people. Little is known about active aging in older Thai adults, and there has been no development of scales to measure the expression of active aging attributes. Purpose The aim of this study was to develop a culturally relevant composite scale of active aging for Thai adults (AAS-Thai) and to evaluate its reliability and validity. Methods Eight steps of scale development were followed: 1) using focus groups and in-depth interviews, 2) gathering input from existing studies, 3) developing preliminary quantitative measures, 4) reviewing for content validity by an expert panel, 5) conducting cognitive interviews, 6) pilot testing, 7) performing a nationwide survey, and 8) testing psychometric properties. In a nationwide survey, 500 subjects were randomly recruited using a stratified sampling technique. Statistical analyses included exploratory factor analysis, item analysis, and measures of internal consistency, concurrent validity, and test–retest reliability. Results Principal component factor analysis with varimax rotation resulted in a final 36-item scale consisting of seven factors of active aging: 1) being self-reliant, 2) being actively engaged with society, 3) developing spiritual wisdom, 4) building up financial security, 5) maintaining a healthy lifestyle, 6) engaging in active learning, and 7) strengthening family ties to ensure care in later life. These factors explained 69% of the total variance. Cronbach’s alpha coefficient for the overall AAS-Thai was 0.95 and varied between 0.81 and 0.91 for the seven subscales. Concurrent validity and test–retest reliability were confirmed. Conclusion The AAS-Thai demonstrated acceptable overall validity and reliability for measuring the multidimensional attributes of active aging in a Thai context. This newly developed instrument is ready for use as a screening tool to assess active aging levels among older Thai adults in both community and clinical practice settings.

Poverty, Perceived Economic Strain, and Psychological Distress Among Thai Older Adults

This study examines the relationships between poverty, defined as having an income below the poverty line, perceived economic strain, and psychological distress among Thai older adults. Data were taken from the 2002 National Elderly Survey in Thailand. The sample included 21,417 men and women aged ≥60 years. Multiple regression models were employed for data analysis and findings revealed that elderly poverty was significantly associated with perceived economic strain and psychological distress. After controlling for sociodemographic and health-related variables, perceived economic strain fully mediated the effect of poverty on psychological distress. Family support had a powerful buffering effect on the relationship between poverty and economic strain, as well as between poverty and psychological distress. Policy and strategies targeted at poverty and economic strain in later life and filial support should be continuously promoted.