Sunanta Wongchalee

The Influence of Chronic Illness and Lifestyle Behaviors on Quality of Life among Older Thais

Chronic conditions and lifestyle behaviors have a detrimental influence on the quality of life for seniors because of physical disability and emotional concerns. This study aimed to assess the influence of chronic illness, smoking, and alcohol use on quality of life among Thai seniors. A cross-sectional study was conducted in three communities, selected purposively from the North, Northeast, and Central regions, and 1278 senior participants were recruited. Binary logistic regression was used to predict the influence of factors on quality of life with adjusted covariates. Most participants were aged 60–70 years and married, earned 500–1,000 Baht/month (US

Influence of socioeconomic factors on daily life activities and quality of life of Thai elderly

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Conclusions and Recommandations

35), had one chronic illness, and were nonsmokers and nondrinkers. Surprisingly, there appeared to be no link between chronic conditions and quality of life. Current drinkers were more likely to have a high quality of life, with Odds Ratios of 2.16 for men and 2.73 for women. Seniors of both genders who were current drinkers were more likely to accept death and dying and this improved their quality of life. Social participation in alcohol consumption may encourage seniors to share their concerns about death and dying and eventually accept this as a foundation of life.

Funding Policy, Project Implementation Strategies and Cooperation Strategies with the RTG

Background The increasing number of older people is a significant issue in Thailand, resulted in growing demands of health and social welfare services. The study aim was to explore the influence of socioeconomic factors on activities of daily living and quality of life of Thai seniors. Design and methods Using randomised cluster sampling, one province was sampled from each of the Central, North, Northeast and South regions, then one subdistrict sampled in each province, and a household survey used to identify the sample of 1678 seniors aged 60 years and over. The Mann-Whitney U-test and binary logistic regression were used to compare and determine the association of socioeconomic variables on quality of life and activities of daily living. Results The findings showed that sociodemographic and socioeconomic factors were significantly related to functional capacity of daily living. Education levels were strongly associated with daily life activities, with 3.55 adjusted ORs for respondents with secondary school education. Gender was important, with females comprising 61% of dependent respondents but only 47% of independent respondents. Seniors with low incomes were more likely to be anxious in the past, present and future and less likely to accept death in the late stage, with 1.40 Adjusted ORs (95%CI: 1.02-1.92), and 0.72 (95%CI: 0.53-0.98), respectively. However, they were more likely to engage in social activities. Conclusions While socioeconomic factors strongly indicated the functional capacity to live independently, a good quality of life also required other factors leading to happiness and life satisfaction. Significance for public health Increasing numbers of ageing population raise a public health concern in Thai society due to the increasing demands of medical and health services regarding chronic diseases and disability. Unfortunately, few studies have mentioned socioeconomic factors on daily living activities and quality of life and none has taken place across regions in Thailand. Epidemiological population-based studies are necessary to identify social determinants and potential contributing factors that influence quality of life and disability which in turn, may utilise information shaping the policy through better support and care.

The Dynamics, Needs and Constraints of Stakeholders

The root cause of this issue remains unresolved; the conflict within Myanmar. At the same time, there are signs of change in Myanmar, with the release of Aung San SuuKyi and the increasing engagement of ASEAN and the wider international community. Donors and funders are urged to maintain their support for now, and to increase pressure through trade and other links to make Myanmar a safe place for repatriation. The agencies are encouraged to continue moving from emergency response to developmental programmes, including within Myanmar. Collaboration on solutions, such as CCSDPT/UNHCR’s 5-year plan, is encouraged as long as all options are considered, not just local integration. The RTG must continue to be flexible, and to see strategies to encourage self-reliance of the displaced persons as preparation for eventual repatriation of the majority once Myanmar is free of conflict.

The Impacts of Existing Intervention Mechanisms, Including Gender-Related Aspects

The funding of the humanitarian and developmental programmes with the displaced people is examined in more detail, including how bodies such as UNHCR receive their funding. The relationship between the RTG and international actors is explored, looking in particular at the different perspectives that exist and how these have made joined-up policy and practice more difficult. The relationship between NGOs and other actors is also reviewed, and between them and the RTG, showing that communication has been a weakness. The 5-year strategic plan of CCSDPT/UNHCR is evaluated in terms of its scope and likelihood of success; it fails to put forward a solution based on a combination of the durable solutions. The relationship of actors with the RTG remains a barrier, in terms of culture and understanding of each others’ perspectives.

The Limitations and Constraints on Effective Intervention Mechanisms

The current situation is looked at from the perspectives of the different actors, in terms of commitment to finding a solution and to carrying on funding when change appears distant. The attitude of the different actors to the standard durable solutions is examined; international humanitarian agencies have long favoured local integration as a sustainable solution, one which the Royal Thai Government (RTG) implacably opposes. Resettlement has had some effect, but there is a question mark over its continued operation, and it has not reduced camp size, because new arrivals have replaced those who have gone. Gradually, there is an acceptance among most actors, including long-term donors, that voluntary repatriation must be at the heart of any sustainable solution; the challenge remains how to make Myanmar feel like a safe place of return for those who have fled, and for those born in the camps who have no memory of Myanmar.

Factors affecting the experiences of drug use by adolescents in a Bangkok slum

The current levels of support within the settlements are assessed from the perspective of the displaced persons. In general, despite differences in approach from different actors, and the RTG’s stated policy of confinement and restriction of movement and access to services that might encourage local integration, the displaced persons themselves feel they have been well supported in terms of basic food, shelter, education and healthcare. However, problems resulting from long confinement are starting to impact, in terms of loss of self-confidence and self-reliance. There are also signs that funding is slowing down, partly related to the economic crisis in Europe and North America. Women, in particular, have experienced some disadvantage as a result of the way agencies and the RTG have supported traditional, male-dominated administration of the camps. There is consensus amongst all actors that change is needed now.

Depression among adolescents: a study in a Bangkok slum community.

Generally, the displaced persons themselves are relatively contented with the way they have been treated in the settlements by all the various stakeholders. They have found relative safety and security, and have access to basic life requirements such as food and shelter and, increasingly, to education, health care and other services. However, the displaced persons are in limbo, and have been for a long time in some cases, and lack hope and motivation, leading to increasing social and community issues in the shelters. For the donors, the issue has become a strain on resources, and a peripheral issue in world affairs. For the UN agencies and NGOs, with no solutions in sight, this protracted situation has taxed resources and patience. For the RTG, also, there are more major issues to attend to. All parties have different perspectives, and communication between them is poor. The RTG’s approach has been more flexible in practice than is its policy, but it has been unable to agree a solution with the other actors.