Effects of Home-Based Lifestyle Change Program on Quality of Life among elderly in Khonkean Province, Thailand


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GRF 2nd One Health Summit 2013: Presentation by YODMAI, Korravarn, College of Public Health Science, Chulalongkorn University

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Effects of Home-Based Lifestyle Change Program on Quality of Life among elderly in Khonkean Province, Thailand

  1. 1. Effects of Home-Based Lifestyle Change Program toward Quality of Life among Aging People in Khon Kean Province, Thailand Korravarn Yodmai, Ratana Somrongthong, Tipawan Dansawadikul  College of Public Health Sciences, Chulalongkorn University, Thailand  Faculty of Nursing Science, College of Asian Scholar, Thailand Korravarn Yodmai, PhD candidate in Public Health
  2. 2. Thailand   Thailand located Southeast of Asia Thailand connected with Laos, Cambodia, Myanmar, and Malaysia
  3. 3. Introduction     Increasing the proportion of elderly in Thailand Thailand is become “ an Aging Society” The increased of elderly proportion was affected from baby boom reach retirement and an increased of life expectancy. In 2050, Thais elderly is expected increasing to 25% of whole population (UNFPA, 2006).
  4. 4. 4 regions of Thailand Study area: KhonKean Provinc (Northeast of Thailand) Source of Picture: http://www.learnthailanguage.org/tag/regions/
  5. 5. Aging in European countries Vs Thailand Aging in European Aging in Thailand
  6. 6. The 2nd National Plan for Older Persons (Plan for 2002 – 2019)   We were set up with 5 implementation strategies to protect and support Thai elderly which included preparation for the quality of life in aging, promoting well-being among elderly, providing social security for older people Thailand created many projects to promote well-being and improve quality of life in aging but some aging people reply that there are not be able to join those activities due to housing duty
  7. 7. Lifestyle behaviors changed   This project aims to develop intervention to improve the quality of life. We were applied the network theory and the knowledge of community-based education into our study by links between participant with their neighbors One person can be link to several people that human behavior is influence to other people by copy the behavior and idea of important people as their close friends and family.
  8. 8. Social Network O R J A P P E K D C G This study applied the link between people and their network’s people are affect to each other to change their attitude and behavior.
  9. 9. Step 1:Recruitment  One hundred elderly aged between 60 to 75 years at baseline survey was explanted and encouraged them to enroll this study.  Respondent who are interested that their home must located connected with other group members and/or usually spend day times with other member group  They were separated into 5 groups (11 participants per group) by using community selection  Two persons are vote to be team leader
  10. 10. Step 1: Provided the training of Triple Etraining for all participants Three days of Triple-E training was provided to participants who was enrolled in this study Triple – E training included: E-Exercises E-Eating nutrition foods E-Emotional Focused Coping Management Exercis e Food Emotion al
  11. 11. Step 2: Provided the training on Empowerment technique and group Monitoring for team leader  Two team leaders in each group was provided the training on empowerment technique and how to monitoring their group member to be more practices of triple –E (more exercise and activities, eating healthy food, and have a good emotional in their daily living  The training was conducted 1 day for technique and 6 days for practices.
  12. 12. Step 3: Home-based activities - Home visits by team leaders - Routine activities in their home - Group advisory by team leaders
  13. 13. Step 4: Monthly Meeting Monthly meeting was done at community center. It was conducted by researcher and health volunteers. The activities were • Demonstrated of an exercise by group member • Sharing their experience of their life after used triple-e education • Discussion on • Meditation • Appointment for next meeting
  14. 14. Process of study Intervention baseline X OI0 Control baseline OC0 6th month O I1 9th month O I2 6th month 9th month O C1 O C2 O: Observation, I: Intervention group, C: Control group X: HBLC intervention
  15. 15. Data collection
  16. 16. RESULTS
  17. 17. Figure 1: mean score of quality of life at baseline, 6 th month, and 9th month
  18. 18. Table 9: Effects of HBLC intervention on QOL at F/U 1& Outcome variable Follow – Up 2 Follow-Up 1 Estimate Mean 95% CI P-value Change TQOL Estimate Mean 95% CI P-value Change 8.23 1.28-15.19 0.021 3.53 (-2.15-9.23) 0.220 SAB 0.25 -1.87-2.37 0.815 -0.94 -2.76-0.87 0.307 AUT 3.96 2.35-5.56 <0.001 2.59 1.34-3.85 <0.001 PPF 1.64 0.10-3.18 0.036 1.89 0.59-3.19 0.005 SOP 1.60 0.38-2.82 0.010 2.54 1.20-3.89 0.000 DAD -1.84 -4.02-0.33 0.095 -3.89 -6.20-1.59 0.001 INT 2.14 0.52-3.75 0.010 1.34 -0.37-3.05 0.124 *Linear Mixed Model with Unadjusted
  19. 19. Discussions    However, total QOL was not statistically significant after intervention due to SAB is found commonly in elderly that it needs to be add in to an account in order to support sensory aids for elderly AUT, PPF, and SOP was improved after intervention at 9 months. Those improvement may due to training grogram that increased of social activity of participants
  20. 20. Discussion (con’t)   Negative- affect of an intervention on DAD is not clear. It needs to be study on this facet. As observation that it may link to the increasing of relationship between their friends that it influence to their fear to be alone. Intimacy is not improve after intervention may due to individual attitude of participants and their culture.
  21. 21. Limited of this study   Selection bias due to the network of participants Limitation of quasi-experimental study could not control all external confounders and cointervention  Limitation of generalization, the finding may not be able to transferrable to other community  Limitation of eating behavior in study area
  22. 22. Recommendation   HBLC can be benefits to improve AUT, SOP, and PPF facets of QoL in elderly, especially in elderly in developing counties as Asian people that neighbors are important key to pass though the messages to elderly. Health provider should consider of the linking between people and apply it in their community, especially vulnerable people
  23. 23. Acknowledgement    This work was a financial supported by 90th year King Anniversary Thesis Research funding Scholarship, Chulalongkorn University Thankful to Prof. Dr. Robert Chapmen for Data Analysis
  24. 24. Ethical Approval    Research Ethical was approval from Chulalongkorn University Research Ethics Committee Respondents were signed informed consent form before the data collection Participants information was commitment to keep it confidentially
  25. 25. Thank you for your attention