Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative conte...Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative content analysis study using data from the focus group,individual in-depth interview,and observation.The study population was domiciled in Pakpoon Village,Mung Dis-trict,Nakhon Si Thammarat Province,a tight-knit settlement typical of most retirement communities.Data were collected through two focus group discussions,direct observation,and in-depth interviews with 19 participants.Respondents represented key community groups:local nurses and public health officers,elderly residents,family caregivers(family members),and village health volunteers.Results:The participants shared similar perspectives about the social determinants of health influencing obesity in the aged,which spanned three themes.These were:1)neighborhood food environment(easy access to unhealthy food,no choice to recruit healthy food);2)social networks influencing obesity(family affects food choices and prohibitions on exercise;belief,and socially imposed body image per-ceptions contributing to obesity in the aged);and 3)knowledge,attitudes,and beliefs behind lifestyle choices that cause obesity in the elderly(lack of awareness,personal attitudes,job and familial duties as barriers to engaging in physical activities;over-consumption behaviors lead to obesity in older people).Conclusion:These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community.This finding suggests that policymakers and nurses can create healthy environments,both to treat and prevent obesity,by raising awareness in younger generations,providing aging the provision of healthy food choices for older adults,encouraging health care professionals to share knowledge,and by modifying the attitudes and beliefs of both caregivers and older adults.展开更多
Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from t...Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.展开更多
Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing ...Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.展开更多
Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects shou...Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.展开更多
文摘Objective:This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders.Methods:This was qualitative content analysis study using data from the focus group,individual in-depth interview,and observation.The study population was domiciled in Pakpoon Village,Mung Dis-trict,Nakhon Si Thammarat Province,a tight-knit settlement typical of most retirement communities.Data were collected through two focus group discussions,direct observation,and in-depth interviews with 19 participants.Respondents represented key community groups:local nurses and public health officers,elderly residents,family caregivers(family members),and village health volunteers.Results:The participants shared similar perspectives about the social determinants of health influencing obesity in the aged,which spanned three themes.These were:1)neighborhood food environment(easy access to unhealthy food,no choice to recruit healthy food);2)social networks influencing obesity(family affects food choices and prohibitions on exercise;belief,and socially imposed body image per-ceptions contributing to obesity in the aged);and 3)knowledge,attitudes,and beliefs behind lifestyle choices that cause obesity in the elderly(lack of awareness,personal attitudes,job and familial duties as barriers to engaging in physical activities;over-consumption behaviors lead to obesity in older people).Conclusion:These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community.This finding suggests that policymakers and nurses can create healthy environments,both to treat and prevent obesity,by raising awareness in younger generations,providing aging the provision of healthy food choices for older adults,encouraging health care professionals to share knowledge,and by modifying the attitudes and beliefs of both caregivers and older adults.
基金This work was supported by the Ministry of Health and Sports,Republic of the Union of Myanmar(MOHS IR Grant 2019,Research ID No.501).
文摘Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.
基金The Center of Research and Development in Community Health System,Faculty of Nursing,at Khon Kaen University,Thailand provided supporting for the research grant (Ref:61-00-001)
文摘Objectives: This study aimed to describe work and activities of community networks focusing on the improvement of the quality of life (QOL) of older people in Thailand.The understanding of the work can help enhancing the community development and strengthening of local communities and their networks.Methods: Qualitative methods including in-depth interview,observation,and focus group discussion were employed to the study.64 participants participated to the study and were recruited from 4 key actors within the community.Content analysis was used to analyze the obtained data.This study was conducted in 6 local administrative organizations (LAOs) which selected from the outstanding areas of the project.Each LAO represents one sub-district of the regions of Thailand namely;(1) the upper north,(2) the lower north,(3)the upper eastern,(4) the lower eastern,(5) the central and (6) the south.Results: The findings of this study were categorized into three main themes: (1) Social capital including people in the community,social groups,and organizations,(2) Mutual help/collaboration activities composed of six sets of activities related to social capitals working on the improvement of QOL of older people,and (3) Impacts of the mutual help/collaboration activities on older people and local communities who help to improve of QOL of older people.Conclusion: The findings are important features for the community development.These themes should be recommended for community nurses,health related groups and organizations for the improvement of QOL of older people in the community.
文摘Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.
