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      Exploring quality of life among the elderly in Hai Duong province, Vietnam: a rural–urban dialogue

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          Abstract

          Background

          Quality of life (QoL) is an important health index for the elderly, necessary for assessing interventions, and prioritising medical and social care needs. As the ageing population in Vietnam continues to increase, understanding important dimensions of QoL for the elderly is essential. There is a paucity of research in this area, however, and the available literature focuses on functional capacities. The purpose of this article is to explore perceptions on the dimensions of QoL among the elderly in Vietnam, to use these perceptions to broaden the concept, and to explore similarities and differences between those living in urban compared to rural areas.

          Method

          Qualitative methods included in-depth interviews (IDI) with experts in ageing and elderly persons, as well as focus group discussions (FGDs) in three communes in Hai Duong province. IDIs and FGDs were recorded and transcribed. NVivo software was used to analyse the data.

          Results

          Thematic analysis identified physical, psychological, social, environmental, religious, and economic as important dimensions of QoL. For elderly participants in both urban and rural areas, physical health, social relations, finances and economics, the physical and social environment, and psychological health were reported as important. Rural participants also identified religious practice as an important dimension of QoL. In terms of relationships, the elderly in urban areas prioritised those with their children, while the elderly in rural areas focussed their concerns on community relationships and economic conditions.

          Conclusion

          Isolating individual factors that contribute to QoL among the elderly is difficult given the inter-relations and rich cross-linkages between themes. Elderly participants in urban and rural areas broadly shared perspectives on the themes identified, in particular social relationships, but their experiences diverged around issues surrounding finances and economics, their respective physical and social environments, and the contribution of religious practice. The study findings may help provide guidance for the development of a socially and culturally relevant instrument for measuring QoL among the elderly in Vietnam. The results will also be useful for developing policies and interventions that are responsive to the needs of the elderly, and reflect the themes perceived to be important.

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          Most cited references30

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          A multidimensional model of the quality of life in older age.

          The broad aim of the research presented here was to define the constituents and indicators of quality of life (QoL) in older age, in order to offer a more multidimensional and useful model of quality of life, based on the perspectives of older people themselves. This paper focuses on the extent to which self-evaluations of global QoL are influenced by health, psychological and social variables, and social circumstances. It reports the results of a national survey of the quality of life in people aged 65 and over, living at home in Britain. Multiple regression analysis with the self-evaluation of quality of life rating as the dependent variable showed that the overall model (Model 9) of QoL indicators explained 26.7% of the variance in quality of life ratings. This is sizeable given the amorphous nature of this concept. The main independent predictors of self-rated global quality of life were: social comparisons and expectations, personality and psychological characteristics (optimism-pessimism), health and functional status and personal and neighbourhood social capital. These variables explained the highest proportion of the variance between groups in their quality of life ratings. Socio-economic indicators contributed relatively little to the model.
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            WHOQOL-Hindi: a questionnaire for assessing quality of life in health care settings in India. World Health Organization Quality of Life.

            Quality of life is becoming an important component of overall assessment in health care settings. However, satisfactory instruments are not available for use in India. Qualitative and quantitative work was conducted at the Delhi centre as a part of the WHOQOL (World Health Organization Quality of Life) project at 15 centres in developing and developed countries to construct a new quality of life instrument (WHOQOL). The pilot field trial at Delhi was conducted on 304 adult subjects using the 236-item questionnaire. Based on the pilot field trial data, item reduction could be done to develop a 100-item version (WHOQOL-100, Hindi). The items are distributed into 4 domains (physical; psychological, social and environmental health) and 25 facets. Each facet has four items, rated on a five-point scale. The initial psychometric properties of this instrument are satisfactory. A 26-item short version has also been developed (WHOQOL-Bref, Hindi). The WHOQOL-100, Hindi appears to be a suitable instrument for comprehensively assessing quality of life in health care settings. WHOQOL-Bref, Hindi can be used for intervention studies including drug trials.
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              Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

              Background Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. Methods SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. Results The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. Conclusion The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL.
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                Author and article information

                Journal
                Glob Health Action
                Glob Health Action
                GHA
                Global Health Action
                Co-Action Publishing
                1654-9716
                1654-9880
                22 December 2012
                2012
                : 5
                : 10.3402/gha.v5i0.18874
                Affiliations
                [1 ]Department of Health Policy, Faculty of Social Sciences, Behaviour and Health Education, Hanoi School of Public Health, Hanoi, Vietnam
                [2 ]Department of Health Sociology, Faculty of Social Sciences, Behaviour and Health Education, Hanoi School of Public Health, Hanoi, Vietnam
                [3 ]School of Population Health, The University of Queensland, Brisbane, Australia
                [4 ]Masters of Public Health Candidate (Global Health Stream), Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
                Author notes
                [* ] Nguyen Thanh Huong, Faculty of Social Sciences, Behaviour and Health Education, Hanoi School of Public Health, 138 Giang Vo, Ba Dinh, Hanoi, Vietnam. Tel: +84 4 62662321, Fax: +84 4 62662385. Email: nth@ 123456hsph.edu.vn
                Article
                18874
                10.3402/gha.v5i0.18874
                3530174
                23273251
                8d0dd69c-03a9-4bcc-b3f0-19145b0d644a
                © 2012 Nguyen Thanh Huong et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 May 2012
                : 28 October 2012
                : 01 November 2012
                Categories
                Public Health in Vietnam: Here's the Data, Where's the Action?

                Health & Social care
                quality of life,elderly,perception,qualitative study,vietnam
                Health & Social care
                quality of life, elderly, perception, qualitative study, vietnam

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