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Assessment of Need for Elderly in Community in Hang Dong District

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Assessment of Need for Elderly in Community in Hang Dong District Original Research Article S143 ASSESSMENT OF NEED FOR ELDERLY IN COMMUNITY IN HANG DONG DISTRICT, CHIANG MAI PROVINCE, THAILAND USING CAMBERWELL ASSESSMENT OF NEED FOR THE ELDERLY QUESTIONNAIRE (CANE) Piyanuch Tiativiriyakul, Peter Xenos* College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand ABSTRACT: Background: The population ageing is an inevitable demographic change occurring in many countries including Thailand. Therefore, the actual need of the elderly should be evaluated properly in order to manage the continuing growth of the ageing society. This study aimed to identify the needs and the sufficiency of support for elderlies using Camberwell Assessment of Need for the Elderly questionnaire (CANE) and determine the relationship between socio-demographic characteristics, living status and health status and needs of the elderly in community in Chiang Mai Province, Thailand Method: The study design is a cross-sectional quantitative study. The CANE questionnaire was translated to Thai; and the validity and reliability test were performed. The translated version of questionnaire was reviewed by three experts. The IOC score of the questionnaire was 0.76. The reliability was test in 30 elderly samples. The Cronbach’s Alpha coefficient was 0.82. The data collection was performed by interviewing the participants using questionnaires as the guideline. The chi-square analysis was used to explore the association between and sociodemographic, living status and health status and need identification. The regression analysis was performed to evaluate association between independent factors and the number (level) of need, met need and unmet need Results: Among 330 participants who aged 60 years old or above, 66.4% of them had at least one and 22.7% had at least one unmet need. The average need score of the sample was 3.09 out of 24 topics (SD= 3.33) which 0.4 was unmet need (SD=1.05). The areas which had high percentage of need were physical health, eyesight/hearing/communication and memory respectively, while the area with the high percentage of unmet need (per total need) were the self-care, caring for other, benefit and accommodation. The age, number of disease and type of insurance had significant association with the number of total needs whereas, the monthly income and living environment had relationship with the unmet need determination (p-value < 0.05). Conclusions: Although the most frequent identified need was in physical area, the highest proportion of unmet need was found in function category. Even age, number of disease and type of insurance had association with the number of total needs, the monthly income and living environment were the factors determining the unmet need. Therefore, the more attention should be paid on needs in function area and the support for the cost of living and living environment. Keywords: Elderly; Care for elderly; Camberwell Assessment of Need for the Elderly Questionnaire (CANE); Thailand DOI: 10.14456/jhr.2017.78 Received: June 2017; Accepted: September 2017 INTRODUCTION Due to the fast-continuous growth of the aging * Correspondence to: Peter Xenos society around the world [1], the real need of the E-mail: [email protected] Tiativiriyakul P, Xenos P. Assessment of need for elderly in community in Hang Dong district, Chiang Cite this article as: Mai province, Thailand using Camberwell Assessment of Need for the Elderly questionnaire (CANE). J Health Res. 2017; 31(Suppl.2): S143-54. DOI: 10.14456/jhr.2017.78 http://www.jhealthres.org J Health Res vol.31, Supplement 2, 2017 S144 elderly is crucial for providing the accurate care and MATERIALS AND METHODS management. The growth in the numbers and Design and study sample proportions of elderly have far impact reaching This study is a cross-sectional descriptive study. economic, social and need political implications. The study included Thai individuals who age 60 or The trend of dependency ratio which is the ratio of above, living in Hang Dong district for more than 3 people who more than 60 years old divide by the months and no communication problem. The 330 working population (age 15-60 years old) has participants sample size was calculated by using the increased gradually from 10.7% in 1994 to 18.1% following formula; and 22.3% in 2011 and 2014 respectively [2]. The dependency ratio is a numerical measure of the 2 2 푧훼/2휎 economic burden imposed on the working 푛 = × 푑푒푠푖푔푛 푒푓푓푒푐푡 푑2 population who have to ultimately take care people who are not in the labour force. Nowadays, some The average SD of the mean of total unmet need developing countries consider this issue as a country accessed by the community-dwelling elderly from topic and try to find the cost-effective ways of using the literature review which is 1.01, the 0.15 as theirs limited resources to meet the needs of older absolute error, type 1 error at 5% and design effect people [3]. Moreover, given the diversity of life at 1.7 were used for the calculation [9, 10]. histories and physical/mental conditions of the The five sub-districts (San Phak Wan sub-district, elderly, the goals/needs vary by each individual [4], Hang Dong sub-district, Num Prae sub-district, and thus accurate and comprehensive assessment of Nong Kwai sub-district and Sob Mae Kha sub-district) the individual needs of the elderly is a challenge for were simple random sampling from 11 sub-districts. frontline care providers and policy management by Then participants were simple randomized from the the government [5]. list of elderlies from the district municipality office. In Thailand, there are also the Act on Older The face to face interview by trained interviewers Persons; Thailand 2003 which has been in force using the structural questionnaire method was used for since 1 January 2004 to ensure welfare to cover data collection. many aspects for the elderly [6]. Even, there are a lot of activities and supports for the elderly in Thailand, Measurement and some studies have been conducted for Please state the operational definition of the term assessment, there are still no formal study ‘need for elderly in community’ demonstrates of fulfillment/ or satisfaction for all The original English version of CANE was aspect of needs in the elderly in Thailand. Moreover, translated to Thai language by the Chulalongkorn the research to assess the basic need of the older and University Language Institute. Then it was verified expand to all aspects is limited. by researcher and team for the completeness and The Camberwell Assessment of Need for the appropriateness of the language. The content validity Elderly questionnaire (CANE) can evaluate the was reviewed by 3 experts, the first expert from needs and the sufficient of support of the need as Geriatric Medicine Center of Medical Excellent individual [7] and also can evaluate the support from Center, Faculty of Medicine, Chiang Mai University, the formal (government related agencies) and the second expert from the Preventive and Social informal source of support (relative, family, friend Medicine, Chulalongkong University and the third and neighbor). Moreover, it is the comprehensive expert from the Faculty of Public Health, Mahidol measurement designed to evaluate the broad range University. The IOC (Index of Consistency) score of of needs of the elderly. Even it was developed this questionnaire is 0.76. Then the reliability of this especially for patient with mental health problems. Thai version was tested in 30 elders in Hang Dong However, it was intended in all setting ranging from district, Chiang Mai province, Thailand. The primary care, out-patients, psychiatric ward, nursing Cronbach’s Alpha coefficient is of the questionnaire and residential home [8]. This research aimed to is 0.82. identify and evaluate the met-needs and un-met The socio-demographic characteristics included needs of the elderly which is one of the interesting age, sex, education, income and marital status were topic. It can lead to the better understanding of the collected as the background independent variables. need in elderly, and hence benefit for further facility In addition, the living status and health status were or service development for the older population. also evaluated. Then, the self-perceived needs were J Health Res vol. 31, Supplement 2, 2017 http://www.jhealthres.org S145 Table 1 The characteristics of the 330 older adults participating in this study General data Number Percentage Socio-demographic data Gender Male 132 40.00 Female 198 60.00 Age (years) 60-69.9 203 61.50 70-79.9 85 25.8 80-89.9 35 10.6 90-99.9 7 2.1 Education None 31 9.4 Primary school 200 60.6 Middle school 34 10.3 Senior high school / vocational certificate 37 11.2 High vocational certificate 7 2.1 Bachelor degree 11 3.3 Master degree or higher 10 3 Occupation Government officer/ retired 26 7.9 Merchant/ business owner 39 11.8 Agriculture 41 12.4 General labor 61 18.5 Other e.g. take care of home, does not work 163 49.4 Monthly income (baht) 3,000 and less than 187 56.7 3,001-5,000 53 16.1 5,001-10,000 29 8.8 10,001-15,000 22 6.7 15,001-30,000 27 8.2 more than 30,000 12 3.6 Marital status Single 20 6.1 Married 223 67.6 Divorce 10 3 Widowed 77 23.3 Living status Living condition Alone 31 9.4 With spouse 201 60.9 With children 87 26.4 With relative 11 3.3 Living environment Owned house 268 81.2 Rent house 17 5.1 Relative's house 45 13.6 http://www.jhealthres.org J Health Res vol. 31, Supplement 2, 2017 S146 Table 1 The characteristics of the 330 older adults participating in this study (cont.) General data Number Percentage Health status Number of disease None 131 39.7 1 disease 115 34.8 2 diseases 52 15.8 3 or more than 3 diseases 32 9.7 Health insurance Universal coverage 236 71.5 Social insurance 9 2.7 Government 85 25.8 CANE Total needs, Mean (SD) 3.09 (3.33) Met needs, Mean (SD) 2.67 (3.02) Unmet needs, Mean (SD) 0.4 (1.05) assessed using the CANE questionnaire.
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