An assessment of the quality of life of the Thai elderly : a study of the uses of multi-dimensional indexes

Abstract

The proportion and numbers of the population aged 60 years and above in the overall population structure of Thailand are increasing in the midst of rapid socio-economic and cultural changes. These changes inevitably affect the well-being of the Thai elderly. This study aimed to indentify significant domains of quality of life and the constituent factors that are appropriate for the elderly people in the Thai context. It was expected that this study would contribute to an increased awareness of the existing and potential needs of this segment of the population and to a better understanding of how their needs may be measured and met.

The study presented a macro-prespective of the quality of life of the Thai elderly and used multi-dimensional indexes for assessing the quality of life of the sample elderly. A survey was carried out during 6-25 May, 1993. There was a sample of 879 elderly included in this study and the response rate was 79.5 percent. The results of the study showed that female elderly reported more economic, psycho-social and health problems and less life satisfaction than male elderly. Using the LISREL model for analysis of factors affecting the quality of life of the elderly., the initial proposed model included 20 observed variables in measurement equations for five latent variables, namely:predisposing, enabling, risk, need, and quality of life variables. The first two variables were exogenous latent variables. The initial model was then modified to include 13 observable indicators with the same five latent variables. The Chi-squared value of the modified model dropped to 146.94 with 59 degrees of freedom from 1149 with 177 degrees of freedom in the initial model. Similarly, the Adjusted Goodness of Fit Index (AGF) increased from 0.869 to 0.982 and the root mean square residual reduced from 0.137 to 0.060. The total coefficient of determination for the modified model was 0.268.

The model suggested that the predisposing and enabling exogenous latent variable had little direct influence on the quality of life. Their effects were found to be mainly through the risk and need factors. The study also discussed the reasons that the age indicator of the predisposing factor was discarded in the modified model, and the significance of living arrangement as one indicator of the enabling factor's positive influence on the quality of life of the elderly. Policy implications for measures to be taken to strengthen family and community-based services and the delivery of supportive services by all sectors involved were discussed. Further investigations were recommended to study: cohort effects and quality of life, gender differentials in quality of life, and mechanisms for coping with stress among the elderly in the Thai cultural context.