Ethnographic Exploration of Elderly Residents' Perceptions and Utilization of Health Care to Improve Their Quality of Life

Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

Abstract:

The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: Ethnographic study, health care needs, elderly Malay people, Malaysia, quality of life, residential home.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1125747

References:

[1] Beswick AD, Gooberman-Hill R, Smith A, Wylde V, Ebrahim S. ‘Maintaining independence in older people’. Reviews in Clinical Gerontology. (2010); 20(2): 128–53.
[2] Ahmad A, Purewal TS, Sharma D, Weston PJ. ‘The impact of twice-daily ward rounds on the length of stay in two general medical wards’. Clinical Medicine. (2011); 11(6): 524–8
[3] Liu L. The Health Heterogeneity of and Health Care Utilization by the Elderly in Taiwan. Int. J. Environ. Res. Public Health. (2014); 11: 1384-1397
[4] Naughton, C., Bennett, K., and Feely, J. Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age and Ageing. (2006); 35(6): 633-636.
[5] Wauthier, V., Verbeeck, R.K. and Buc Calderon, P. The Effect of Ageing on Cytochrome P450 Enzymes: Consequences for Drug Biotransformation in the Elderly. Current Medicinal Chemistry. (2007); 14: 745-757.
[6] Selvaratnam, D.P. and Tin, P.B. Lifestyle of the Elderly in Rural and Urban Malaysia. Annals of the New York Academy of Sciences. Healthy Aging and Longevity. Third International Conference. (2007); 14: 317-325.
[7] Momtaz, Y.A., Hamidi T.A., Yahaya N., Ibrahimi R. Effects of Chronic Comorbidity on Psychological Well-being Among Older Persons in Northern Peninsular Malaysia. Applied Research Quality Life. (2010); 5: 133–146
[8] Poi, P.J.H., Forsyth, D.R. and Chan, D.K.Y. Services for older people in Malaysia: issues and challenges. Age and Ageing. (2004); 33: 444-446.
[9] Gallagher R, and Gallagher P. Emergency department nurses’ perceptions and experiences of providing care for older people. Nursing and Health Sciences (2014); 16, 449–453.
[10] Chen H., Chiu PY.A., Lam P.SS., Poon WK., Chow SM., Ng WP., Yung R.WH. Prevalence of infections in residential care homes for the elderly in Hong Kong. Hong Kong Med. (2008); 14:444-50
[11] Sherina, M.S. Zulkefli, N.A.M. and Shah, S.A. Factors associated with depression among elderly patients in a primary health care clinic in Malaysia. Asia Pacific Family Medicine. (2003); 2: 148–152.
[12] Robichaud, L., Pierre, J., Durand, R.B. and Jean, P.O. Quality of life indicators in long term care: Opinions of elderly residents and their families. Canadian Journal of Occupational Therapy. (2006); 73(4): 245-251.
[13] Berglund, A.L. Satisfaction with caring and living conditions in nursing homes: Views of elderly persons, next of kin and staff members. International Journal of Nursing Practice. (2007); 13: 46–51.
[14] Onder, G., Carpenter, I., Finne-Soveri, H., Gindin, J., Frijters, D., Claude Henrard, J., et al. Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Services Research. (2012); 12:5
[15] Gregory L.A. An Analysis of Nursing Home Quality Measures and Staffing. Qual Manag Health Care. (2008); 17(3): 242–251.
[16] Kehusmaa, S., Autti-Rämö, I., Helenius, H., Rissanen, P. Does informal care reduce public care expenditure on elderly care? Estimates based on Finland’s Age Study. BioMed Central Health Services Research. (2013). 13:317.
[17] Slade, M. and McCrone, P. The Camberwell Assessment of Need (CAN). In G. Thornicroft (Ed.), Measuring Mental Health Needs (2nd ed., pp. 291-303). London: Gaskell. (2001).
[18] Wild, B., Lechner, S., Herzog, W., Maatouk, I., Wesche, D., Raum, E. et al. Reliable integrative assessment of health care needs in elderly persons: The INTERMED for the Elderly. Journal of Psychosomatic Research. (2011); 70: 169–178.
[19] Pedersen, R., Nortvedt, P., Nordhaug, M., Slettebo, A., Grothe, K. H., Kirkevold, M. et al. In quest of justice? Clinical prioritisation in healthcare for the aged. Journal of Medical Ethics. (2008); 34(4): 230-235.
[20] Bowers, B.J., Fibich, B. and Jacobson, N. Care-as-service, care-as-relating, care-as-comfort: Understanding nursing home residents’ definitions of quality. Gerontologist. (2001); 41(4): 539-545.
[21] Muller, C.A. Framwork for nurse staffing in Long-Term Care facilities. Geriatric Nursing. (2000); 21(5): 262-267.
[22] Murphy, G.T., Birch, S, MacKenzie, A., Alder, R, Lethbridge, L. and Little, L. Eliminating the shortage of registered nurses in Canada: An exercise in applied needs-based planning. Health Policy. (2012); 105: 192– 202.
[23] Politi, P., Bodini, P., Mortilla, M.G., Beltrami, M., Fornaciari, G., Formisano, D., et al., Communication of information to patients with inflammatory bowel disease: A European Collaborative Study in a multinational prospective inception cohort. Journal of Crohn's and Colitis. (2008); 2: 226-232.
[24] Loguercio, C., Tiso, A., Cotticelli, G., Blanco, C.D.V., Arpino, G., Laringe, M., et al. Management of chronic liver disease by general practitioners in Southern Italy: Unmet educational needs. Digestive and Liver Disease. 43: 736– 741.Muller, C.A. (2000). Framwork for nurse staffing in Long-Term Care facilities. Geriatric Nursing. (2011); 21(5): 262-267.
[25] Budych, K., Helms, T.M. and Schultz, C. How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient–physician interaction. Health Policy. (2012); 105: 154–164.
[26] Harding R., Selman L., Beynon T., Hodson F., Coady E., Read C., et al. Meeting the Communication and Information Needs of Chronic Heart Failure Patients. Journal of Pain and Symptom Management. (2008); 36(2): 149-156.
[27] Attard A. and Coulson, N.S. A thematic analysis of patient communication in Parkinson's disease online support group discussion forums. Computers in Human Behavior. (2012); 28: 500–506.
[28] Horsburgh, D. Evaluation of qualitative research. Journal of Clinical Nursing, (2003); 12(2): 307-312.