- About
-
The Global ETD Search service is a free service for researchers
to find electronic theses and dissertations. This service is
provided by the
Networked Digital Library of Theses and Dissertations.
Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
Search results
Showing 101 to 110 of 110 (0.031 seconds)Spelling suggestions: "subject:"maritalstatus"" "subject:"aritalstatus""
| 101 |
一九九○年臺灣地區人口之婚姻狀況分佈的省籍差異探討 / The Domicile Difference of Marital Distribution for Total Population in Taiwan Area in 1990翁志遠, Weng, Chih-Yuan Unknown Date (has links)
本研究的主要抱負旨在，藉著分析實證人口普查資料俾便檢視，受限於某種不利的人口條件之桎梏，復加上對迥然相異的特殊生命歷程之體驗，生活在臺灣地區的不同省籍之住民，其如何受到諸如年齡、性別、教育程度等人口或社會經濟特徵之影響，因此決定了自身在某一個時間點上所歸屬的婚姻狀況，及伴隨而來在整個人口母群中婚姻狀況的非常態之集體分佈模式與深度階層化現象。在實際作法上，本研究乃選擇某一個時間橫斷面（一九九０年）為分析基準，並清楚展現位於該時點之上，臺灣地區十五歲以上人口的婚姻狀況之分佈模式所具有的省籍差異；接著則進一步探討省籍和年齡、性別、教育程度等變項間之互動情形，冀賴此釐清隱身於省籍差異表象其後的形塑機制或成因。至於在本研究的定義中，所謂婚姻狀況的「狀態集合」（state space），乃由「未婚」、「有配偶同居」、「離婚分居」與「喪偶」等四個互斥且週延的類屬所構成。
具體而言，本研究有著兩個主要發現：首先，即所謂的第一代外省籍男性，儘管他們之中絕大多數早已過了知天命之年，卻有著極高比例（約30%）仍然未婚，而此一現象有很大的部分乃肇因於移民人口中男多女少、極端不平衡的性比例組成。同時，我們還發現，一種深刻的婚姻階層化確實存在於第一代外省籍男性身上。理由是他們之中因為教育程度低下而遭排除在婚姻市場以外的情形相當嚴重：低學歷的第一代外省籍男性中有接近三分之一的人半被迫地保持無限期單身，此與高學歷的第一代外省籍男性中的未婚者之比例相差了近20%左右，而我們相信前者的構成主體極有可能就是一般社會意象中的自謀生活老兵。惟值得慶幸的是，此種未婚人口比例偏高及附帶產生的深刻婚姻階層化現象在55歲以下的「外省人」身上已不復見。
其次，則是全體「外省人」，尤以男性為然，似乎也比同年輪的本省籍對應群有著更高的離婚分居者之比例，而且至少在40歲以上的各年齡層中皆無例外。這意謂著離婚人口比例偏高在「外省人」（尤其是男性）中也呈現出一種代間一致性（如果我們將40歲以上的「外省人」以55歲為界分作兩個世代的話）。而在我們大致描繪出第一代外省籍男性離婚分居者有著相較於同輩的「本省人」或外省籍女性稍高的失能比例，而且低教育程度者在其中過度代表等特質後，另一種形式的婚姻階層化業已呼之欲出：我們以為，一般社會意象中所普遍指涉的自謀生活之外省籍老兵，於其年輕之際雖然囿於自身有限的教育程度及所得收入而被排除在競爭激烈的婚姻市場以外，但他們之中仍然有一些人可能不甘願於打一輩子光棍，只好退而求其次地降低標準，在逾半百之年後選擇臺灣社會裡處於邊緣地位的非外省籍婦女作為配偶。但無可諱言的是，這樣的組合幾乎得與所謂的「貧賤夫妻」劃上等號；再加上在如此的配對裡，夫妻之間的籍貫、熟悉的語言，生活背景等差距實在太大，幾乎毫無交集可言，我們因此不難想像該類的異質性婚姻（heterogamy）通常很有可能為時不久即告瓦解。雖然我們沒有很明確的證據來支持上述的推論，但我們以為其相當程度上應該可以比較合理地解釋為何55歲以上的外省籍男性離婚分居者中會以低教育程度者為過度代表，同時失能者比例也偏高的事實。至於55歲以下的第二代外省籍男性中仍有較大比例的離婚分居者之原因，由於久缺更為有力的線索，本文遂以移民特質─其因喪失固有親屬網絡，而後者又為緩衝或調解婚姻衝突的主要支持來源，從而產生降低婚姻品質並提高離婚機會的可能－權充說明，實則臆測成分過高，此乃大有進一步探究的必要。
最後，有關本研究所可能面臨到的重大限制主要皆存在於次級資料的適用性上，這可分三點說明。第一就是1956年的普查資料中，軍人並無入籍的問題，這無疑將會導致，在「外省人」的部份，整體性比例的計算被低估，同時可能也無法突顯出究竟在哪幾個單一年齡組中的性比例特別不均衡。第二，就是在我們欲以家戶為單位，從而挑選出於普查當時仍維持已婚或有配偶同居狀態者以進行夫妻雙方的人口屬性或社經特徵之媒合（match）分析時，這些偏誤的樣本（biased sample）─其偏誤性主要來自於排除掉其他曾經維持過已婚或有配偶同居狀態者，如普查當時的喪偶者及離婚分居者─所傳遞出來的訊息是否仍然具有價值則需要更仔細地加以評估。而最後也是最大的一個限制，無疑就是在大陸早有妻室的第一代外省籍男子可能於接受普查之時卻報告自己的身分為未婚。儘管如此，我們仍以為將反映出婚姻之實（de facto）而非婚姻之名（de jural）的普查資料作為分析對象毋寧更富意義，畢竟上述之人在臺灣的的確確過了四十年以上的非婚生活，吾輩焉能不察。在這種看法之下，本研究更需要注意的或許是所謂「自述偏差」之情況，此即受社會壓力影響而做不實宣稱之現象。
目錄
第一章、前言 1
第一節 研究動機與目的 1
第二節 「婚姻狀況」釋義 7
第三節 研究旨趣－人口的婚姻狀況之分佈 10
第四節 影響人口在婚姻狀況上的分佈之可能機制 13
一、生命歷程 13
二、人口條件 14
三、階層化 14
四、其他 15
第二章、文獻探討 17
第一節 生命歷程與婚姻 17
第二節 婚姻擠壓再探 19
第三節 臺灣歷史上的婚姻擠壓經驗 21
第四節 夫妻差異（spouse difference）與婚姻存續的關聯 23
第三章、研究架構 26
第一節 研究方法與分析資料 26
第二節 分析架構 28
第四章、分析結果 30
第一節 臺灣地區人口之婚姻狀況分佈的省籍差異－整體的初步探討 30
第二節 臺灣地區人口之婚姻狀況分佈的省籍差異－省籍和性別的互動 32
一、未婚 32
二、有配偶同居 34
三、離婚分居 37
四、喪偶 37
第三節 婚姻解組（marital dissolution）模式的省籍差異 40
第四節 第一代「外省人」與婚姻階層化 46
第五章、成因探討 50
第一節 第一代「外省人」的性別組成與婚姻擠壓 50
第二節 「外省」老兵特殊的軍旅生活經驗及其影響 50
第三節 外省籍離婚者的基本人口特徵分析 55
第六章、結論 60
第一節 主要研究發現 68
第二節 研究限制 71
參考書目 74
中文部分 74
英文部分 76
附錄 82
圖表目錄
圖1-1-1：一九九五年美國20歲以上人口的婚姻狀況按年齡組分 5
圖1-1-2：一九九０年臺灣地區20歲以上人口的婚姻狀況按年齡組分 5
圖1-3-1：二次戰後歷年臺灣地區人口的婚姻狀況分佈之變化 12
圖2-4-1：夫妻差異與離婚行為所具有的可能關聯形式 25
圖3-3-1：分析架構 28
圖4-1-1：一九九０年臺灣地區本省籍人口的婚姻狀況按單一年齡分 31
圖4-1-2：一九九０年臺灣地區外省籍人口的婚姻狀況按單一年齡分 31
圖4-1-3：一九九０年臺灣地區15歲以上人口中未婚者所佔比例按單一年齡分 33
圖4-1-4：一九九０年臺灣地區單一年齡人口中未婚者所佔比例按籍別及性別分 33
圖4-1-5：一九九０年臺灣地區15歲以上人口中有配偶同居者所佔比例按單一年齡分 35
圖4-1-6：一九九０年臺灣地區單一年齡人口中有配偶同居者所佔比例按籍別及性別分 35
圖4-1-7：一九九０年臺灣地區15歲以上人口中離婚分居者所佔比例按單一年齡分 36
圖4-1-8：一九九０年臺灣地區單一年齡人口中離婚分居者所佔比例按籍別及性別分 36
圖4-1-9：一九九０年臺灣地區15歲以上人口中喪偶者所佔比例按單一年齡分 39
圖4-1-10：一九九０年臺灣地區單一年齡人口中喪偶者所佔比例按籍別及性別分 39
圖4-2-1：一九九０年臺灣地區本省籍人口之婚姻解組模式按單一年齡分 41
圖4-2-2：一九九０年臺灣地區外省籍人口之婚姻解組模式按單一年齡分 41
圖4-2-3：一九九０年臺灣地區單一年齡人口之婚姻解組模式按籍別及性別分 43
圖4-2-4：一九九０年臺灣地區人口之性比例按年齡與籍別分 45
圖4-2-5：一九九０年台灣地區外省籍人口的年齡金字塔 45
圖4-3-1：一九九０年臺灣地區外省籍人口教育程度按年齡組及婚姻狀況分 47
圖4-3-2：一九九０年臺灣地區本省籍人口教育程度按年齡組及婚姻狀況分 47
圖4-3-3：一九九０年臺灣地區55歲及以上人口的婚姻狀況按籍別、性別與教育程度分 49
圖4-3-4：一九九０年臺灣地區15-54歲人口的婚姻狀況按籍別、性別與教育程度分 49
圖5-1-1：歷年外省籍人口之性比例按單一年齡分 54
表1-3-1：歷年美國人口（18歲及以上者）在四種婚姻狀況中的分佈情形 10
表1-3-2：歷年臺灣地區人口（15歲及以上者）在四種婚姻狀況中的分佈情形 10
表1-3-3：一九九五年美國人口的婚姻狀況分佈按年齡組分 11
表4-2-1：一九九０年臺灣地區結婚人數按新郎新娘婚前狀況及年齡組分 43
表5-1-1：一九四五年以後來臺「外省人」按來臺年分及性別分 51
表5-1-2：歷年外省籍現住人口性比例 52
表5-1-3：歷年外省籍人口之性比例按五歲年齡組分 53
表5-3-1：一九九０年臺灣地區的離婚分居者之年齡分佈按籍別與性別分 60
表5-3-2：一九九０年臺灣地區的離婚分居者之身體狀況按籍別及年齡組分 61
表5-3-3：一九九０年臺灣地區的外省籍離婚分居者之身體狀況按性別及年齡組分 61
表5-3-4：一九九０年臺灣地區的離婚分居者之教育程度按籍別及年齡組分 62
表5-3-5：一九九０年臺灣地區的外省籍離婚分居者之教育程度按性別及年齡組分 62
表5-3-6：一九九０年臺灣地區本省籍全體人口、外省籍全體人口、外省籍男性人口和外省籍女性人口的教育程度按年齡組分 63
表5-3-7：一九九０年臺灣地區本省籍全體、外省籍全體、外省籍男性和外省籍女性中離婚分居者的教育程度之代表性指標按年齡組分 64
附錄表1-1：抽樣之15-29歲的丈夫與其妻子之年齡差距（夫減妻）的次數分佈按夫妻省籍配對模式分 82
附錄表1-2：抽樣之15-29歲的丈夫與其妻子之教育程度的交叉比例分析按夫妻省籍配對模式分 83
附錄表2-1：抽樣之30-54歲的丈夫與其妻子之年齡差距（夫減妻）的次數分佈按夫妻省籍配對模式分 84
附錄表2-2：抽樣之30-54歲的丈夫與其妻子之教育程度的交叉比例分析按夫妻省籍配對模式分 85
附錄表3-1：抽樣之55歲以上的丈夫與其妻子之年齡差距（夫減妻）的次數分佈按夫妻省籍配對模式分 86
附錄表3-2：抽樣之55歲以上的丈夫與其妻子之教育程度的交叉比例分析按夫妻省籍配對模式分 87 / The purpose of this study is to explore the domicile difference-between Mainlanders and Taiwanese（except the Aborigines）-of distribution of marital status for total dwellers older than 15 in Taiwan Area. We argue that, dominated by somewhat disadvantageous population conditions（e.g. unbalanced sex ratio）, one who experienced his own unique life course（like migration event） must belong to some kind of marital status at a certain time according to his other characteristics such as domicile, sex, age and education, which will add up to an abcdrmal collective distribution pattern of marital status for the total population. Accordingly, this study is conducted by employing the 1990 census in Taiwan Area. Results suggest that, compared with female Mainlanders and all Taiwanese of the same cohort, the never-married and the divorced are significantly over-represented in the first-generation male Mainlanders who was older than 55 in 1990. We conclude that it is his socioeconomic status but not his domicile that determines whether the first-generation male Mainlander is never-married, married or unmarried in his late years. In other words, we believe that among the first-generation male Mainlanders does exist severe marriage stratification to some degree.
|
| 102 |
Effects of the biographic factors and religious convictions on littering to enhance waste management in Pretoria city, South AfricaMathe, Ronald 03 1900 (has links)
The economic and population growth have led to the increased volumes of municipal solid waste in South Africa, hence more pressure to the waste management facilities. Municipal solid waste management is a by-product of everyday living, this is the reason why there is an environmental burden caused by waste to the environment. This study was conducted in Pretoria within the three sampled areas, namely: Garsfontein, Marabastad and Pretoria Central Business District (CBD). The rationale of the study was to establish the influence and effects of biographic factors (age, marital status, educational background, gender) and religious conviction on littering. This project constitutes both qualitative and quantitative data collection methods. About 150 of the questionnaires were administered to each of the three sampled areas. Therefore, the overall proportion of the respondents was 450. Visual inspection was done in all the three sampled areas to observe the littering status quo and waste management situation in these particular areas. The visual inspection uncovered very interesting findings. It was established that Marabastad was cleaner in the morning than in the late hours while Garsfontein was clean throughout the day. Another problem that was discovered, amongst others was that of the condition of the bins in Marabastad and Pretoria Central Business District (CBD) which was bad compared to Garsfontein. From the questionnaire, it was found that the 72% of elderly respondents (< 36 yrs) are more environmental conscious than the young people (18-35 yrs) who 83% of them claim to litter when there is no bin. Further, among young people, 78% said litter cigarette butts and 93% of these said better street cleanliness would help reduce littering. 72% of adults said religious convictions would help reduce littering. The chi-square and correlation coefficient statistical data analysis methods were used to establish the relationship between different biographic and religious variables. Gender, marital status, monthly income, age and religious conviction were all found to have significant effects on issues regarding littering in the city. / Environmental Sciences / M. Sc. (Environmental Science)
|
| 103 |
Hållbara investeringar : vem, hur och varför? / Sustainable investments : who, how, and why?Bogren, Julia, Samuelson, Anna January 2021 (has links)
Bakgrund: Under de senaste åren har svenska investerares intresse för hållbara investeringar ökat. Tidigare studier har genomförts för att identifiera vem den hållbara investeraren är, varför de väljer att investera hållbart och hur de går till väga. Däremot finns det fortfarande behov av vidare forskning på den svenska marknaden varav en kunskapslucka identifierats. Syfte: Syftet är att via en kvantitativ studie undersöka vilka demografiska faktorer som kännetecknar svenska, hållbara investerare. Studien ämnar även att undersöka vilka motiv och tillvägagångssätt som ligger till grund för hållbara investeringsbeslut på den svenska finansmarknaden. Metod: Studien har tillämpat en kvantitativ metod, deduktiv ansats, och en ickeexperimentell tvärsnittsdesign. Det empiriska materialet samlades in via en digital enkätundersökning via ett bekvämlighetsurval. Undersökningen resulterade i totalt 469 användbara svar som sedan analyserades via regressionsanalyser. Resultat: För de demografiska faktorerna är det endast kön som har ett 5 procent signifikant samband med den beroende variabeln. Resultatet visar även att samtliga undersökta motiv och tillvägagångssätt, med undantag för flockbeteende, har ett 5 procent signifikant samband med den beroende variabeln. Slutsats: Ambitionen med studien var att öka förståelsen för hållbara investeringar från den privata investerarens perspektiv. Således har studien bidragit med en förståelse för vem den svenska, hållbara investeraren är, hur den går till väga och varför den investerar hållbart. / Background: In recent years, Swedish investors have shown an increasing interest in sustainable investments. Previous studies have been conducted to identify who the sustainable investor is, why the investor chooses to invest sustainably and what strategy he or she uses. However, there is a need of further research in the Swedish market, whereof a knowledge gap has been identified. Purpose: The purpose of this study is to investigate what demographic factors that characterize Swedish, sustainable investors. The study also intends to examine the motives and strategies used in the sustainable investment decision. Methodology: The study has applied a quantitative method, deductive approach, and a non-experimental cross-sectional design. The empirical material was conducted via a digital survey based on convenience sampling. The survey resulted in a total of 469 useful responses which were then analyzed via regression analyzes. Results: The result shows that the demographic factor gender is the only independent variable with a 5 percent significant impact on the dependent variable. The result also shows that all examined motives and strategies, with the exception of herding, have a 5 percent significant impact on the dependent variable. Conclusion: The aim of the study was to increase the understanding of sustainable investments from the perspective of the private investor. Thereby, the study contributes with an understanding of who the Swedish, sustainable investor is, what strategy the investor uses and why the investor invests sustainably.
|
| 104 |
Implicit Family Process and Couples Rules: A Comparison of American and Hungarian FamiliesGergely, Noemi 13 July 2006 (has links) (PDF)
Family life is organized by rules, and most of them are unspokenly agreed-upon by family members and may be even out of awareness. Implicit family process and couple rules may facilitate or constrain family relationship and intimate couple relationship growth. Prevalence of family rules may be different across cultures. Family members may perceive their rules and family functioning differently according to their family position and gender. Married couples may view their relationship rules differently than couples who cohabit. This study utilized the Family Implicit Rules Profile (FIRP) and the Couples Implicit Rules Profile (CIRP) Questionnaires to answer these research questions. The questionnaires were translated into Hungarian, and the content validity of the Hungarian translation was established. Hungarian non-clinical families and couples were compared to American (U.S.) non-clinical families and couples to examine how prevalent implicit rules were in the two cultures. According to the findings, Hungarian families and couples scored lower on the total FIRP and CIRP scores. Hungarian families perceived implicit family rules regarding kindness and monitoring less prevalent, and rules regarding constraining their thoughts, feelings and self more prevalent than American families. No differences were found in expressiveness and connection and inappropriate caretaking of parents between the two cultures. Hungarian couples perceived their implicit relationship rules regarding kindness, expressiveness and connection and monitoring less prevalent than American couples. No differences in implicit rules about constraining thoughts, feelings and self and inappropriate caretaking of partner were found between the two cultures. Mothers in both cultures viewed their families in a more positive light than other family members, and female family members (mothers and daughters) were more positive than their male counterparts (fathers and sons) about rules in their families in both cultures. Sons in both cultures perceived more responsibility to protect their parents emotionally than did daughters. Married couples in both cultures perceived their relationship rules more favorably in terms of kindness and monitoring than cohabiting couples. Results were interpreted in the context of cultural differences between the American and the Hungarian cultures. Limitations and the possibility of future research are discussed.
|
| 105 |
Intimate Partner Violence Predictors in an International Context: An Analysis of the International Violence against Women SurveyForrester, Trina K. 21 April 2011 (has links)
Using the International Violence Against Women Survey (IVAWS), this paper identifies factors contributing to women’s individual risk of being victimized by their current intimate partner. Additionally, this analysis examines the overlap of physical and sexual violence within intimate relationships. Past research into IPV has identified a numerous predictor variables. Adapting nine such variables (controlling behaviours, male heavy drinking, female only income, female past marriage, female past IPV, respondents’ age, relationship duration, relationship status and violence outside the home) to the IVAWS dataset, a framework identifying risk patterns for physical and sexual violence was developed. The results identify a number of variables that performed as expected and increased a women’s risk of being a victim of IPV; however, some variables decreased women’s risk and therefore acted as protective factors. These findings suggest that IPV at the country level is more complex and requires additional research to fully explain the variation observed.
|
| 106 |
Intimate Partner Violence Predictors in an International Context: An Analysis of the International Violence against Women SurveyForrester, Trina K. 21 April 2011 (has links)
Using the International Violence Against Women Survey (IVAWS), this paper identifies factors contributing to women’s individual risk of being victimized by their current intimate partner. Additionally, this analysis examines the overlap of physical and sexual violence within intimate relationships. Past research into IPV has identified a numerous predictor variables. Adapting nine such variables (controlling behaviours, male heavy drinking, female only income, female past marriage, female past IPV, respondents’ age, relationship duration, relationship status and violence outside the home) to the IVAWS dataset, a framework identifying risk patterns for physical and sexual violence was developed. The results identify a number of variables that performed as expected and increased a women’s risk of being a victim of IPV; however, some variables decreased women’s risk and therefore acted as protective factors. These findings suggest that IPV at the country level is more complex and requires additional research to fully explain the variation observed.
|
| 107 |
Intimate Partner Violence Predictors in an International Context: An Analysis of the International Violence against Women SurveyForrester, Trina K. 21 April 2011 (has links)
Using the International Violence Against Women Survey (IVAWS), this paper identifies factors contributing to women’s individual risk of being victimized by their current intimate partner. Additionally, this analysis examines the overlap of physical and sexual violence within intimate relationships. Past research into IPV has identified a numerous predictor variables. Adapting nine such variables (controlling behaviours, male heavy drinking, female only income, female past marriage, female past IPV, respondents’ age, relationship duration, relationship status and violence outside the home) to the IVAWS dataset, a framework identifying risk patterns for physical and sexual violence was developed. The results identify a number of variables that performed as expected and increased a women’s risk of being a victim of IPV; however, some variables decreased women’s risk and therefore acted as protective factors. These findings suggest that IPV at the country level is more complex and requires additional research to fully explain the variation observed.
|
| 108 |
Intimate Partner Violence Predictors in an International Context: An Analysis of the International Violence against Women SurveyForrester, Trina K. January 2011 (has links)
Using the International Violence Against Women Survey (IVAWS), this paper identifies factors contributing to women’s individual risk of being victimized by their current intimate partner. Additionally, this analysis examines the overlap of physical and sexual violence within intimate relationships. Past research into IPV has identified a numerous predictor variables. Adapting nine such variables (controlling behaviours, male heavy drinking, female only income, female past marriage, female past IPV, respondents’ age, relationship duration, relationship status and violence outside the home) to the IVAWS dataset, a framework identifying risk patterns for physical and sexual violence was developed. The results identify a number of variables that performed as expected and increased a women’s risk of being a victim of IPV; however, some variables decreased women’s risk and therefore acted as protective factors. These findings suggest that IPV at the country level is more complex and requires additional research to fully explain the variation observed.
|
| 109 |
Bullying: Out Of The School Halls And Into The WorkplaceCooney, Lucretia 01 January 2010 (has links)
The primary purpose of this study is to identify those people at most risk of being bullied at work. While much research is being conducted on school bullying, little has been conducted on workplace bullying. Using data gathered from a 2004 study conducted by the National Opinion Research Center for the General Social Survey, which included a Quality of Work Life (QWL) module for the National Institute for Occupational Safety and Health (NIOSH), linear regressions indicated significant findings. As predicted, workers in lower level occupations, as ranked by prestige scoring developed at National Opinion Research, are more likely to be victimized. Data also suggest that being young, Black, and relatively uneducated may contribute to being bullied in certain situations. Future research is needed to examine influences of socio-economic, legal, and other demographic factors that may predict the chance of being bullied.
|
| 110 |
Health for community dwelling older people : trends, inequalities, needs and care in rural VietnamVan Hoi, Le January 2011 (has links)
Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations. The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services. Conclusions There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups. Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services. / Aging and Living Conditions Program / Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec
|
Page generated in 0.0456 seconds