published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

In Hong Kong, the population of older adults aged 65 and above is expected to nearly double by the beginning of the 2030s, which will then represent just over a quarter of the population. A local study found that many people in Hong Kong had given very little thought to plans for retirement and old age, including aspects of financial, health, social, and living arrangements (Lee & Law, 2004). Many similar retirement studies can be found in the West, primarily using a quantitative inquiry framework. The number of qualitative inquiries on aging issues has steadily increased over the last decade. Results from previous studies showed similar patterns, i.e. low levels of planning activities for retirement and old age across all social classes. However, none of the studies explored beyond the correlations and associations among variables. This study aims to add to the body of knowledge in the field of aging by employing life course perspectives with a qualitative approach through examining whether situational and contextual factors do in fact affect individuals’ old age readiness. There are two core objectives of this study. The first objective is to investigate whether and how life experiences from significant events or transitions influence important decisions in life, in this case, the planning for retirement and old age among the target population of mid-aged women from middle and working class backgrounds in Hong Kong. The second objective is to explore relationships and the degree of significance between Chinese traditional belief systems and the level of retirement preparedness amidst high volatility in global financial markets and the development of old age friendly welfare and policies in Hong Kong. Semi-structured interviews were conducted with a purposive sample of 34 women between the ages of 45 and 59. Results connote that most of these women witnessed the growth of economic development in Hong Kong; unfortunately they have not accumulated enough physical resources to prepare for retirement or old age after its growth plateaued and has been stumbling since the late 1990s. Their social network system is very limited and in many cases also fragile. Minimal preventive health measures are being taken except for addressing pre-existing physical and mental health issues. Living arrangements is the area least planned for, including those women who are public rental housing tenants. The interviewed women hold the same Chinese traditional value that they are hoping to receive family support during old age. Nonetheless, they also feel vulnerable because their adult children are struggling to make ends meet as well. Public cash assistances are these women’s last resort if their children cannot afford to provide support due to economic difficulties or after depletion of their own funds from MPF, personal savings and investments. This group of women is likely to actively utilize the public healthcare system, community programs, and long-term care facilities in the near future. Implications of the study include social work practices and public policies that will support the potential needs of the forthcoming wave of the old age population. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Pau King-man. / Thesis submitted in: October 2001. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 173-181). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (Chinese version) --- p.iii / Table of Contents --- p.iv / List of Figures --- p.xii / List of Tables --- p.xiii / List of Abbreviations --- p.xxiv / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- Women's Overweight and Obesity Prevalence and Trends --- p.1 / Chapter 1.2 --- Etiology of Overweight and Obesity --- p.2 / Chapter 1.3 --- Health Consequences of Obesity in Women --- p.4 / Chapter 1.4 --- Dietary and Physical Activity Recommendations for Good Health for Adults --- p.6 / Chapter 1.5 --- Health Behavior Change Theories --- p.8 / Chapter 1.6 --- Weight Control/Loss Interventions for Women --- p.10 / Chapter 1.7 --- Weight Loss Risks --- p.11 / Chapter 1.8 --- Health Promotion Programs for Women --- p.12 / Chapter 1.9 --- General Situation and Population Trends Among Hong Kong Middle- aged Women --- p.15 / Chapter 1.10 --- Nutrition-related Morbidity and Mortality Among Hong Kong Women --- p.16 / Chapter 1.11 --- Diet Composition of Hong Kong Middle-aged Women --- p.20 / Chapter 1.12 --- Physical Activity Patterns of Hong Kong Middle-aged Women --- p.21 / Chapter 1.13 --- Education and Health in Hong Kong Middle-aged Women --- p.23 / Chapter 1.14 --- Attitudes Toward and Beliefs About Diet and Health of Hong Kong Middle-aged Women --- p.24 / Chapter 1.15 --- Common Weight Loss Methods Among Hong Kong Middle-aged Women --- p.25 / Chapter 1.16 --- Sources of Health Information Among Hong Kong Middle-aged Women --- p.25 / Chapter 1.17 --- Summary --- p.26 / Chapter 1.18 --- Study Purpose and Objectives --- p.26 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Recruitment of Participants --- p.29 / Chapter 2.2 --- Focus Groups --- p.29 / Chapter 2.3 --- Survey Instrument --- p.30 / Chapter 2.3.1 --- Questionnaire --- p.30 / Chapter 2.3.2 --- Three-day Dietary Record --- p.35 / Chapter 2.3.3 --- Anthropometric and Cholesterol Measurements --- p.35 / Chapter 2.4 --- Intervention --- p.37 / Chapter 2.5 --- Evaluation --- p.39 / Chapter 2.5.1 --- Process Evaluation --- p.39 / Chapter 2.5.2 --- Outcome Evaluation --- p.40 / Chapter 2.6 --- Data Management --- p.40 / Chapter 2.7 --- Statistics --- p.40 / Chapter 2.8 --- Data Analysis --- p.41 / Chapter 2.8.1 --- Physical Activity Patterns --- p.41 / Chapter 2.8.2 --- Dietary Patterns --- p.44 / Chapter 2.8.3 --- Nutrition Knowledge Score --- p.45 / Chapter 2.8.4 --- Physical Activity Knowledge Score --- p.46 / Chapter 2.8.5 --- Blood Total Cholesterol --- p.46 / Chapter 2.8.6 --- Body Mass Index --- p.47 / Chapter 2.8.7 --- Percent Body Fat --- p.47 / Chapter 2.9 --- Ethics --- p.47 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Focus Group Results --- p.43 / Chapter 3.1.1 --- General Description of Participants --- p.48 / Chapter 3.1.2 --- Perceived Values and Views on 'Health' --- p.50 / Chapter 3.1.3 --- Perceived Values and Views on 'Healthy Lifestyle' --- p.51 / Chapter 3.1.4 --- Perceived Values and Views on 'Healthy Eating' --- p.52 / Chapter 3.1.5 --- Perceived Values and Views on 'Physical Activity' --- p.53 / Chapter 3.1.6 --- The Factors Motivating the Women to Adopt a Healthy Lifestyle --- p.53 / Chapter 3.1.7 --- Sources of Information About Healthy Eating and Physical Activity --- p.55 / Chapter 3.1.8 --- Suggestions for the Type and Content of Activities in a Health Promotion Program --- p.55 / Chapter 3.2 --- Participation Rate in the Study --- p.56 / Chapter 3.3 --- Pretest --- p.57 / Chapter 3.3.1 --- General Participant Sociodemographic Description --- p.57 / Chapter 3.3.2 --- Anthropometry --- p.59 / Chapter 3.3.3 --- Health Conditions Reported --- p.60 / Chapter 3.3.4 --- Meal Patterns --- p.61 / Chapter 3.3.5 --- Nutrient Supplements Practices --- p.62 / Chapter 3.3.6 --- Cooking Practices --- p.63 / Chapter 3.3.7 --- Food Removal Behavior --- p.65 / Chapter 3.3.8 --- Food Label Reading --- p.65 / Chapter 3.3.9 --- Dietary Intake --- p.66 / Chapter a. --- From the Three-day Dietary Records --- p.66 / Chapter b. --- From the Food Frequency Questionnaire --- p.68 / Chapter 3.3.10 --- Nutrition Knowledge --- p.69 / Chapter 3.3.11 --- Physical Activity Habits --- p.72 / Chapter 3.3.12 --- Physical Activity Knowledge --- p.73 / Chapter 3.3.13 --- Intention and Confidence in Changing Behavior --- p.76 / Chapter 3.3.14 --- Perceived Difficulties in Changing Behavior --- p.77 / Chapter 3.3.15 --- Perceived Methods Facilitating Behavior Change --- p.79 / Chapter 3.3.16 --- Health Information Desired --- p.80 / Chapter 3.3.17 --- Areas of Health the Women Would Like to Improve --- p.81 / Chapter 3.3.18 --- Summary Profile of the Women at Pretest --- p.82 / Chapter 3.4 --- Outcome Evaluation --- p.85 / Chapter 3.5 --- Posttest --- p.85 / Chapter 3.5.1 --- General Participant Sociodemographic Description --- p.85 / Chapter 3.5.2 --- Anthropometry --- p.86 / Chapter 3.5.3 --- Health Conditions Reported --- p.87 / Chapter 3.5.4 --- Meal Patterns --- p.88 / Chapter 3.5.5 --- Nutrient Supplements Practices --- p.89 / Chapter 3.5.6 --- Cooking Practices --- p.90 / Chapter 3.5.7 --- Food Removal Behavior --- p.91 / Chapter 3.5.8 --- Food Label Reading --- p.91 / Chapter 3.5.9 --- Dietary Intake --- p.93 / Chapter a. --- From the Three-day Dietary Records --- p.93 / Chapter b. --- From the Food Frequency Questionnaire --- p.94 / Chapter 3.5.10 --- Nutrition Knowledge --- p.95 / Chapter 3.5.11 --- Physical Activity Habits --- p.98 / Chapter 3.5.12 --- Physical Activity Knowledge --- p.99 / Chapter 3.5.13 --- Analysis the Changes by Education Level --- p.102 / Chapter 3.5.14 --- Analysis the Changes by Age Group --- p.104 / Chapter 3.5.15 --- Intention and Confidence in Changing Behavior --- p.105 / Chapter 3.5.16 --- Perceived Difficulties in Changing Behavior --- p.107 / Chapter 3.5.17 --- Perceived Methods Facilitating Behavior Change --- p.109 / Chapter 3.5.18 --- Health Information Desired --- p.110 / Chapter 3.5.19 --- Areas of Health the Women Would Like to Improve --- p.111 / Chapter 3.5.20 --- Summary Profile of the Women at Posttest --- p.112 / Chapter 3.6 --- Participants' Evaluation of the Intervention Program --- p.113 / Chapter 3.7 --- Follow-up --- p.118 / Chapter 3.7.1 --- General Participant Sociodemographic Description --- p.118 / Chapter 3.7.2 --- Anthropometry --- p.118 / Chapter 3.7.3 --- Health Conditions Reported --- p.121 / Chapter 3.7.4 --- Meal Patterns --- p.121 / Chapter 3.7.5 --- Nutrient Supplements Practices --- p.122 / Chapter 3.7.6 --- Cooking Practices --- p.123 / Chapter 3.7.7 --- Food Removal Behavior --- p.125 / Chapter 3.7.8 --- Food Label Reading --- p.126 / Chapter 3.7.9 --- Dietary Intake --- p.127 / Chapter a. --- From the Three-day Dietary Records --- p.127 / Chapter b. --- From the Food Frequency Questionnaire --- p.129 / Chapter 3.7.10 --- Nutrition Knowledge --- p.131 / Chapter 3.7.11 --- Physical Activity Habits --- p.135 / Chapter 3.7.12 --- Physical Activity Knowledge --- p.136 / Chapter 3.7.13 --- Intention and Confidence in Changing Behavior --- p.140 / Chapter 3.7.14 --- Analysis the Changes by Education Level --- p.142 / Chapter 3.7.15 --- Analysis the Changes by Age Group --- p.143 / Chapter 3.7.16 --- Perceived Difficulties in Changing Behavior --- p.144 / Chapter 3.7.17 --- Perceived Methods Facilitating Behavior Change --- p.145 / Chapter 3.7.18 --- Health Information Desired --- p.148 / Chapter 3.7.19 --- Areas of Health the Women Would Like to Improve --- p.149 / Chapter 3.7.20 --- Summary Profile of the Women at Follow-up --- p.150 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Implications of Findings --- p.154 / Chapter 4.1.1 --- Current Situations in Diet and Physical Activity of Hong Kong Middle-aged Women --- p.154 / Chapter 4.1.2 --- Overall Effects of the Program --- p.161 / Chapter a. --- Changes in Knowledge --- p.161 / Chapter b. --- Changes in Awareness and Intention --- p.163 / Chapter c. --- Changes in Behavior --- p.164 / Chapter d. --- Changes in Anthropometery --- p.166 / Chapter 4.2 --- Strengths and Limitations of the Study --- p.167 / Chapter 4.3 --- Implications and Recommendations for Meeting the Challenges of Improving Hong Kong Middle-aged Women's Nutrition and Physical Activity Habits --- p.169 / Chapter 4.4 --- Suggestions for Future Research --- p.170 / Chapter CHAPTER FIVE: --- CONCLUSIONS --- p.172 / References --- p.173 / Appendices / Chapter A --- Consent form (Chinese version) --- p.182 / Chapter B --- Consent form (English version) --- p.183 / Chapter C --- Questionnaire (Chinese version) --- p.184 / Chapter D --- Questionnaire (English version) --- p.196 / Chapter E --- Photos for food amount quantities and household measures (Chinese version) --- p.210 / Chapter F --- Photos for food amount quantities and household measures (English version) --- p.213 / Chapter G --- Sample of dietary record (Chinese version) --- p.216 / Chapter H --- Sample of dietary record (English version) --- p.217 / Chapter I --- Three-day dietary record (Chinese version) --- p.218 / Chapter J --- Three-day dietary record (English version) --- p.221 / Chapter K --- Pamphlets for health talks (Chinese version) --- p.224 / Chapter L --- Pamphlets for health talks (English version) --- p.236 / Chapter M --- Pamphlets for physical activity demonstration (Chinese version) --- p.248 / Chapter N --- Pamphlets for physical activity demonstration (English version) --- p.253 / Chapter O --- Process evaluation questionnaire (Chinese version) --- p.258 / Chapter P --- Process evaluation questionnaire (English version) --- p.260 / Chapter Q --- Overall evaluation questionnaire (Chinese version) --- p.262 / Chapter R --- Overall evaluation questionnaire (English version) --- p.263 / Chapter S --- Focus group questionnaire (Chinese version) --- p.264 / Chapter T --- Focus group questionnaire (English version) --- p.265 / Chapter U --- Focus group question guides (Chinese version) --- p.266 / Chapter V --- Focus group question guides (English version) --- p.268 / Chapter W --- The food consumption patterns of women in the Education and Control Groups --- p.270