| dc.description | A Dissertation submitted to the Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, in partial fulfillment of the requirements for the award of the Degree of Master of Public Health (Health Promotion and Education) of the University of Ibadan, Ibadan, Nigeria. | en_US |
| dc.description.abstract | The elderly face a broad range of medical, physical, psychological and social needs that require assistance and supervision on a temporary or permanent basis. This needs and health challenges often vary from community to community due to a number of factors. However, such concerns among the elderly in peri-urban setting, with a mixture of rural and urban characteristics, have not been fully investigated. This study was therefore designed to determine the perceived psycho-social needs, quality of life and health-related challenges experienced by the elderly in Apete, a peri-urban Ibadan community.
The study was cross-sectional and employed a two-stage sampling technique to select 600 consenting elderly from the 12 neighborhood clusters and houses in the community. A semi-structured questionnaire used had questions on socio-demographic characteristics, perception, perceived needs, health-related challenges and typologies of social support received. These were measured using Quality of life-QOL (36); depression (30); General Health-GH (33); and dementia (8) scale. Scores of ≤15 and ≥15-36 on the QOL scale are categorized as high and low respectively. Depression scores of 0-9, >9-19 and >19-30 were classified as normal, mild and severe respectively. The GH scores of ≤15, >15-20 and >20-34 were categorized as lack of distress, moderate distress and severe distress respectively. Dementia scores were categorized 33 follows: 0-2 (intact functioning), 3-4 (mild impairment), 5-6 (moderate impairment) and 7-8 (severe Impairment). Data were analysed using descriptive statistic. Chi-square test and logistic regression at p=0.05.
Age of respondents was 67.7±7.1 years; 56.2% were males; 78.1% are married; 28.7% had no formal education and 12.5% were living alone. Majority (86.2%) opined that home-based care was better for the elderly while most 90.1% had high QOL. Respondents' needs Included inadequate financial support (78.8%) and poor access to regular medical check-up (64.8%). Respondents with mild and severe depression were 27.7% and 4.7% respectively while moderate and severe dementias were 12.2% and 3.2%. Few (9.3%) had mild dementia: moderate and severe dementias were 0.2% and 0.3% respectively. Other reported health problems included insomnia (40.5%), hypertension (36.0%), diabeties (28.3%) and stroke (20.0%).
Insomnia was significantly higher in females (46.0%) than males (36.2%). Health workers' unfriendly behaviour (93.3%) was a major concern among respondents. Among the married, more males (44.6%) than females (22.7%) received social support from their spouses. Children (91.3%) constituted respondents' main source of social support while support from the community was 15.5%. Significantly more females (93.9%) than males (89.3%) received social support from children. Respondents with formal education were more likely to have high QOL compared to those with informal education (OR: 2.5; CI: 1.2-5.0). Respondents living with other people were more likely to have high QOL compared to those living alone (OR: 2.2: Cl: 1.2-4.0).
Access to adequate social support and provision of patient friendly health care services constituted the major needs of the elderly at Apete. There is need to re-orientate health workers on their behaviour towards the elderly and government should subsidise healthcare delivery to improve access to medical care. | en_US |
