Developing an understanding of rural Thai elderly resilience: An Ethnography of the Primary Care Unit (Tambon Health Promoting Hospital) subculture

Traditionally in Thailand, the elderly rely on their adult children to provide them with support while they are ageing. 71.4% of Thai elderly live in rural provinces. Rural Thai family structure is changing. Adult children increasingly migrating to the major cities. 1990s Low physical health Lack of social support Lower quality of life of the rural Thai elderly Resilience; an ability to bounce back Rural Thai Elderly Community nurses are the support resource in provincial communities Experiencing difficult times  Protect against negative outcomes  Contribute to healthy ageing Adaptation Compensation Resilience Healthy ageing Successful ageing Autonomy Independence Figure 2: Model of Healthy Ageing (Hansen-Kyle, L. 2005) Introduction Aim Design and methods Results Adversities Worries with children and/or grandchildren Severe Diseases e.g. CA cervix, Renal failure, CA liver. Vulnerabilities/ dependence Debts and insufficient life support Conflict among family members/ relative Death of loved one Divorced with husband Cultural artefacts of Thai society How those things helped Religious • Make merit/ meditation practice • Donating their money • Pay homage to Budda image at home/ temple • Buddhist teaching • Felt empty and nothing to be worried about • Felt happy • Seeing the way to solve problems Family Sufficiency support e.g. money and cheerful • Living cost and travelling support • Felt proud if their children looked after them and derived pleasure talking to everyone else about how good their children are Community Positive: • Talking and having laugh • Enjoyed local music and dance Negative: Don’t want their personal business talked about by others Positive: Enjoyment from their life Negative: Afraid to talk or release their feelings Having a belief in superstition • Seeking support from fortune teller • Wearing good luck symbols • Wishes will be come true after they make enough merits • Helps them to accept with the difficult times • Be happy and secure • Their wishes have been fulfilled Conclusion School of Nursing and Midwifery, University of Newcastle, Australia For further information: Wilaiwan Pathike E-mail: Figure1: The effect of changing family structure and rural Thai elderly health Figure 3: The relationship of resilience in rural Thai elderly and community nurses Figure 4: Data collecting methods Picture 1: Tambon Health Promoting Hospital: A PCU Figure 5: The adversities or difficulties of rural Thai elderly Table1: Rural Thai cultural artefacts and their affects to help rural Thai older people overcome difficult times Resilience is an important contributor to healthy ageing. Community nurse play a key role in the promotion of healthy ageing of Thai rural elderly. Therefore, community nurses are well position to support resilience of Thai rural elderly.