Healthy ageing conceptualisations: older Malays in Malaysia
thesisposted on 01.03.2017 by Mohd Tohit, Noorlaili
In order to distinguish essays and pre-prints from academic theses, we have a separate category. These are often much longer text based documents than a paper.
Population ageing is a worldwide phenomenon. Promoting healthy ageing is now firmly in the policy agenda of many countries.This thesis aimed to explore healthy ageing conceptualisations among older Malays in Malaysia. The thesis addresses two broad questions: What factors are important in conceptualising healthy ageing from the perspective of older Malays and how are the factors being expressed? What are the barriers to and facilitators of healthy ageing in the community studied? This thesis comprises two consecutive studies. Study 1 involves focus group interviews to explore healthy ageing conceptualisations and facilitators of and barriers to the healthy ageing experience in older Malays. To further explore these issues, Study 2 examines six case studies, selected from Study 1 on the basis of a quantitative screening tool that identified participants as healthy and unhealthy agers. Study 2 focussed on the role of spirituality in healthy ageing. The cases were used to construct individual perspectives of healthy ageing using data from a structured interview and open ended qualitative responses, focus group interviews (Study 1), observation and reflections of the interaction with the participants throughout the study period. Eight focus groups consisted of 38 older Malays aged 60 to 95 years participated in Study 1. In Study 2, six cases were selected via maximal variation sampling. Six interconnected themes captured the healthy ageing concepts in Study 1. Firstly, spirituality was the driving force followed by peace of mind as the ultimate aim for healthy ageing. Physical health and function, family relationships, financial independence, and living environment greatly affected the lives of older Malays in this study. The six themes were used as a framework to address facilitators of and barriers to healthy ageing in Study 2, in particular the role of spirituality in healthy ageing. The older individuals have their own perception of their healthy ageing status and healthy ageing was seen as a process in balancing the facilitators and barriers to it. In Study 2, the sprirituality was mainly experienced as connectedness to God (intrinsic spirituality) and as mutual responsibility in their relationship with others (extrinsic spirituality). The role of spirituality was not limited as a facilitator for healthy ageing; unfulfilled intrinsic and/or extrinsic spirituality can be barriers to healthy ageing. More importantly, Study 2 identified the need to listen to the perspectives of older people to address healthy ageing in a bio-psycho-social-spiritual framework. Based on the thesis findings a model of healthy ageing was developed: the Dynamic Adaptation, Prioritisation and Transcendent Acceptance (aDAPTA) model. Older people used the processes outlined in the model in balancing the barriers and facilitators to achieving healthy ageing. In conclusion, the different cultural values explored in this thesis provided an avenue to expand healthy ageing concepts and make them relevant to the local context in Malaysia. Healthy ageing should not be restricted to a biomedical or a psychological model, the lay multidimensional bio-psycho-social-spiritual approach should be considered, particularly in addressing the needs and the adaptation experiences of older people in the local community.