lTl'iGnui!,NGmUi;«ii
Danh gia siic khoe va sii tham gia cua ngiidi cao tudi trong phat tridn cong ddng tai 3 xa cua huyen Tiln Hai, tinh Thai Binh nam 2010
Lfi Vu Anh", Dang Huy Hoang^, Tran VC', Nguyin Ngpc Bich", Nguyin Tidn Thingf
Ket qud cua nghiin cdu tdng quan chinh sdch cua Hdi Y te Cong cdng Viet Nam vd bdo cao thuc hiin Chuang trinh hdnh ddng qudc live ngUdi cao tudi (NCT) trong 5 ndm cua Uy ban Quoc gia NCT cho thdy NCT ngdy cdng tham gia vdo qud trinh phdt triin cgng dong. Bdi bdo ndy trinh bdy ddnh gid ban ddu nhdm tim hieu tinh hlnh sdc khoe vd stf tham gia cua NCT trong cdc hogt ddng gia dinh, xd hgi vd trong phdt trien cdng dong tgi 3 xd cda huyen Tien Hdi, linh Thdi Binh. Ddnh gid dugc thiit kicdt ngang. kit hgp phuang phap dinh lugng vd dinh tinh. Cd mdu phdng vd'n dinh lugng Id 958 NCT; thdng tin dinh tinh thu thdp qua 6 thdo lugn nhdm vdi NCT vd 12 phong vdn sdu ldnh dao cua 3 xd. Kit qud chira rang ty If NCT ttf ddnh gid siic khde binh ihudng cao (47,5%) nhung sd ngudi NCT mdc mgt hay nhieu benh ly sdc khoe cung rdt cao (97,4%). NCT tham gia cdc cdng vifc gia dinh (CVGD), xd hgi (VHXH) vd lao ddng sdn xud't (LDSX) chiim ly le khd cao. ldn lugt Id 88%.
79,7% vd 29,5%; ngodi ra nhieu NCT bie't vd tham gia trong cdng tdc phong chdng ldc hgi (PCTH) thudc Id vd phdng chdng Igm dung rugu bia tgi dia phuang. Ddc biet NCT td 60-74 tuoi da sdcdn sdc khoe vd dang tham gia vdo cdc cdng viec gia dinh vd xd hdi theo hinh thdc tU nguyen vd cd nhu cdu duac ddo tao kiin thdc. ky ndng. Tuy nhiin chinh quyin dia phuang vdn thiiu cdng tdc truyin thdng vd cdc vdn bdn hudng dan cho su tham gia cua NCT. Do dd, de khuyin khich su tham gia cua NCT. cdc chuang trinh can thiep cdn phd'i hgp vdi chinh quyin dia phuang xdy dung mgt ca chi phd hgp. NCT tham gia vdo cdc hogt dgng giup phdt triin cgng ddng nin d do tuoi td 60 -74. nhiit tinh, cd kinh nghiem chuyin mdn.
Td khod: ngudi cao tudi, su tham gia.
Assessment on health status and participation in community development of the elderly in 3
communes of Tien Hai district, Thai Binh province in 2010
Le Vu Anh", Dang Huy Hoang^, Tran Vu', Nguyen Ngoc Bich", Nguyen Tien Thang'
20 Tap chi Y td Cdng cdng, 1.2015, Sd 34
• Ngdy nhjn bii: 1.12.1014 • Ngdy phin bi$n: 11.12.2014 • Ngiy chinh sOa: 18.12.2014 • Ngdy difOc chap nblD ding: 20.12.2014
I TdNG QUAN & NGHIEN ctiu I
Findings from a policy review conducted by Vietnam Public Health Association (VPHA) and a Report on 5 years implementing the Intematioruxl action program on Ageing by Vietnam National Committee on Ageing (VNCA) showed that there has been more and more involvement of the elderly in the community development process. This article will present our baseline survey with ihe aim of assessing the health status and participation ofthe elderly in family, social activities arui community development in 3 communes of Tien Hai district. Thai Binh province. It was a cross-sectional study combining qualitative and quantitative methods. The sample size of quantitative interview was 958 older persons. Qualitative data was collected from 6 focus group discussions and 12 in-depth interviews conducted in 3 communes. The findings showed that the proportion ofthe elderly who self- rated their health to be good was high (47.5%) but the proportion ofthe elderly having al least one or more diseases was also very high (97.4%). Surprisingly, the proportion of the elderly who participated in family, social and production activities was quite high (88%, 79.7% and 29.5%, respectively). Besides, there was also a quite high number ofthe elderly who knew and got involved in local tobacco and alcohol control activities. Particularly, most ofthe elderly aged between 60 - 74 were healthy and participating in family and social work voluntarily and in need of knowledge and skill training. However, local governments still tacked communication activities and guidelines for encouraging the participation ofthe elderly. Therefore, we proposed to cooperate with the local
government lo develop a network of Public Health Association at the grassroots level. The core group of this nelM'ork consists of the enthusiastic elderly aged 60-74 having professional experience to involve in community development.
Keywords: elderly, the participation.
T i c gil:
Tnrdng Dai hoc Y td Cdng Cflng Hfli Y td Cflng cOng Vidt Nam
1. D$t vS'n dd
G i l hda dan s d d a n g la mpt vl'n de c a p b i c h cd anh htfdng Idn den cac khia c a n h v l n hda xa hdi tai Vifit Nam. T h e o b i o d o ke't qua suy rpng m l u ciia Tdng d i l u tra D i n sd va nha d 2009, ty le N C T d Vifit Nam hifin la 9%. So vdi Dieu Ira nam 1999, do ty Ifi N C T tang trong khi ty le tre e m dtfdi 15 ludi giam, "chi s d g i l hda" cua dan s d Vifit Nam Iang 1 1 % trong l O n a m (tff 2 4 , 5 % len 35,9%) [1]. Dan s d Vifit Nam se chuyen sang giai doan " d i n s d gia"
trong didi gian ng^n khoang 17 - 20 n i m . Cho ddn nam 2025, dtf d o i n se cd 15,45% dan s d i a NCT [6].
Trong khi dd, Iheo B a o d o p h i t trien con ngtfdi n i m 2009, tudi thp trung binh cua ngtfdi Viet Nam II 73,3 trong khi tudi tho k h d e manh chi dtfdc 66 moi. Nghia la sd'nam dm dau trung binh cua ngtfdi
dan Vifit Nam la 7,3 n a m [ 11].
T d chtfc Y le thd gidi ( T C Y T T G ) da dtfa ra khli n i e m "gia hda chu d p n g " cd nghia 11 " Q u i trlnh tan dung d c ccf hpi v l y t e , stf tham gia v l an sinh nhiim n a n g cao chat Itfdng cudc sd'ng ciia N C T " [13]. Va
"chij ddng" nghia 11 stf i h a m gia h e n tuc vao c i c boat ddng xa hdi, kinh l e , v l n h d a , tinh than, chtf khdng ddn t h u l n II kha n a n g boat ddng thd chl'l h o l e tham gia v a o Itfc ltfdng Iao d d n g " . R l s o l i t l i hfiu cho tha'y cd mdi lien quan giCfa stf tich ctfc hoat ddng va duy tri trang t h i i k h d e m a n h d N C T [8] [9].
T r o n g b d i c a n h q u i trinh g i l h d a d i n s d d Vifit N a m , b i n c a n h n p i d u n g c h a m sdc N C T , can cd nhiTng chinh sach huy d p n g stf i h a m gia cua NCT vdi m u c dich N C S K cho N C T c u n g nhtf tan dung ngudn Itfc ciia n b d m N C T . Luail N C T 2 0 0 9 da danh
T a p chi Y te C o n g cdng, 1.2015, Sd 34 21
I TfiNG aUftN& NGHIIN cdu I
1 chtfdng n i - Phil huy vai Ird NCT nhtflig Lull NCT chi la Lull khung. Vific phat tridn cic chinh sich cu the de phat huy vai trd, ting ctfdng stf Iham gia ciia NCT can cd nhffng bang chtfng cu the. Ke't qua bao d o Ihtfc hifin Chtfdng trinh hlnh ddng qudc tfi' vl NCT trong 5 nam ciia Uy ban vl NCT Vifit Nam cho th^y NCT ngay cang Iham gia vio qui Irinh phat tridn cpng ddng. Tuy nhien, kdt qua dat dtfdc d nhffng hoat dpng trong cic Iinh vtfc cdn rat han che va khdng cd stf htfdng din thtfc thi cu the.
Nghifin ctftf dtfdc tien hanh vdi muc Hfiu: md ta tinh hinh stfc khoe va stf tham gia ciia NCT Irong d c boat dpng gia dinh, xa hpi va Irong phit trien cdng ddng tai huyfin Tien Hai, tinh Thii Bmh nam 2010. Kfi't qua nghifin ctfu nay se dtfdc siJ dung lam d n ctf xay dtfng chtfdng uinh can thiep nham phli huy vai trd tham gia ciia NCT cho phat tridn cdng dong vl gdp phan cho vific thtfc thi Lull vl NCT.
2. Phiicfng phdp nghiin cihi
2.1. Bdi tugng nghien cdu: 11 ngtfdi cao tudi tff 60 tudi trd len vl d c lanh dao cdng ddng tai thj trin Tiln Hai, xa Phtfdng Cdng va xa Tay Giang ciia huyfin Tien Hai tinh Thii Binh.
2.2. Thdi gian nghien cdu: Thing 5 - thang 10 nam 2010
2.3. Thiet ke nghien cdu: md ta cat ngang kfi't hdp dinh Itfdng va dinh tinh.
- Phucmg phdp dinh lugng: Su" dung phtfdng phip phdng van phieu hdi ca'u true.
- Phuang phdp dinh linh: Su" dung phtfdng pbap
"tiep cln cd stf tham gia lip ke hoach (Participant Action Planning Approach) vie't lat II PaPa vdi cic hoat ddng thao luan nhdm t|p Irung vl phdng vl'n sau 2.4. Chgn mdu va phuongphdp chgn mdu Chgn dia bdn nghiin cdu: Huyln Tiln Hai la dia ban cd sd'ltfdng NCT ddng, chifi'm 12% din sd' Irong huyfin vl chi hdi YTCC hoat ddng rat hifiu qua. tich ctfc Irong mang Itfdi YTCC ciia tinh Thii Binh. Hdi YTCC Vidt Nam da thd'ng nhat vdi Ianh dao huyen va chi hpi YTCC huyfin Tien Hai chpn 3 xl cho dieu Ira dtfa trfin d c tifiu chi sau:
- Lanh dao xa nhipt tinh, tam buyfi't vl ung hd viec phit huy vai trd tham gia ciia NCT.
- Cd td chtfc chi hdi YTCC boat ddng.
- Cd td chtfc Hdi NCT huyfin vl cd sd hoat dpng tdt.
Cd mdu cho nghiin cdu dinh lugng: sA dung cdng Ihtfc tinh cd mlu sau cho mot phtfdng/xl
Trong dor
n: ca mSu diiu tra (NCT)
p: Ty l( mong muffn (Nghien ciiu ndy chgn tf If tham gia ciia
- a/2P(l-p)
NCT cho phdl min c^ng dong vtH p = 30% d^a tren ket gud bdo edo ihi^c kifn Chuang trlnh hdnh d$ng quoc t^ve NCT trong S ndm cia [)> ban vi NCH' Vi?t Nam {?}.
d: Khodng sai l$ch cho phip giQa r^ 1$ mdu vd quin the (Nghiin citu chon d = 5%).
a: Sai sgbac I = 5%: H? so tin cdy d sdc xud't 95% = 1.96.
Cd mlu tai mdi phtfdng/xa dtfdc chpn II n = 320 (NCT)/1 xl. Nhtf viy tdng sdNCTd 3 xa dtfdc dinh gil d huyen Tien Hai 11 960 NCT. Hd gia dinb dieu tra se dtfdc Itfa chpn nglu nhifin hfi thd'ng trong danh sach hp gia dinh cung cap bdi UBND xa vl tl't ca NCT trong hd gia dinh dtfdc chpn se dtfdc phong van. Kdt qua nbdm dilu tra vifin dl phdng van 958 NCT tai hd gia dinh.
Cd mdu cho nghiin cdu dinh tinh:
- Tii'n hanh 2 thao lu§n nhdm d mdi xa gdm nhdm d c trtfdng thdn, nhdm NCT tich ctfc tham gia d c boat ddng cpng ddng. Tdng cdng cd 6 thao luin nhdm tap trung
- Tifi'n hanh phdng vl'n siu 4 ddi Itfdng gdm Bi thtf Dang Uy, Chu tich UBND, chu tich hdi NCT, Chii lich Hpi phu nCf xa d mdi xa. Tdng cdng cd 12 phdng van sau
3. Ke't qua 3.1. Thdng tin chung:
Bang 1 cho thay da cd 958 NCT dtfdc phdng vl'n dat 99,79% cd mau xac dinh cho nghifin crfu vl dtfdc phan bd'hpp IJ cho 3 xa nghifin ciiti. Ddi ttfdng nff gidi nhieu hdn so vdi nam gidi. Sd NCT d nhdm radi tit 60 de'n dtfdi 75 d 3 xa chie'm 64,3%.
Ve ca'u tnic gia dinh ciia NCT, kdt qua dilu tra cho thl'y hai phin ba sdNCT dang sdng vdi vd hole chdng, khoang 50% sd'ng trong gia dinh chi cd mdt thfi'hfi, ttfc II NCT sdng vdi nhau. Khoang mpt phin ba so'NCT dtfdc dao tao chuyen mdn ngliifip vu, cdn Iai 11 ttf hoc/gia truyen/kinh nghipm dan gian.
Trong so' NCT dtfdc dao tao, giao viin la nginh dtfdc dio tao nhieu nhat (22,9%), tidp Iheo la cd khi (14,7%) va yte (14,2%).
22 Tap chi Y te Cdng cdng, 1.2015, Sd' 34
I TfiNG HUM & NGHIEN ctiu I
Bdng 1. Dgc diem doi tiOfng nghien cdu
DAcfflfrndd
N ™ NS NbAmiuJi
iO-7i 71*
Tinb Inne Min shin dJi NCT CA va/chSng aoa I. to iifWn Ki«ic
dinh NCT Nghin
T&ii ctng
^
U\
180
230 90
22^
9 ' 0 0 3
u Z69 321 IV
J3 9 S6L
71.9 :8 1
10.1 29.U 0 0 0 0 0.9
14.1 BS.9 IOD
XJl Tav GunB N
134 1B4
191 127
202 1(M 3 4 i
71 23S 318
•(
421 57 9
60.1 39 9
61.*i i;.7 0.9 13 1.6
:3.7 76J im
X
N
M3 176
I W 125
207 105 0 3 J
7 : U l 3!9
•i
44.e S5J
60.E 19 2
M.9 12.9 0.0 0.9 U
13 77 I M
Cb
N
JI8 540
6IS 342
631 302 3 7 12
189 74S 998
"^
lc
43 6 5S.4
64.1 35 7
66 2 31.5 OJ 0.7 1.2
202 79 S IDD
Nhdm nghiin ctfu da tim hidu vl cac khoan thu nhap vl chi phi cua NCT. Ket qua cho thay t^ ifi sd hp gia dinh NCT ngheo 11 20,2% dtfa theo chuan ngh^o qudc gia trong Quyet dinh 170/2005/QD-TTg vl dtfa trfin tdng thu nhip nam qua ciia hd gia dinh.
3.2. Mgt sdddc diem ve sdc khoe NCT T j lp NCT cho rang minh khde va rat khde chiem tJ II khong cao (7,7% va 0,4%). Trong khi t^
lp NCT Itf dinh gil stfc khde binh thtfdng chie'm da sd 47,5% vl ty Ifi NCT ttf danh gil sffc khde kfim vl rl't kfim cung chiem f} 11 khi cao (34,8% va 9,5%).
Khi so sinh giiia 2 nhdm radi 60-74 va tff 75 tudi trd lln ta Ihl'y stf khic bifit. Ket qui bieu dd 1 cho thafy nhdm NCT Itfa tudi 60-74 njf danh gil ty Ie stfc
I
• RftttSoe iKhM •Binhthiion)i KemBieu do 1. Phdn bdty If phan logi sdc khoe theo ddnh gid cua NCT theo nhdm tuoi
khde d mffc binh thtfdng (50,4%) cao hdn ban NCT tff 75 tudi trd len (42,2%) vl ngtfdc lai sffc khoe rl't kim thi NCT tff 75 tudi trd len (15%) cao hdn ban nhdm NCT tff 60-74 tudi (6,5%). Stf khic nhau cd $ nghia tbdng kl vdi p < 0,05.
v l ly Ie m^c d c bpnh/nhdm benh d NCT dl dtfdc cln bp y te khim chan doin, kdt qua nghifin ctfu chi ra rang ty le cao nhl't 11 nhdm bfinh vl xtfdng khdp, tifi'p theo la d c bfinh vl rang, m^t, lang huyei Ip va thrf 5 11 benh da day/rupt. Ngoli ra, sd NCT cho biet bi mac Iff 3 bfinh trd lln chilm ty lp r^I cao, chidm 75,1%. Sd NCT khdng m^c benh chiem tJ 11 thi'p (2,6%), cdn lai 22,3% NCT bi m^c tff 1-2 bfinh, va cic benh mac phli chii yeu 11 bfinh man Iinh phai dieu tri lau dai.
Ve mdt sd hanh vi sffc khde ciia NCT, 79,4%
NCT nam da tffng hdt thudc Il/thudc lio, 34% hifin cdn hiit. Trong dd, 12,4% hiit trfin 24 dieu/ngay. Ty Ifi NCT nam vl niJ udng rtfdu hang ngiy chiem ty Ifi khi cao (72,5% NCT nam vl 30% NCT nff). VI ty Ifi nam lam dung rtfdu/bia 11 19,8%. Ba phin ttf sd NCT cd tip thd due hang ngay (74,4%).
3.3. Slf tham gia cua NCT vdo hogt d$ng CVGB, VHXH, LBSX:
CVGD, VHXH vl LDSX la nhffng mang boat ddng chinh dtfdc nhdm nghifin crfu tim hieu. Qua PVS cic Ianh dao xa, kei qui cho Ih^y NCT vln dtfdc dinh gil cao Irong cac boat ddng niy "NCT vdn Id mdt tiem ndng ldn cua xd hdi...Vd ngUdi ta [NCT] cd thich Id sd'ng phdi cd 3 noi dung Sd'ng vui, sd'ng khde, vd phai sd'ng cd ich. cd phdi khdng g?...Sd'ng cd ich Id minh phdi phdt huy cdc cu tham gia xd hdi vd tham gia cdc phong trdo cua dfa phuang, tham gia ngay vdo cdi viic cila gia dinh.
gido due con chdu cung Id mgt vdn di. Rdi Id lao ddng sdn xudt. Ndi thdt vdi anh Id bdy gid Id cd nhdng id'm gUang sdu bdy muai vdn ldm kinh tigidi"
(PVS - Bi thtf Dang iiy xa) va "Nhdm cdn sdc khde thi cdi khi thi cung rd't Id hdng hdi, phdn cong thi citng deu nhdn cd. cUng diu ldm cd " (PVS - Chii tich Hdi NCT xa).
Theo kfi't qua dinh Itfdng, nhdm nghifin ctfu chia mrfc dp tham gia cua NCT thinh 4 mrfc Iff 0 ddn 3 vdi mrfc 0 II khdng tham gia bdt crf boat dpng nao, mrfc 3 la tham gia ca 3 nbdm hoat dpng. Ket qui dinh Itfdng chi ra mffc dp tham gia khdng khic bifit giffa 2 gidi, nhtfng cd khic biet giffa nhdm tuoi (60- 74 va 75 trd len).
Tap chi Y te Cdng cpng, 1.2015, Sd 34 23
ITl'HGQUUItlieHltNCIilll
• luioiig duuu jiia • rnitc 1
Bieu do 2. Ph&n bS'ty /# cdc mdc dp tham gia cua NCT theo nhdm tuii
Bieu dd 2 trinh bay mrfc dp tham gia ciia NCT vio d c nhdm boat dpng giffa 2 nhdm wdi 60-74 va Iff 75 trd Ifin vl kfi't qui cho thl'y cd stf khic bifit rd ret khi ty Ie khdng Iham gia 6 nhdm trf 75 thi'p hdn mdt d e b cd '$ ngbia thdng ke so vdi nhdm dtfdi 75 tudi. Ttfdng ttf, ty Ifi tbam gia ca 3 nhdm cdng vific cung khic bi|t, cao hdn d nhdm tudi tha'p. Gil tri xac suat thdng kfi rl't nhd (p<0,001) cho th^y mdi lifin quan cb§t che giffa hai bidn nbdm tudi va mrfc dp tham gia ciia ddi trfdng nghien crfu.
3.3.1. Tham gia CVGD
Ket qua nghifin cffu chi ra rang cd nhieu NCT Iham gia vao CVGD vdi ty le chung d 3 xa la 88%.
Ty Ifi tham gia CVGD cd stf khac bill giifa 2 nhdm tudi cd stf khac biet rl't ldn. Cu thd, NCT thupc nhdm tudi it hdn (60-74) tham gia nhieu hdn trong d c CVGD so vdi nhdm NCT nhieu radi hdn. Stf khic bifit the hien d ca 3 dia ban nghifin crfu vdi sai khac vl ty Ifi thap nhl't la 16,8% d xa Tay Giang.
Gil tri xic sul't thd'ng ke rl't nho (p<0,001) cho tha'y cd md'i lifin quan chat giffa bidn nhdm tudi va cd/khdng tham gia vio CVGD.
Ly do tham gia CVGD dtfdc NCT nfiu nhilu nhl't la vi gia dinh vln cdn stf girfp dd (59,6%), tie'p de'n la cam thay vui, thanh than vi cdn boat dpng (26,8%). Trong khi dd, ly do khien khoang 12%
NCT khdng diam gia CVGD la gil yfi'u, bpnh tit, va cd ngrfdi khic lam thay.
3.3.2. Tham gia VHXH
Ty Ifi NCT Iham gia hoat ddng VHXH trong quan the ngbien crfu la khi cao 79,7%. Tuy nbifin, ty Ifi niy khic bifit giffa d c khu vtfc nghifin crfu, cao nhl't d xa Phtfdng Cdng (90.3%) vl thap nhat d xa
Tiy Giang (65,1%). Srf khic biel nay cd ^ nghia didng kfi (p< 0,001).
Kdt qua Ihio luan nhdm vdi NCT cung cho thl'y NCT van r^t ning nd tham gia vao cic boat dpng van hoi xl hdi: "Cdc cu ldn Ign hogt dgng trong cdc cdng viic ciia xd hdi nhuNCT, cm chii'n binh vdn vdn day Id tinh thdn cua cdc cg d Phuang Cdng ndy, dang hdng hdi ldm mgi viic" (TLN NCT xl Phtfdng Cdng).Nhin chung, hoat dpng VHXH ma NCT diam gia nhilu nhat la tham gia vao d c Hpi, doin the vdi ty le 82%. Ty 16 NCT cdn Uiam gia cdng tac quan IJ nhtf thudc ban chdp hlnh cic Hdi, ban Ufin lac...
rat thi'p chi chiem 2,6%.Trong cac Hpi. doan the;
Hdi NCT II id chffc ma NCT diam gia nhilu nh^t vdi l^ le tham gia dfi'n 83,6%. Trong khi ty Ifi NCT tham gia id an ninh nhan dan thS^p nh^I, chi 9,2%.
L J do cdn hoat ddng VHXH dffdc NCT vifin dan nhieu nha't 11 vi d m thl'y vui, tbanh than vi cdn boat dpng. Hai phin ba sdddi tffdng NCT tham gia chpn ly do nay. Trong khi cbi 20% dd'i ttfdng tham gia vi gia dinh, cdng ddng. Nhffng IJ do tham gia dd giiip khoe manh, minh min (4%); drfdc con chiu, lang xdm coi trpng (1,5%) cung rat thl^p. LJ do ngan can NCT khdng tham gia boat ddng VHXH nhieu nhat 11 gia yeu. Cd den 63,6% sdddi Itfdng khdng tbam gia hoat ddng VHXH vifin dan ly do nay. Nhffng boat ddng ml NCT cd nguyfin vpng iham gia vdi ty le cao nhl't II tham gia ho^t dpng doan the (69,2%) va Iham gia CLB NCT (52,4%); trong khi chi 8,1%
NCT cdn mud'n tham gia chinh quyln cd sd.
3.3.3. Tham gia LDSX
Kdt qua nghifin crfu cho thl'y tJ Id NCT cdn tham gia LDSX 1129,5% nhiftig cd srf Jchlc bilt giffa 3 xa nghifin crfu, dao ddng trf 19,9% den 37,1%. Stf khic biet niy cd y nghia thdng kfi vdi p<0,001. Ty le NCT d mrfc tudi thap hdn tham gia LDSX nhieu hdn so vdi nhdm cao tudi hdn. Srf Ichlc bifit vl ty IS tham gia LDSX giffa nhdm tudi trfin 75 vl drfdi 75 va d cic dia bin nghifin crfu deu cd y nghia Ihdng kfivdip<0,001.
Ve IJ do tham gia LDSX, da sd^NCT cho bifi't vi mudn ddng gdp tbu nhap cho gia dinb (72,9%).
Trong khi dd, hau bet IJ do NCT vifin dan cho vific khdng tham gia LDSX vi elm thay gia yeu (80,1 %).
Khoang 10% sdNCT khdng LDSX vi cd Itfdng htfu.
3.4. S^tkam gia cda NCT vdo hogt d$ng phong chong tdc hgi (PCTH) thu&c Id vd riUfuhia
24 Tap chi Y td Cdng c^ng, 1.2015, Sd 34
I TfiNG QUAN & NGHIEN BtiB I
Trong sd 666 NCT biet cd boat dpng PCTHTL d dia phrfdng, ty Ifi cd tham gia d c boat ddng nay la 53%. Ty le nay khdng chfinh Ifich nhieu giffa cic xa nghifin crfu. NCT tham gia kha lich crfc vao moi boat ddng PCTHTL vdi 2 boat ddng nhilu nhat II nhac nhd ngtfdi thin khdng hiit d ndi cd quy dinh cam va van dpng ngtfdi thin cai nghiin (Bieu dl 3).
LJ do chu ydu ml NCT vifin dan cho vific khdng tham gia hoai dpng PCTHTL II gia yeu (48,5%), la ngtfdi hiit thudc nfin khdng mudn tham gia (12,5%) va bin vific khic (10,6%). Die bifit, 5,8% NCT khdng tham gia vi chinh quyen khong keu gpi.
Biiu dS 3. Phdn boty If hogt d^ng PCTHTL md NCT tham gia
Ket qui nghifin crfu cho iha'y ly le NCT tham gia boat ddng PCTH rrfdu bia 11 55,9%. Trong dd, ho chii ydu tham gia tuyen Iruyin tic iiai rrfdu bia (87,8%); v§n dpng ngtfdi thin, hing xdm cai nghifin (91,2%) vl phd bidn quy dinh khong udng rtfdu sau klii tham gia giao Ihdng (54,2%) (Bieu do 4).
100 ^
80 t
60
-—B— -
9 1 ;
^M
TuytnlN^lnttc Phi biln qorfinh Utii«ingcii ^i^tEMnFtilUii ( H K
Bieu di 4. Phdn boty l^ cdc hogt dgng PCTH rugu bia NCT tham gia
L J do chii yeu ml NCT vien dan cbo vific khdng tham gia hoat dpng PCTH rtfdu bia II do gia ydu (54,1 %). Tifi'p theo la cic iJ do ban vific gia dinh va chinh quyln khdng keu goi NCT tham gia, lan Itfdt chiem 9,1% va 9,6%.
4. Ban lu§n
NCT ttf dinh gil khde va rat khde chi«n ty Ifi khdng cao (7,7% vl 0,4%). Cdn NCT Itf dinh gil stfc khde binh tbtfdng chiem gin mpl niJa (47,5%) vl ttf dinh gil srfc khde kim va ra't kem cung chiem ly Ifi khi cao (34,8% vl 9,5%). Ke't qua nay cho thay ty Ie srfc khde binh thtfdng va khde thi'p hdn so vdi nghien crfu ciia Nguyea Thd Hui 6 979 NCT d 5 tinh, thanh pbd nim 2008 khi NCT danh gia khde va rat khde (11,2%) va srfc khde trung binh (49,8%). Va srfc khde NCT loai kem va ra't kem trong nghifin crfu ciia chiing tdi (44,3%) cao hdn so vdi nghien crfu nay (38,9%) [12]. Ngoai ra, ket qua nghifin crfu cua chtfng Idi ihl^p hdn so vdi nghifin crfu ciia Lfi Van Nhan, Nguyen ThdHufi vdi long ij le NCT ttf dinh gil d mffc khoe vl ra't khde (10,8%), binh thrfdng (50.2%) [4].
De so sinh vl stf Iham gia, trong nghifin crfu cua chrfng tdi, NCT dtfdc phin tich ibeo 2 nhdm tudi 60 - 74 vl Iff 75 trd lln. Nhdm nghiin crfu nhin (h£y nhffng NCT drfdi 75 tudi chifi'm ty Ifi khi cao ttong sd' NCT va hifin van cd dii sffc khde de tham gia vio d c cdng vide thich hdp vl mdl ly le ichdng nho trong sd NCT niy da dtfdc dio tao vl cd kinh nghiem Irong llnh vrfc y tdgilo duc.cd the tidp tuc tbam gia ddng gdp vio cic bo^t ddng gia dinh, xa hdi. Dieu nay phff hdp vdi nghien cffu ciia Ll Vln Nhan, Nguyin Thd Hufi cho rang nhdm tuoi tff 60- 69 cd sffc khde tdt vl can phit huy vai trd tbam gia [4], Nhrf v|y, nghifin crfu d Tiln Hai cho thl'y cln phit buy vai trd tham gia NCT d dp tudi cang thl^p lhi se tdt hdn NCT d dp radi cao..
Trong khi cd mdi lien quan ch|I che giffa mtfc dp tbam gia vl nhdm tuoi thi ket qua ngbien crfti ciing chi ra rang khdng cd srf khic biet ve ty Ie tham gia d 2 gidi, vl 2 nhdm kinh te (ngheo/khdng nghfio).
Ket qua niy gdi J cho qui trinh Irfa chgn NCT Uiam gia vio mo hinh cua Hgi YTCC Vifit Nam.
Ty lfi NCT tham gia CVGD khi cao ll 88%. Ket qua niy phii hpp vdi bio d o cua Uy ban qudc gia vl NCT cho thl'y hau hit NCT tham gia trdng nom chim sdc chiu. ddn dtfa chiu di hpc va tham gia cic vific vat trong gia dinh [7].
Vl boat dpng VHXH, kit qui nghiin ctfu cho tha'y tJ lfi NCT tham gia 11 79,7%. Kdt qua niy cd cao hdn so vdi bio d o ciia Uy ban qudc gia ve NCTT cho thay cd 55-60% NCT diam gia vio phong trio khuyen hoc va da socle chii tich hgi khuyen hgc la
Tap chi Y te Cdng cdng, 1.2015, Sd 34 25
I TING IIIMI& NGHIEN ctiu I
NCT, 60% NCT tham gia vio phong trao xiy dtfng gia dinh van hda, 60,2% NCT tbam gia d c cupc bgp Ihao luan vl stf phit trien cpng ddng thdn, xl vl cd 3,7% NCT bifin dang dam nhifim llnh dao td dan crf, thdn vl d c td chrfc xa hpi d xl [7]. Theo bio d o cua ESCAP cho dil'y NCT Vifit Nam da lang crfdng vai trd tham gia trong vific quydt dinh cic chinh sich ve NCT va tham gia xiy dtfng cic kdhoach cho NCT [10]. CIc td chffc xa hdi ma NCT Iham gia nliilu nhl^t 11 tbam gia vao d c Hdi, doin the vdi ty le 82%. Trong dd, Hgi NCT la td chffc ma NCT Iham gia nhilu rdil't vdi i j le thara gia ddn 83,6%.
Kdt qua nay phu hdp nghien ctftf cua Lfi Vln Nhin, NguyenThe Hue: NCTdiamgiaHdi NCT (92,1%), Hdi Crfu chie'n binb (42,3%), Hdi Phu nff (24,2%) [4]. Va nhrfng IJ do tham gia boat dpng VHXH ciia NCT la vi cam thay vui, thanh than vi cdn boat dpng (66,7%). Trong khi chi 20% ddi trfdng tham gia vi gia dinh, cpng ddng (IJ do tham gia CVGD dffdc NCT vien din nhilu nhl't). Nhffng IJ do tham gia de giiip khoe manh, minh man (4%); drfdc con cblu, Iang xdm coi trpng (1,5%) ra't thi'p. Nhffng kit qua niy phu hdp nghifin cffu cua Lfi Vln Nhin, Nguyin The" Hue thl'y dtfdc thoii mli hdn v l linh than (63,1%) va dtfdc tham hdi ddng vien khi din dau (83,2%) [4]. Dilu niy cho tha^y nhu cau drfdc tham gia hoai ddng ciia NCT 11 rat cao, ray nbien NCT chrfa nb4n tbrfc tdt ve vific tbam gia de giup cbinh ban thin minh cd srfc khoe vl dtfdc Idn trpng tff cdng ddng. Vi vay, nghiin crfU can thifip cua Hdi YTCC Vifit Nam can truyen thdng thay doi nhan thffc cua NCT ve ldi ich cai thipn srfc khde (do sdng nang ddng), drfdc cgng ddng tdn trpng khi tbam gia cic hoat ddng.
Ty lfi NCT cdn tbam gia LDSX la 29,5%. Cd srf khic bifit rd vl ty II Iham gia LDSX giffa nhdm radi tren 75 vl dtfdi 75 vdi mrfc chfinh nbd nhat la 15,1%. Kfi't qua nay phiJ hdp nghifin crfu ciia Lfi Vln Nhin. Nguyfin Thd Hufi thay NCT tham gia trdng trot, chin nudi (60,2%), lao dpng gian ddn (11,8%), thrfdng nghifip dich vu (10,9%) [4].
Trong chrfdng trinh PCTH thud'c la,mdt khd khin dat ra la cd dfi'n hdn 1/2 sd'NCT khdng mud'n tham gia boat ddng PCTH thudc 11 vi nhffng IJ do khic nhau nhff la gil yfi'u (48,5%), 11 ngtfdi but thud'c nen khdng mud'n tham gia (12,5%) va ban viec khic (10,6%). Dilu niy cung dat ra vific rayfin truyen vl PCTH thud'c 11 cln hap dan vl cu the hdn de NCT tham gia tich ctfc hdn vio hoat dpng nay.
Kfi't qua nay phu hdp vdi tli hfiu htfdng dan ciia Bp Y id vl xay dtfng cdng ddng khdng thudc II can huy dgng stf tham gia cua hgc sinh va NCT, dac bill nff NCT trong vific v^n ddng cai nghifin thud'c la, Ihud'c la va PCTH do hdt thudc 11 thu ddng tai hd gia dinh [2].
Hifin NCT cd tham gia cac boat ddng PC Iam dung rtfdu, bia nhtf tuyfin Iruyin tic hai rrfdu bia, van ddng ngtfdi than, hing xdm cai nghifin rtfdu, bia vl phd bidn quy dinb cam udng rtfdu, bia khi tham gia giao thdng. Vific tham gia cua NCT irong boat ddng nay lai dia phtfdng se girfp ting ctfdng kien ihrfc ciia cgng ddng, giam thieu nguy cd xay ra d c vu tai nan giao thdng, bao Irfc gia dinb do rtfdu bia gay ra. Dd la IJ do ml tic gia Dim Vie't Crfdng khuyen nghi rang nen thifi't lip mang Itfdi rayfin truyen, iheo doi, giim sll viec srfdung rtfdu, bia tai cpng ddng ma d dd NCT ddng vai trd rat quan trpng d hp gia dinh va xa hdi [3]
Bfin canh dd, trong ca 2 boat ddng giam thieu cic nguy cd cd hai cho srfc khde, mpt sd NCT deu cd nhan dinh hp khdng tham gia vi Ididng cd stf klu ggi cua chinh quyln (5,8% d chrfdng trinh PCTH thudc la va 9,6% d chtfdng trinh PCTH rtfdu bia). Nhiftig ldi keu gpi hole ddng viin tinb than ciia chinh quyln dia phtfdng II mdn qua ding kliich lfi dd'i vdi NCT vi nhrf vay, NCT cam thay minh van cdn cd ich cbo xa bdi, van cd the giiip dd dia phtfdng phli trien vl mong mudn drfdc tham gia d c hoat ddng cdng ddng. Dilu nay cho thl'y dia phrfdng dang thifi'u cdng lac truyin tbdng kfiu goi va van ban htfdng din ciia chinh quyen cho stf tham gia cua NCT.
Tdm lai, ty lfi NCT ttf dinh gil srfc khde binh tbtfdng cao (47,5%) trong khi ttf danh gil ban thin khde va rat khde chiem ty Ifi thap (7,7% va 0,4%).
Ty 11 NCT cd mac it nhl't mgt bfinh la rl^l cao (97,4%). NCT trong dia ban ngbien cffu chii ydu dl dtfdc dao tao va cd kinh nghiem chuyfin mdn. Ty lfi NCT nhdm tudi 60 ddn dtfdi 75 tuoi tham gia vao cic cdng vific gia dinh, Iao ddng san xul't va boat ddng xa hpi cao hdn so vdi nhdm tff 75 radi trd Ifin.
NCT cung tich ctfc tham gia vio d c chtfdng tnnh giam thidu d c nguy cd cd hai cho srfc khde gdm PCTH ihudc II vl rrfdu bia. Tuy nhifin, chinh quyen dia phtfdng vln chrfa cd ke hoach vl vln ban htfdng din keu gpi stf Iham gia ciia NCT vio cic hoat ddng cdng ddng.
Vi v§y, chung tdi dtfa ra mdl sd'khuyen nghi nhtf sau:
26 Tap chi Y td Cdng cdng, 1.2015, Sd 34
I TfiNG QUAN & NGHIEN ctiu I
- Nfin huy dgng stf tham gia cua NCT Iim nhiJig cdng vipc phff hdp vdi sffc khoe va nhu cau ciia minh, die bifit cln phit huy vai trd NCT trong nhdm NCT Ire tff 60 -74 vi cd sffc khoe, nhiet dnh, kinh nghifim chuyfin mdn nghifip vu.
- De xay dtfng nghien ctfu can thiep danh cho NCT, Dang tiy xl cln xay dtfng nghi quydt chuyen de vl NCT vl kdhoach boat ddng ciia xa vl NCT dtfdi stf cd van ky diu|I ciia Hgi 'YTCC Vidt Nam dd tao cd c h l cho stf tham gia cua NCT.
Tai lifu Iham kbao:
Tifng Vi^t:
1. Ban cbi dao Tdng di^u tra din sd v^ nhi A Dung iXdog (2009). Bio edo ket qua suy r^ng mlu. Hi Ngi.
2. BQ Y tf (2005), Tii Ji^u hiASng dSa mo hlnh c$ng d6ng khdng ±}i6c \A, Nhi xuft b^o giao th6ng v^n tli.
3. Dim Viet Ctfdng. Vii Minh Hanh (2006), Dinb gii dnh hinh lam dung rUdu bia t?i Vi?t Nam, Vi^n chifn lUcJc vi chinh s I c h y l f B O Y t f .
4. L6 ViD Nhan, Nguygn Thf Huf (2004), Di^u tra thi^c nrang NCT Vi€t Nam nhSm phdt huy tii ning. trf tu$ cia hg trong stf nghifp cdng nghidp hda. bifn dai bda tai Tp.HCM, Yen Bii vi Sdc Tring, H$i ngiTdi cao tuoi Vift Nam 5. QuSc hOi Vift Nam (2009), Luit Ngirdi cao m^i, Lu^t sf:39/2009/QH12
6. T^ng cijc thong kf (2006). Di^u tra bien df ng din s6 2006. Nhi xu£'t bin thdng ke.
7. Uy ban qufc gia v^ NCT (2008). Bio cao 5 nim thi^c hifn chUdng tiinh hinh dOng quoc tf Madrid ve ngtfdi cao tu^i.
Nh^ xuft bin Lao df ng.
Tifng Anh:
8. Aogel Rodriguez-La so, Mana Victoria Zunzuaegiii, Angel Otero (2007). The effect of social relationships on survival in elderly residents of a Southern European communiiy: a cohort smdy. Biomedcentral.
9. Aron S. Buchman, MD, Patricia A. Boyle, PhD, RobenS.
Wilson, PhD (2009). Association between Late-Life Social Activity and Motor Decline in Older Adults. National Insnmte of Health.
10. ESCAP (2009). In the care the state and the family:
Understanding Care of the Elderly through Macro and Micro Perpeciives. Gender and Development Discussion Paper Series No.22
11. UNDP (2009). Human Development Report 2009. New York.
12. Vietnamese Smdies (2009). The Elderly in Viet Nam, Tbe Gioi Publishers Nol-2009 (171)
13. WHO (2002). Active ageing: A policy framework.
Geneva.
Tap chi Y t f C d n g cong, 1.2015, Sd 34 27
