A model of factors contributing to perceived abilities for health-promoting self-care of community-dwelling Thai older adults
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The purpose of this descriptive correlational study was to examine factors contributing to perceived abilities for health-promoting self-care of communitydwelling Thai older adults. An integration of selected concepts from Orem’s (1995) self-care theory and Bandura’s (1997) self-efficacy theory is established to generate a conceptual model for this study. The study variables included age, education, perceived family support, perceived friend support, chronic health problems, functional ability, perceived health status, and perceived abilities for healthpromoting self-care. A survey-interview method was used for data collection. Perceived family support, perceived friend support, chronic health problems, functional ability, perceived health status, and perceived abilities for health-promoting self-care were measured by the Family APGAR Questionnaire, the Friend APGAR Questionnaire, the Chronic Health Problem Checklist, a composite on the Modified Barthel ADL Index and the Chula ADL index, the Self-Rated Health Scale, and the Self-Rated Abilities for Health Practices Scale, respectively. Stratified random sampling, based on age and gender, was employed to recruit a sample of 211 older adults living in rural areas in Thailand. Pearson’s product-moment correlation coefficient was used to examine the relationships among the study variables. All hypothesized relationships were supported except for the relationship between age and chronic health problems and between age and perceived health status. The hypothesized model was tested by path analysis through the EQS6 program. The initial hypothesized model did not fit the data, and so was modified until the goodness-of-fit indices were adequate (>.90). The robust comparative fit index (robust CFI = 1) indicated that the final modified model fit the data well. In summary, five exogenous variables in the final modified model (age, education, perceived family support, perceived friend support, and chronic health problems) contributed to perceived abilities for health-promoting self-care, directly and/or indirectly through two mediating variables (functional ability and perceived health status). Mediating variables in the model also contributed to perceived abilities for health-promoting self-care. Sixty-one percent of the total variance in perceived abilities for health-promoting self-care was explained by all study predictors. Using the multisample structural equation modeling approach to test the modified model across groups, gender differences were not found in this study.