Gaps and opportunities in addressing the needs of older adults in the Philippines and Vietnam: a qualitative exploration of health and social workers' experiences in urban care settings.

Background: Despite numerous government initiatives, concerns and disparities among older adults have continually been growing. Empirical studies focused on older adults in the Philippines and Vietnam appear minimal and mostly regarding perceptions of aging. An effective geriatric care strongly relies on functional service providers requiring their perspectives to be explored toward inclusive service delivery. Objective: To investigate the perceived gaps and opportunities in geriatric care service delivery among health and social care workers in selected urban areas in the Philippines and Vietnam. Methods: A qualitative case study approach drawn on social constructivism theory, examined working experiences, observed characteristics of older adults, geriatric services and needs, difficulties on service delivery, and recommended solutions. A total of 12 semi-structured interviews and 29 focus group discussions were conducted in the Philippines, with 174 health and social care workers, while in Vietnam, there were 23 semi-structured interviews and 29 focus group discussions with 124 participants. An inductive thematic analysis was employed. Results: Interview participants highlighted the increasing unmet needs such as accessibility, availability, and acceptability of geriatric care services. The implementation of interventions on the older population faced multiple challenges, including issues related to older adult conundrums and dilemmas in geriatric care providers and facilities. The participants from the two countries felt that strengthening implementation of collaboration toward an integrated geriatric care structure and expansion of training and capability in handling older adults can be potential in addressing the gaps at both individual and institutional levels. Additionally, a committed leadership was viewed to be the important step to effectively operationalize the strategy. Conclusion: Health and social workers emphasized that the needs of older adults are exacerbated by various challenges within a fragmented geriatric care system. To address this issue, an establishment of an integrated service delivery mechanism with dedicated leadership is needed. The findings from this study may help develop appropriate solutions for addressing the health and social care needs of older adults in similar settings across Southeast Asia. Further examination of the impact of these challenges and solutions on service delivery and the wellbeing of older adults is essential.

Can collaboration among health and social care workers play a role in addressing geriatric care challenges? A qualitative case study in Central Vietnam.

BACKGROUND: Vietnam's healthcare system offers limited services and facilities for older adults. This study explored the perceptions of health and social care workers regarding geriatric care issues, their impact on older adults and the potential of collaboration for enhancing older adults' health and well-being. METHODS: This qualitative case study employed 27 focus group discussions and two in-depth interviews with 174 participants in Thua Thien Hue Province, Vietnam. An inductive thematic analysis was conducted. RESULTS: According to the participants, the major challenges that hindered geriatric care consisted of caregiver and care recipient issues, which were identified to constrain care accessibility, resulting in decreased physical, mental and social health. Across different settings and professions, collaboration was considered a routine and natural aspect of daily work. It was perceived that establishing and strengthening collaboration could facilitate improvement in health and social welfare services through the prioritization of needs and enhancement of caregiver skills and training. CONCLUSIONS: Collaboration was viewed as ad hoc but indispensable for addressing the identified geriatric care issues that could improve the general health and well-being of older adults. The findings indicate a need for better collaboration in Vietnam, achieved through defined guidelines, training and improved interprofessional education and practice.

In-service training programme for health and social care workers in the Philippines to strengthen interprofessional collaboration in caring for older adults: a mixed-methods study.

BACKGROUND: A growing number of older adults require complex care, but coordination among professionals to provide comprehensive and high-quality care is perceived to be inadequate. Opportunities to gain the knowledge and skills important for interprofessional collaboration in the context of geriatric care are limited, particularly for those already in the workforce. A short-term training programme in interprofessional collaboration for health and social care workers in the Philippines was designed and pilot tested. The programme was devised following a review of the literature about geriatric care education and group interviews about training needs. The objectives of this paper are to introduce the training programme and to evaluate its influence on attitudes and readiness to collaborate among participants using both quantitative and qualitative methodologies. METHODS: A total of 42 community health workers and 40 health institution workers participated in the training in July 2019. Quantitative indicators were used to evaluate attitudes towards and readiness for collaboration before and after the training. Content analysis was performed of responses to open-ended questions asking participants to evaluate the training. A convergent parallel mixed-methods design was applied to determine the patterns of similarities or differences between the quantitative and qualitative data. RESULTS: Significant improvements were seen in scores on the Attitudes Towards Health Care Teams Scale among community health (P < 0.001) and health institution (P < 0.001) staff after the training. Scenario-based case studies allowed participants to work in groups to practise collaboration across professional and institutional boundaries; the case studies fostered greater collaboration and continuity of care. Exposure to other professionals during the training led to a deeper understanding of current practices among health and social care workers. Use of the scenario-based case studies followed by task-based discussion in groups was successful in engaging care professionals to provide patient-centred care. CONCLUSIONS: This pilot test of in-service training in interprofessional collaboration in geriatric care improved community and health institution workers' attitudes towards such collaboration. A 3-day training attended by health and social care workers from diverse healthcare settings resulted in recommendations to enhance collaboration when caring for older adults in their current work settings.

Greater Risk of Negative Health Outcomes of Older Adults Living Alone in Vietnam: A Community Survey.

In modern Asian societies, there has been a shift in the living arrangements of older adults away from living with others. Knowing the health characteristics of individuals living alone can help identify high-risk groups. This cross-sectional study aimed to describe characteristics of the Vietnamese older adults and to investigate the association between living alone and their reported health outcomes by utilizing survey data of individuals aged ≥60 years in Vietnam in 2018. The community survey included questions about sociodemographic factors, living arrangement, and self-reported physical functional status. Multivariate logistic regression was used to examine whether or not living alone was a predictor of health outcomes. Of 725 study participants, 8.9% lived alone. These participants were more likely to be female, aged 70-79 years, living in rural areas, and currently single or previously married. After adjusting for covariates, older adults who were living alone were more likely to have arthritis (adjusted odds ratio [AOR] = 1.95, 95% confidence interval [CI]: 1.10-3.45), a history of falling (AOR = 2.44, 95% CI: 1.02-5.82), visual difficulties (AOR = 1.89, 95% CI: 1.04-3.41), feelings of loneliness (AOR = 1.95, 95% CI: 1.10-3.47), and high fear of falling (AOR = 1.88, 95% CI: 1.02-3.46). Older adults living alone in Vietnam were at greater risk of negative health consequences than those living with others. Screening and providing adequate social support for this specific population is important in preventing the adverse effects of solitary living among these older adults.

Digital Health Literacy About COVID-19 as a Factor Mediating the Association Between the Importance of Online Information Search and Subjective Well-Being Among University Students in Vietnam.

Introduction: Digital health literacy (DHL) has recently been proposed as a means of enabling healthy decisions for protective behavior, preventive measures, and adherence with COVID-19 policies and recommendations especially in the era of the "infodemic". This study aimed to (1) identify COVID-19 related DHL and its association with online information seeking; (2) to elucidate COVID-19 related DHL as a mediator predictor between the importance of online information search and its association with subjective well-being among Vietnamese university students. Methods: A cross-sectional web-based survey was used to elicit the responses of Vietnamese students over 2 consecutive weeks (from April 25 to May 9, 2020, n = 1,003, 70.1% female students, mean age 21.4 ± 3.1). The online survey questionnaire collected data on the sociodemographic characteristics of participants, DHL about COVID-19, information seeking behavior, and subjective well-being. Mediation analysis was conducted using the importance of searching COVID-19 related information as independent variables, subjective well-being as a dependent variable, and DHL as a mediator variable. Results: Among 1,003 students, the mean (SD) of DHL related to COVID-19 was 2.87 ± 0.32. In the survey, 87.2% of the students reported sufficient well-being, while almost 13% reported low or very low well-being. The findings also indicated that search engines were the most popular platform for information seeking by Vietnamese students (95.3%) and 92.8% of participants had searched for information related to the current spread of COVID-19. Not searching for hygiene regulation as part of infection control and an average level of information satisfaction were associated with limited DHL (p < 0.05). The importance of online information searching related to COVID-19 increased the subjective well-being of students significantly and limited DHL (p < 0.05). DHL was found to mediate the relationship between the importance of online information searching and the subjective well-being of students. Conclusion: The finding provides insight into DHL about COVID-19 among university students, and their ability to find, understand, appraise, and use online health related information during lockdown throughout the first COVID-19 pandemic wave. DHL should be highlighted as a mediating factor that enhances the positive effect of the importance of information seeking on psychological well-being. However, further studies are needed to better define the mediating role of DHL across other factors.