Factors Associated with Self-Rated Health Among Elderly People Living in Old Age Homes of Kathmandu Valley, Nepal
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Background: Self-rated health (SRH) is the subjective assessment of own general health. It has been used frequently to predict future health, disability, functional ability and mortality. Exploring factors associated with SRH is vital as it will help inform efforts aimed at promoting health among the elderly. However, there are limited studies regarding SRH and factors associated with SRH among elderly people living in old age homes in Nepal. Objective: The purpose of the study was to describe SRH and explore the factors associated with it among elderly people residing in old age homes in Nepal. Methods: A cross-sectional study was conducted in Kathmandu valley, Nepal. A sample of 208 elderly people aged over 60 years living in one governmental and three private old age homes were randomly selected through multi-stage cluster sampling. An interviewer-administered questionnaire was used to collect data. Descriptive analyses were first conducted. Univariable and multivariable logistic regression analyses were then used to explore the association between socio-demographic factors, self-reported chronic illnesses, lifestyle factors, functional status, social network, satisfaction with health services and SRH. Results: Seventy-four percent of the participants reported good SRH while the remaining twenty-six percent rated their health as “poor”. Females were significantly more likely to rate their health as good compared to males (adj OR 3.69, CI= 1.92-11.03, p<0.000); the same was true for unmarried elderly compared to married ones (adj OR=4.55, CI=1.29-9.87, p<0.000). Those who were functionally independent were more likely to report good SRH (adj OR 7.00, CI=5.79- 9.31, p< 0.005); the same was true for those who did physical exercise (adj OR= 1.96, CI=0.67-5.67, p<0.019) and who were members of a social network (adj OR 1.70, CI= 0.78-3.71, p<0.017) compared to their counterparts. Those who consumed alcohol (adj OR=0.23, CI=0.07-0.78, p<0.019) and those who did not have a friend circle (adj OR=0.62, CI=0.29-1.34, p<0.023) were less likely to report good SRH. Education and participation in recreational activities were significantly associated with SRH in univariable analysis. However, the association disappeared in the final model. Conclusion: The study found that sex, marital status, functional status, physical exercise, alcohol consumption, membership in a social network and the presence of friend circles were independently significantly associated with SRH among elderly people living in old age homes of Kathmandu valley. These findings can be used to develop public health interventions and allocate resources to mainstream physical, behavioral and social support to elderly people living in old age homes. Functional dependence appears to be particularly important, and therefore services to address it including physical rehabilitation need to be promoted.
Master i International Social Welfare and Health Policy