Participation in Shareholding Network for the Care of Older People in Rural Thailand


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Publication Details

Author list: Voraroon, Supaporn

Publisher: Mid Sweden University

Place: Sundsvall

Publication year: 2019

ISBN: 978-91-88947-24-6


The overall objective of this thesis was to explore how older persons and their relatives’ experience taking care of older people as part of a shareholding network related to health promotion activities for older people in rural areas of Thailand. The thesis had a qualitative research design and was based on original articles (I-IV). Data were collected through paired interviews with older persons and their relatives (I) and by narrative interviews with older persons (II-IV). Qualitative data were analyzed with content analysis, phenomenological hermeneutics and phenomenological philosophy.

Article I showed that older persons and their family members experienced outsider status and disregard for older persons individuality in the community when participating in shareholding networks. The theme of outsider status described shortcomings in health care encounters and the theme of disregard described the lack of engagement of authorities and caregivers in the care of older persons. Older people and their family members should engage in dialogue in order to support health care based on shared understanding. Article II found that older person’s lived experiences with participation in shareholding networks entailed both positive and negative meanings. The participation could be understood as being satisfied, valued, frustrated and bored. Article III showed that participating in shareholding network activities entails an always-present existence of aging intertwined with life. The participants further described the essential meaning of the phenomenon: “experience of improved self-management”, “feeling of increased self-esteem” and “bridging a gap in the care of older people”. Participation in shareholding network activities meant keeping contact with oneself and being able to have a life that corresponds with perceptions of self and must, therefore, be understood from a holistic perspective. Older persons’ need for support includes places where safe and profound reflection on existential issues can take place. Article IV identified four categories that reflected expressions ofxiihealth-promoting elements in shareholding network activities: empowerment in health control, participation in society, self-determination and shared responsibility, all of which can be seen as important parts of a health process. The elements of knowledge, fellowship and dignity were found to be key components of health promotion in the experiences of older persons. The results indicated that shareholding network activities contributed to peer volunteering support with the potential to be an effective strategy for increasing activities in older adults, particularly among those who are inactive and socially disengaged. Shareholding networks for the care of older people in rural areas seem to promote and preserve volunteerism satisfying the needs of individual older persons from a holistic perspective as a way to strengthen self-care.

The conclusions drawn from the findings indicate that the participants experienced benefits when they participated in shareholding networks for the care of older people in rural areas. Participation improved health, increased independence and improved ability for self-care in addition to strengthening feelings of dignity. Health professionals should initiate a dialogue with shareholding participants to develop a cooperating model of care focusing on the participants` needs. Health care must be based on shared understanding and reflections on existential issues such as identity, trust, self-confidence and dignity.


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