Cảm nhận đa chiều của người cao tuổi về già hóa

CAM NHAN DA CHIEU
CUA NGUOI CAO TUOI VE GIA HOA
Bai viet ia mOt phan ket qua nghien ciru de tai cap co sd 2016: Cam nhan tuoi gia 6
ngifdi cao tuoi; Vien TSm ly hoc chO tri; PGS.TS. Le Van Hao lam chQ nhifm.

PGS.TS. LS Van Hao
Phd Vien trudng Vien Tdm ly hgc.
TOM TAT
Cdm nhdn gid hoa - vi mat bdn chdt - mang tinh da chieu. Nghien cim da sic
dung bdng hdi APQ (Aging Perceptions Questionnaire) tren mgt mdu chon WO nguai cao
tudi tic 55-90 v&i ludi trung binh Id 68,25 lir mgt vung thudn ndng a Thai Binh vd ven do
d Hd Ngi Kel qua nghien ciru cho thdy, ngu&i cao tudi y thuc khd rd ve ddng thai gian qud trinh gid hda cua minh. Hg y thicc vd tin rdng, minh cd the ldm chu cdc trai nghiem
tich cue cua gid hda nhung cdc khia canh lieu circ cua nd ciing tdc dong rdt Idn tdi ho.
Du mang link phiic hgp nhung nhin chung, gid hda dugc cdm nhdn vd trdi nghiem khd
lich cue d ngu&i cao tuoi
Tu khoa: Ngirdi cao tudi. Cdm nhdn gid hda
Ngdy nhdn bdi: 5/9/2016; Ngdy duyet ddng bdi. 25/3/2017.
ABSTRACT
Perceptions of aging - by nature - have been found mult idimentional Aging Perceptions
Questionnaire (APQ) was administered to a sample of 100 elderly aged 55 - 90 (age average
68,25) living tn a rural area of Thai Binh and a suburban area of Ha Noi The results show
that the elderly were aware of aging and the process over time (timeline) They were aware
of and believed that they could manage and/or control positive experiences of aging, but the
negative experiences of it also had a significant impact on them A.s a complex process, in
general, aging is perceived and experienced as a relatively positive process among the elderly
Keywords: Old people; PercLplions of aging
Van de
Cam nhan cua nguoi cao luoi vc gia hoa co anh h u o n g d^n hanh vi va
ky vong ciia xa hoi doi voi nguoi cao tuoi (Pasupathi va Lockcnhoff. 2002),
den cam giac khoe manh, hanh phuc va ung pho cua ho trong qua trinh gia hoa
(Lev). 2003; Levy va Myers, 2004). Da s6 cac nghien ciru trong ITnh vuc nay

TAP CHI TAM LY HOC, SO 4 (217), 4 - 2017


duQfc thuc hien of c^c n6n van hoa phuorng Tay nhimg ngay cang co nhieu bang
chung cho thdy, gia h6a 6 cac nen van hoa phuong Bong co the khac (Amhoff,
Leon va Lorge, 1964; Giles etal., 2000, dan theo Levy, 2003).
Theo ly thuy6t \h bi^u tugng xa hoi (Moscovici, 1988), each nhin nhan ve
gia hoa trong mpt xa hpi nao do la mot dang hay hinh thiic bieu tirpng van hoa
chung. Biiu tupng nay la hinh anh tupng trung, hinh anh cua tri giac, nhan thiic
ve ngudi cao tuoi hay qua trinh gia hoa, each thiic iing xii cua nguai cao tuoi
hay voi nguofi cao tu6i trong xa hpi. Cam nhdn ve gia hoa - ve mat ban chat - da
dupe chiing minh Ik mang tinh da chieu {Hummert, 1990), chiia dung cac dac
tinh tich cue, tieu cue (Hummert, 1990; McTavish, 1971; Heckhausen, Dixon va
Baltes, 1989) va phan anh su dan xen giira nhiing mieu ta chinh xac ve cac thay
doi lien quan den gia hoa \ln each nhin nhan khdng chinh xae, meo mo ve nguoi
cao tudi (Kite, Stockdale, Whitley va Johnson, 2005). d mot miic dp nao do,
cam nhan hay tri giac ve gia hoa phan anh nhiing khac biet tren co so sinh hpc
va dieu nay mang tinh pho quat. Nhung ngupc lai, nhung thay doi trong qua
trinh gia hoa ve mat cam xiic, xa hpi hay vi the xa hpi ducmg nhu it phu thupc
vao sinh hpc ma phu thupc nhieu hon vao eac moi uu tien ve mat dpng co (Fung,
Rice va Carstensen, 2005) va cac vai tro xa hpi (Eagly, Wood va Diekman, 2000).
Vi the, cam nhan ve gia hoa theo nghTa nay eo the rat khac nhau o cac nen van
hoa khac nhau.
Trong boi canh mpt nen van hoa thien ve trpng lao nhung lai dang trai
qua nhirng bien doi xa hpi 1cm lao suot 30 nam qua nhu Viet Nam, cau hoi dat ra
la cam nhan cua nguoi cao tuoi - xet tu nhieu chieu canh khac nhau - nhu the nao?
Phu'(xng phap nghien ciru
Nghien ciiu sii dung bang hoi tri giac/cam nhan gia hoa APQ (Aging
Perception Questionnaire) de thu thap du lieu. Thang do nay do Barker M.,

O'Hanlon A., McGee H.M., Hickey A,, Conroy R.M. (2007) ihi^t kl, sau do
dupe thich nghi tren nhieu nen van hoa khac nhau va phat trien thanh phien ban
nit gpn. APQ (ban nit gpn) co 17 menh de, gom 6 tieu thang, moi tieu thang
gom 3 menh de, trir tieu thang Kiem soat (lieu cue) chi gom 2 menh de. Cu the,
CO cae lieu thang do dong Ihoi gian. he qua, kiem soat va bieu tupng cam xuc.
Ddng th&i gian la tri giac hay cam nhan ciia nguoi cao luoi \c tien trinh gia hoa
(vi du: "Toi luon y thiic vc mpt thuc te la toi dang ngay eang gia di"). He qua
cua gia hoa lien quan den niem tin ve gia hoa - mpt tien trinh co chieu canh tich
cue (vi du; "Khi gia htm. loi Ihong thai hem") va tieu cue (vi du: "Khi loi gia
hon, loi khong iing pho tot voi cac van de nay sinh"). Kiem sodt lien quan den
niem tin ve viec con nguoi co the lam chii dupe cac khia canh gia hoa cila minh
toi miie nao - iheo ca 2 ehieu lich cue (vi du: "Chat lu(mg cac moi quan he ciia
toi \oi nguoi khac phu thuoc vao loi") va lieu cue (vi du: "Cham chap hon ciing

TAP CHI TAM LY HOC, S64 (217), 4 - 2017

25


voi mai tac Id di6u toi khong thi k i t o sodt duoc"). Biiu tuangcani xuc hay hinh
dung vi mat cdm xuc Id cdc phdn iing ti6u cue vi mdt cam xiic d6i vdi gid hoa,
bao gflm lo au, lo Idng va trdm cdm (vi du: "Toi cdm thdy tuc gian khi nghi vi
vice tro nen gia hon"). Ddy la mot thang do duoc ddnh gia Id co dO hieu lire vd
dp tin cdy Alpha cua Cronbaeh duge bao cdo Id cao, dao dong t^ 0,70 din 0,80.
Trong n^ien cihi cua ching toi, he so Alpha eua Cronbaeh = 0,72.
Miu nghien cuu
Ddy Id mot nghien ciiu nho, duac thuc hien trSn mot quan the dan cu
ban ch6, chon theo nguyen tdc tien loi. Mdu nghien ciiu gom 100 nguoi cao
tu6i, ty 1$ nam, ntt can bdng, pham vi tuSi tir 55 den 90, voi tuoi trung binh Id
68,25. Nhom nguoi cao tu6i ven do song a Tdy M6 - mgt xa ven do mdi

chuySn thdnh phuiyng cr quan Nam TCr Liem (Ha Ngi). Nhom nguoi cao tu6i
nong thon sdng 6 Quynh Chau, mgt xa thudn nong thuoc huyen Quynh Phu
(Thai Binh). Day Id mgt nghien ciru vdi mdu chgn nho, tinh dai dien rdt ban
chi nen viee khdi qudt hoa kit qua nghien ciiu can luu y.
Ket qua va ban luan
1. Kit qud chung
Bdng 1: Cdm nhdn gid hda theo cdc chieu canh khdc nhau (DTB)
Cac tieu thang do

Viet Nam
(N = 100, tuoi 55+)

Ireland'
(N= 8.500, tuoi 50+)

Do lech chuan
(Viet Nam)

1. Dong thai gian±

3,49

2,66

1,04

2. He qua tich circ+

2,48

3,78

0,99

3 Kiem soat tich circ+

4,08

3,93

0,86

4. He qua tieu circ-

3,51

2,91

1,07

5, Kiem soat tieu circ-

3,71

3,10

1,17

6, Bieu tugng cam xuc-

2,92

2,31

1,19

Ghi chu Pham vi diem Irung binh dao ddng tir 1 (Ichdng dung) din 5 (dung). Vdi tiiu Ihang 2
(he qud lich cue), lieu ihang 3 (idem sodl lich cue) diem trung bhih cdng cao, sic cdm nhdn
gia hda cdng lich cue. Vdi lieu thang 4 (he qua lieu cue), liiu thang 5 (IdSm sodt lieu cue) vd
lieu thang 6 (cam xuc diiu cue) lid diem Irung binh cdng cau. su cdm nhdn gid hda cdng lieu

Mot nghien ciiu theo tu\ en doc, dugc thuc hien tii nam 2009 cho iin nay, tren mau
chon hon 8.500 nguoi cao tuoi tii 50 tu6i tro len, dai dien cho mdu dan s6 Ireland, dimg
thang do APQ day du (32 menh di) tren thang l.ikert 5 miic (xem chi dk Wsh Longitudinal
Study on Aging - TILDA)

26

TAP CHI'TAM LV HOC, So4 (217), 4 - 2017


Kit qua chung thu dugc tti thang do APQ (Aging Perception Questionnaire)
dugc trinh bay trong bdng I.
Tir bang I co thi thdy, nguoi cao tu6i o Viet Nam (it nhdt Id trong mdu
chgn ndy) y thiic khd ro vk ddng thai gian - qua trinh gid hoa ciia minh (DTB = 3,49/5).
Vi du, 76,0% s6 nguM cao tu6i d6ng y (of cac miic d6 khac nhau) vdi menh de
"T6i luon y thiie ve mgt thue te la toi dang ngdy cang gia di" ho^c 57,0% so
nguoi dong y rdng "T6i luon xep minh vao nhom ngudi eao tuoi". Ket qua
khong gdy ngae nhien, co le vi gia hda la mgt qud trinh tit yiu vdi ngudi Viet
Nam (sinh, lao, benh, tir), xd hoi truyjn thdng lai thien vi trgng lao nen hg y

thirc vi dieu nay va thudng cung khong kho khdn gi de thira nhdn thuc te do.
Ban thdn cdch xung hd theo tudi d noi cdng cdng hay trong giao tiep hdng
ngay ciing cd the Id dieu nhac nhd vi thudng tham chieu ddn tudi tac.
He qud tich cue ciia biiu tugng gid hoa cd diem sd dudi mirc trung tinh
(DTB = 2,48/5). Y kien "Khi tdi gid hon, tdi tran trgng eac thir hon" cd diem
trung binh eao nhdt (DTB = 4,25/5) trong khi "Khi gia hon, tdi tiep tuc phat
trien" lai cd diem trung binh thdp nhdt (DTB = 1,50), ehi hon 11,0% sd ngudi
cao tudi ddng y vdi menh de ndy (vdi cdc miic do khac nhau). Ndi each khdc,
khi cd tudi, con ngudi the hien su tran trgng cugc sdng bon nhung hg lai khdng
coi tudi gia la tudi cd the "tiep tuc phat trien". Van hda truyen thdng ggi y rang,
khi mdt ngudi gia di, hg thudng thu hep hoac dimg cac boat ddng cua minh lai
hon la bdt ddu mdt sd hoat ddng md hg hirng thu bode chua cd co hdi thue hien
trude ddy.
Kiem sodt tich cue cd diem sd cao nhat (DTB = 4,08) phdn anh mdt dieu
rang ngudi cao tudi trong mau chgn nay y thiic va tin rang - d mgt miic do rat
Idn - hg cd the lam chii cac trai nghiem tich cue cua gia hda. Vi du, cd tdi 92,0%
sd ngudi cao tudi tin rang "Chat lugng cugc sdng xa bdi ciia tdi vao nhung nam
sau nay phu thudc vao tdi" hoac 80,0% sd ngudi ddng y vdi menh de "Viec tdi
cd tiep tuc sdng cugc ddi trgn ven hay khdng phu thudc vao tdi". Kinh nghiem
sdng, su tran trgng cugc sdng, khi ve gia, cd ve lam hg rat tu tin trong viec kiem
soat itch cue qua trinh gia hda cua minh.
Tuy nhien, tir bang 1 cung thay r5 rang, ngudi cao tudi ciing cd diem sd
kha cao dieo hudng he qud tieu cue (DTB = 3,51) va Iciiin .mat tieu arc (DTB = 3,71).
Vi du, theo hudng he qua tieu cue, 75,0% sd ngudi ddng y rSng "Khi tdi gia di,
tdi cd the it tham gia vao cac hoat ddng hon". Theo hudng kidm soat tieu cue, cir
10 ngudi thi cd 8 ngudi dong y rang "Chain chap hon ciing vdi tudi tac la di6u
tdi khdng the kiem soat dugc". DiSm sd kha cao d 2 khia canh vira neu cho thdy,
cac khia canh tieu ciic cua qua trinh gia hoa cd tac ddng va dugc cam nhan kha
ro rang d ngudi cao tudi.

TAP CHI'TAM I f HOC, Sd4 (217), 4 - 2 0 1 7

27


DiJm sd khd thdp theo khia canh bieu tugng cam xuc (phdn ling tieu cue vd
mat cam xuc) (DTB = 2,92) ggi y ring, ngudi cao tudi khdng cd nhigu cdm xuc
tieu cue m?nh me ddi vdi gid hda. Vi du, da sd ngudi cao hioi (72,0%) khdng
ddng y la "Tdi bj tram udt khi nghi ddn viec gia hda..." hodc 71,0% sd ngudi
khdng ddng y rdng "Tdi cdm thdy tiic gian khi nghi vd viec trd nen gia ban".
Tir kdt qua thu duoc trong nghien ciiu ndy - d mdt miic do nhat djnh - cd
thd so sdnh vdi ket qud thu dugc tir nghien ciiu dai dien cho Ireland (xem cot 3,
bang 1). Didm gidng nhau Id khia canh kidm soat tich cue cUng cd diem sd cao
nhdt vd cd hai nhdm ngudi cao tudi ddu khdng cd cac phan ling cdm xiic tieu
cue manh me khi vd gid. Ngugc lai, ngudi cao tudi d Ireland cd cdm nhdn ve
he qua tich cue (lien quan ddn gid hda) cao ban ngudi Viet Nam. Hg cung cam
nhdn kidm sodt tieu cue ciia gid hda tdt hon ngudi cao tudi d Viet Nam.
Kdt qud nghien ciiu d Viet Nam (trong mau nghien ciiu nay) cung cd
mgt sd didm tucmg dong vd khdc biet so vdi mdu nghien ciiu quy md dai dien
cho Ireland - theo thang APQ tren ddy. Nhirng ai md ta gid hda co nhieu he qua
tieu cue thi cung cd nhidu phan irng bidu tugng cdm xiic tieu cue hon, vdi do
tuong quan rdt chat che (R = 0,60). Tuong quan thudn cung the hien giua kiem
soat tieu cue va he qua tieu cue vdi R = 0,72. Ket qud ndy la hgp logic vd
khdng gdy ngac nhien.
2, Mdt so khdc biet
Theg nai sinh sdng
Bdng 2: Cdm nhdn gid hda cua ngudi cao tudi theo nai sinh song
(ven do vd ndng thdn) (DTB)
T-test

MiTC y nghia

Dong thai gian

Tay M6 (Ha Noi) Quynh Chau (Thai Binh)
2,94

3.94

5,507

0,000

He qua tich cue

2,73

2,27

-2,380

0,019

Kiem soal tich cue

3.77

4,33

3,480

0,001

He qua tieu cue

2.90

4,02

6,260

0,000

Kiem soat tieu cue

3,50

3,89

1,706

0,091

Bieu tuang cam xuc

2.35

3,40

4,892

0,000

Ket qua so sanh trong bang 2 tren day cho thay, nhdm ngudi cao tudi d
ndng thdn y thuc ve thdi gian gia hoa rd hon so vdi nhdm ngudi cao mdi d ven
dd. Hg cung co diem sd kiem soat tich cue va he qua tieu circ cao hon nhdm
28

TAPCHl'TAMiyHOC, Sd'4(2l7),4-20I7


ngudi cao tudi d ven do, ddng thdi cQng cd xu hudng trai nghiem he qua tich
cue cua gid hda it hon so vdi nhdm ngudi cao tudi ven dd.
Theo nhdm tudi
N6u chia mau chgn thdnh 3 nhdm tudi (dudi 64, tii 65 va 74, tir 75 tudi
trd len) mdi tidu mdu cd khoang hon 30 ngudi. Tuy cac tidu mdu nay con rat xa
mdi trd thanh cdc tidu mau ly tudng de so sanh nhung nd ciing eho biet mgt sd
dieu ddng luu y. Cdc didm ddng chii y ndy da sd xoay quanh nhdm tudi 64 - 74,
tdc la 10 nam cudi ddi cua ngudi Viet Nam neu tinh theo tudi thg trung binh.
Bang 3: Cdm nhdn gid hda cua ngudi cao tudi theo nhdm tudi (DTB)
Mucy
nghTa

Duoi 64
(N = 39)

65-74
(N = 32)

Tren 75

(N = 32)

F

Dong thai gian

3,06

3,90

3,57

6,556

0,002

He qua tich cue

2,67

2,20

2,53

2,164

0,120

Kiem soat tich cue

3,82

4,34

4,12

3,453

0,035

He qua tieu cue

3,02

3,93

3,69

8,060

0,001

Kiem soat tieu cue

3,47

3,86

3,87

1,358

0,262

Bieu tugng cam xiic

2,48

3,22

3,16

4,563

0,013

Ghi chit: Diem dao dong lir 1 (khong diingj den 5 (diing). Vdi lieu ihang 2 (he qua tich cue),
tieu thang 3 (kiem sodl tich cue) diem trung binh cdng cao, cam nhdn gia hoa cang tich cue.
Vdi lieu Ihang 4 (he qud tieu cue), lieu ihang 5 (kiem sodl lieu cue) va lieu thang 6 (cdm xuc
lieu cue) thi diem trung binh cdng cao, cdm nhan gia hoa cdng lieu cue.

Nhom luoi lu 65 - 74 co xu huong y Ihuc ve thoi gian gia hoa ro nhat
(DTB = 3,90) nhung cung co Irai nghiem kiem soat tich cue cao nhat (DTB = 4,34),
du cam nhan he qua tieu cue cua gia hoa cung la cao nhat (DTB ^ 3,93). Hg
cung CO xu huong the hien cac cam xuc lieu cue voi gia hoa mot each manh me
nhat (DTB = 3,22).
Tom lai, tir nhiing ket qua va ban luan tren day, tham chieu voi 3 ly
thuyet hay dugc nhac den nhat lien quan den gia hoa" (duge phat Iricn a phuong
Tay) thi thay ducmg nhu nguai cao tuoi a Viet Nam co cam nhan kha tich cue ve
gia hoa. Mau hinh ciia ly Ihuyct thii 3 (ihuyel chon lua) dugc ihc hien ro hon

^Thuyet 'Tut lui", Thuyel tich cue (boat dong) va ['huySl chon lua (chi uk xin xem Le
Van Hao. 2016, Bao cao de lai nghien cuii: Cam nhdn tudi gid o ngudi cao ludi, Di}
lai c3p Vicn Tam ly hgc)

TAP CHI TAM LV HOC, SO 4 (217), 4-2017

29


uong nhdm khdch thd cua nghien ciiu ndy. Hg cd thuc hanh vide "nit lui" khdi
mdt sd vai trd xa hdi va tuong ling vdi nd Id hoat ddng xa hdi nhung khdng phdi
tdt ed trong mdt ndn van hda cd su phu thudc lan nhau giua cdc thd he. Hg cung
cd ve khdng hodn toan theo mdu hinh thii 2 la thd hien tinh tich cue rat cao vi
mdi gid Id tudi nghi ngoi, sum vay vdi con chau... Hg cd xu hudng chgn cdch
thii 3, trung dung hon, cdn bdng hon: chgn Igc mdt sd boat ddng phii hgp, sao
cho sdng vui, sdng khde, sdng cd ich.
Kit luan
Tit nhiing gi da trinh bdy trong phdn ket qua nghien ciru cd the riit ra
mdt sd kdt luan sau day:
- Ngudi cao tudi trong mdu chgn nay y thirc khd rd ve ddng thdi gian qud trinh gid hda ciia minh. Nhdm ngudi cao tudi d ndng thdn y thirc vd thdi
gian gid hda rd hon so vdi nhdm ngudi cao tudi d ven dd.
- Khi "ed tudi", ngudi cao tadi thd hien su tran trgng cugc sdng hon
nhung bg lai khdng cho rang tudi gia la cd the "tiep tuc phdt trien". Hg thudng
thu hep hoac dimg cdc hoat ddng cua minh lai hon la bat dau mdt sd boat ddng
ma hg hiing thii hoac chua cd co hdi thue hien trude day.
- Ngudi eao tudi khdng ed nhieu cam xuc manh me ddi vdi gia hda.
- Ngudi eao mdi trong mdu chgn nay y thtic vd tin rang - d mdt muc do
rdt Idn - hg cd the Idm chii cdc trai nghiem tich cue ciia gia hda. Ivlbung cac
khia canh tieu cue ciia qud trinh gia hda cd tdc ddng va dugc cam nhan kha ro
rang d ngudi cao tudi. Dii the nao thi gid hda cung dang dugc cdm nhdn va trai

nghiem kha tich cue d ngudi cao tudi.
Tai lieu tham khao

1. Barker M., O'Hanlon A., McGee H.M., Hickey A., Conroy R.M., Cross-sectional
validation of Ihe Aging Perceptions Questionnaire: A multidimensional instrument for
assessing self perceptions of aging, BMC Geriatr, 7 : 9, 2007.
2. Levy B.R., Mind matters: Cognitive and physical effects of aging .self-stereotypes. The
Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 58:
203 - 211. Doi: IO.I093/geronb/58.4.P203, 2003.
3. Levy B.R., Slade M.D.. Kunkel S.R., KasI S.V., Longevity Increased by Positive
Self-Perceptions of Aging, Joumal of Personality and Social Psychology, Vol. 83, No. 2,
261 - 270, Doi- I0.I037//0022-35I4.83.2 261, 2002.
4. Lockenhoff et.al.. Perceptions of Aging across 26 Cultures and their Culture-Level
Associates, PMC 2010 Sep 3, Psychol Aging, 2009 Dec, 24 (4): 941 - 954, Doi: 10 1037/
aOOI690l,20IO.
3. Moscovici S.. Xoles towards a description of social representations, ioMmdii of
European Social Psychology, I 8 (3): 211 -250, DoiT0,l002/ejsp.2420180303, 1988.
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TAP CHi TAM l y HOC, Sd 4 (217), 4 - 2017