Một số yếu tố tác động đến khả năng nhận biết của người cao tuổi ở khánh mậu, yên khánh, ninh bình

Nghign ctiu
Gia d i n h vA Gi6i
S^ 6 - 2 0 1 2

Mgt so yeii to'tdc flgng Sen kha nang nh^n biet cua
nguoi cao tuoi A Khinh Mdu, Yen Khdnh, Ninli Binh
Lo Viet Phuong
Vi$n Gia dinh vd Gidi

Tdm tat: Dua tren dff li^u ciia nghien cffu "Khao sat ve Sffc
khoe vd Phuc Idi cila ngUdi cao tuoi 6 Vitt Nam" dUdc thUc hien
tai xa Khanh .M,ui, huy?n Yen Khanh, tinh Ninh Binh nam
2010, bdi Viet xem x6t cdc yeu to^ tac dpng den kha nflng nhdn
biet cila ngUcii cao tuoi qua phUdng phap phan tfch hai biffn vd
hoi quy logistic. Ket qua nghien cffu cho thd'y kha nSng nhan
biet cila ngUcli cao tudi chju sU tac dong ciia cac yeu to' nhu mffc
sdng, dp tuoi, sffe khoe lh§ chdt va hoat dpng thUdng ngay.
Nhffng ngUdi cao tuoi cl nhdm tudi 60-69. nhffng ngUcri c6 mffc
sdng kha vd nhflng ngUdi tich cffc tham du cac buoi hop thon,
x6m c6 kha ndng nhdn bi^t to't hOn so vdi nhflng ngUcri cao tuoi
trong nhfim ddi chffng.
Tir khoa: NgUdi cao tuoi; Sffc khoe tinh th^n; Kha nfing nh&n
biet ciia nguoi cao tuoi.

1. Dat van de
Sffc khde tinh thdn Id mdt edu phdn quan trpng trong sffe khde tdng thd.
Theo dd, sffc khde linh thdn Id trang thdi khde manh cua mdi ca nhdn d l
hp nhdn bifi't dupe kha ndng eua ban thdn. cd thi duong dau vdi nhffng
cdng thdng Ihdng thudng trong cudc sdng. cd thi Idm viec va hpc tap mdt
each ed hieu qua va ed ihl tham gia. gdp phdn vao eae hoat ddng ciia cdng
ddng (WHO. 2003:4). Sffc khde tinh thdn Id mdt khai nidm rdng, khdng

1-^6 Viat PhUrfng

27

Ihl tach rdi trong sffc khde ndi chung, tuy nhien nd dupe coi Id ydu id quan
trpng nhd't dl mang lai cam giac hanh phuc cho mdi ngudi.
Sffe khde tinh thdn eua ngudi eao ludi cd y nghia thuc tiln trong viCc
ndng eao chd't lupng co ed'u ddn sd vd vd'n dl ndy da vd dang ddt ra nhffng
nhu edu nghien cffu. Cho ddn nay. cac nghifin cffu vl .sffe khde tinh thdn
ciia ngudi cao tudi d Vifit Nam thudng quan tdm dfi'n su rdi nhilu tdm trf.
su cd dcfn, cae chung bfinh tdm thdn (theo edch tifi'p edn y hoc) hodc Id cdc
hoat ddng sinh hoai van hda linh thdn cua ngudi eao tudi (theo each tifi'p
can vdn hda) (Ld Vifit Phucmg. 2011). Bfin canh dd. kha ndng nhdn bifi't la
mdt trong nhirng bidn sd do ludng vl .sffc khde linh thdn. Nghifin cffu vl
kha ndng nhdn bifi't cua ngudi eao tudi vd cac yeu td lae ddng gdp phdn
mang lai nhdn thffc day du hon vo vd'n dl sffc khde tinh thdn eiia ngudi gid.
la nhdm ddn sd dac bifit, qua dd cac thanh vifin trong gia dinh vd xa hdi se
CO nhimg each ffng xu day cam thdng va su chdm sde phu hop de ngudi
cao tudi ludn cam thd'y lae quan irong eude sd'ng.
Dua trfin kfi't qua nghifin cffu cua "Khao sat vl Sffc khde va Phiic loi cCia
ngucri cao lull d Viet Nam" dupe thuc hifin tai xa Khanh Mau, huyen Yfin
Khanh. linh Ninh Binh ndm 2010. bai vifi't tap trung phdn tfch cac ydu td
tac ddng dfi'n kha nang nhan bifi't eua ngudi cao tudi. Cd 288 ngudi cao tudi
tff 60 tudi trd 16n trong tdng sd 407 ngudi tra Idi dupe su diing 1dm mdu
phdn lich cho bdi vifi't.
Trong nghien cffu nay. kha nang nhdn bifi't eiia ngudi cao ludi (NCT)
duoc kiem chffng qua mpt kifi'm nghiem nhd. Ngudi cao tudi tra Idi eho 4
cau hdi 1- "Bdy gid dang la mua gi?", 2 - 'Ten huyen ndy la gi?", 3'Trung thu vao ngdy nao?" vd 4- "Dpc lai dung thff tu 3 tff: mat trdi, chifi'c

giay, bac sy".
Kfi'i qua thu dupe cho thd'y, kha ndng nhdn bifi't cua NCT d Khanh Mau
kha tdt dd'i vdi cdc su kien don le, cd tfnh true tiep. Cu thi nhu khi ira Idi
cho ede edu hdi "Bdy gid la mua gi?" - cd tdi 89,5% ngudi tra Idi cho bidt
la miia he - dd cung la thdi dilm diln ra dieu tra, cd 7.3% ngudi tra Idi sai
va 3,1% khdng the tra Idi mde du thdi difi'm diiu tra la ndng ndng dat cue
difi'm cua nam 2010 vd d xa Khanh Mau ludn d tinh trang mat dien. Ty lfi
cho edu tra Idi d edu hdi "T6n huy6n nay la gi?" cung cho kfi't qua tuong
duong. Khi phai gdn su kifin vdi mdt dfl lidu cu the nhu "Trung thu vao
ngay nao?". ly le ngudi cao tudi tra Idi sai cao hon mdt chut (10,1%) so
vdi hai edu hdi tren. 6 edu hdi eudi eiing, NCT edn lap lai dung thff tu eiia
3 tff md didu tra vifin dpc (mdt trdi, chifi'c gidy, bdc sy) thi cd Idi 25,3%
ngudi cao ludi tra Idi sai d edu hdi nay; chi cd 58,3% NCT tra Idi dung va


28

Nghioncffu Gia dinh vA Gidi. Quy^n 22, s6'6, tr. 26-37

ty Ifi khdng thi ira Idi eung khd cao (1 d.3%). Nhu vdy, kha ndng nhdn bidt
eua NCI d Khanh Mdu td't d eae su kidn cd tfnh true tidp, cdn nhflng su
kifin cdn su liCn kdt. lifin tudng Ihl ty lfi NCT ludn cam thd'y lung tiing hodc
dua ra phuong an tra Idi khdng chinh xac eao hon khd nhilu.
D6 cd Ihl plidn tich .sdu hon. bifi'n sd kha ndng nhdn bidt dupe xdy dtmg
mdi vdi hai phutTng an tra Idi Id: "tdt" vii "khdng tdt" tren eo sd kdt qua
ciia bdn edu hdi da dupe dua ra. Ddi \di nguoidi cao tudi cd kha nang nhdn
bici tdi. thi nhd't Unci phdi o'l dap :in diing ddi vdi cau "dpc lai dung thff tu
cua 3 iff mat trdi, chific gidy va bdc sy" eung vdi en dap dn dung dd'i vdi 2
Irong 3 edu hdi trfin. Kcl qua sd lifiu eho ih.iy. cd 52.1 ^ NCI ed kha ndng
nhdn blot idi. va ty Id cdn lai dupe eho la cd kha ndng nhan bill khdng idi

(47.'J%). Hdu hei nhuTig ngudi eao tudi cd dap dn diing d cau hdi thff 4
(dpc lai ihff tu dung cua 3 iff cho siin) thi ludn ed dap an diing d 2 trong 3
edu hdi edn lai.
2. Cac yeu to tac dong den kha ndng nhan biet cua ngodi cao tuoi
Ddc diem cd nhdn
Dd'i vdi ngudi cao tudi, ngudi ban ddi khdng chi la ngudi chdm sde ma
thuc su cdn Id ehd dua vimg chde vl tinh thdn, su cd don dfi dang xdm
ehifi'm nfiu nhu ho khdng .sd'ng cung ban ddi hode eon chau. Theo tidp cdn
phdn tich vl co edu xfi hdi, su tuong tde giffa eae mdi quan hd 1dm cho chii
ihfi cdc md'i quan hfi bdc Id nhffng ddc dilm rieng ciia minh. Bfin canh dd.
theo tifi'p can cua phdn tfch vc tudi gia theo sinh hpc vd vdn hda. yfiu Id
quan trpng nhd't tao ra khuynh hud^g cd Idp \d hdi cua ngudi Idn tudi Id
edi chfi't cua ngudi ban ddi (John J. Maeionis. 10S7' 431). Kci qua so lieu
eho thd'y. nhdm NCF hien sd'ng cung vp/chdng cd ly 16 ed kha ndng nhan
bie't cdn tdt cao hon dang kc so vdi nhdm NCT hi6n khdng sdng cung vp/
chdng (ly 16 tuong ffng 64.9^; \'a 45.7'";p).
Cd 74.9% NCT d nhdm 60-69 tudi cd kha ndng nhdn bidt td't trong khi
ly Ifindy dnhdmtff SOiudi trd Ifin la 19.6%. Vdi mffc y nghia quan hfi chdt
che (P<0,01) cho thd'y tudi lac cd anh hudng tdi kha ndng nhdn bie't eua
NCT. Difiu ndy cung phu hpp vdi quy ludi sinh hpe eua con ngudi. ludi
cdng cao thi kha ndng nhdn bifi't cang giam sut.
Kha ndng nhdn bidt cdn ed the bi anh hudng bdi hoat ddng thudng ngay
eiia NCT. Kha ndng nhdn bill cua ngudi cao tudi tan tdt hoac gia ye'u
khdng cd kha nang lao ddng thudng kem hon so vdi nhdm NCT vdn lam
viec hay thudc nhdm him trf, hien dang trdng con chau trong nam qua
(Bangl).


L6 Viet Phiitfng

2

Bang 1. Kha nang nhdn biet tdt (heo dac difim ca nhdn cua NCT (%)
Ciit bit-n tiic d^ng

Kha natiR nhan hiOt tut

r.k'fi tfnh NTL*
Nft

64.4
56.6

60 - 69 tu6i

74.9

70 - 79 ludi

38.S
19.6

Niini

Tu6i**'

80 tu6i ird len
Tmh Irang hiin nhan**
Hi^n sdng ciing vo/cluing

64.9

Khdng sd'ng ciing \o/cli6ng

45,7

Hoat diing chinh trong nim qua **•
Dang lam vific

64.7

Tan I ill, dau yfiu
Hini irf va irflng con chdu

2.5.9
72.5

Sue khuc the' chat hien tai
T6i
Binh thirdng
Xau

62.5
56.1
47.0

(Mfcy nghTd: *p<0.05: **p
Sffc khde thi chd'l cua NCT ed thi ed nhirng anh hudng true tidp dfi'n
sffc khde tinh thdn, vdi the trang sffc khde the chd'l td't, con ngudi cd the ed

dupe irang thai linh than lot. Trong sd nhffng ngudi cao tudi cd sffe khde
the chd'l lot. cd 62,5% cho bifi't kha ndng nhdn bidt eiia hp edn tdt, trong
khi dd, ty Id nay d NCT cd sffe khde trung binh la 56,1% va NCT ed sffe
khoe yfi'u Id 47,0%.
Quan sdt nhffng trieu chffng vl sffc khde ma NCT tffng gap trong thang
qua cho thd'y 3 Iridu chffng cd ly lfi xud't hifin cao nhd't Id; dau ddu (70,8%),
mdt ngu (68,1%) vd dau lung (64,9%) vdi cac mffc dd nghifim trpng hay
trung binh/nhe. Day la 3 chffng bfinh thudng gap ve mat thi chat nhung lai
ed lien quan den sffc khde tinh thdn ciia NCT. Chl ed 50% NCT tffng dau
ddu trong thang qua cd kha ndng nhdn bifi't td't, so vdi 57,1% NCT khdng


30

Nghign cUu G)a dinh v^ GIdt. Quyd'n 22, so 6, tr. 26-37

miic trieu chLrng miy. Khdng cd khac bifit ddng kl vl ly 16 cd kha ndng
nhdn bidt lOl giffa ngirdi NCT mde vd khdng mde trifiu chffng mift ngii
irong Ihdng qua {5i,5''^f vd 53,37r).
7Ym,i,' lliam gia chiSi tnnili hodt tnii qua cdc sU kii-n chdn dimg
Bfin canh ede ddc dilni nhdn khdu hpc eiia NCT. vific lung tham gia
qudn dni hay tffng ir;ii qua mdt sd sir kifin ihdi chidn cung Id mdt trong
nhffng yfiu tdcd thi cd l.ic dCm\: ddn liini ly ciia eon ngudi, ruu cdc su kifin
tffng irai qua thudc nhfliig "sir kifin chdn ddng". Vdi ky vpng tim hilu anh
hudng ctia yeu td chifiii iranh cd l;ic dniij; dfi'n sire khde linh thdn cua NCI
nhu ihdndo. bifi'n sd N( 'I "tffng iham gia qudn ddi va t-ae irai nghifim thdi
cliicn" se dffpc dua viio md hinh dl phdn tfch. Theo Ngo Van Luong
(2009) tham hpa eo the gdy ra nhffng sang chdn idm ly vd nan nhdn d l bi
pha vd cd'u true tdm ly (ki'ch d(i\\\x cam xiie hay mdt hung Ihu), hon nffa.
ngudi bfinh thudng nghifin ngdm sang chflfn mdt edch c6 y thuc va cac rdi

loan nay thudng cd xu hudng tdi didn vd rdi loan trong nhifiu ndm. Kdl qua
phdn tfch so lifiu cho thd'y. nhung NCT tffng chimg kidn cae su kifin trong
thdi chifin cd ly lfi cd kha ndng nhdn bill idl hon so vdi NCr chua iffng
chung kidn, ngoai trff NCT iffng chffng kifi'n canh ngudi thdn chfi't ddt ngdi
(xem Bang 2).
Nghifin cffu nay eung quan idm itcn vific N ( T da iffng irai qua nhirng
ky ffc tdi lfi hay dc mdng. khd cam nhdn nhung cam xtic ddi thudng. mdt
hffng thiJ vdi nhung vific tffng yfiu ihfch. klid ngii. khd tap trung ddi vdi
mdi su kifin tffng gdp phai. Vice lung tham gia chidn su cung cd nhiing tdc
Bang 2. Kha nang nhdn bifit tot ciia NC I da tffng hoac chua l i m g
chung kien ciic sv kien trong thffi chien (%)

I' kii-n

l)il timg
chirngkicn

Khdng
chirng kien

Tirng true iiC'p iham gia chiiJn diu*

69.9

.=^7.8

Tirng chirnp kiOn sir qua dtii ddi ngdi ciia ngu&i t h a n "
Tirng sdng Irong viing chiC'n sir**

59,1

63.7

61.5

52.3

Tirng chii'ng kicn cinh hao tan hay gifii ngirin hiing loat*

63.8

58.0

Tirng Jiim ngiriJi khac bj ihtrcmg liay in vong**
Timg nep xiic vdl cha't tide h6a hoc***

68.6

59.8

80.7

56.7

(Muc J nghia: *p < 0,05; **p < 0.01; • • ' p < 0.001)


Lo Vict PhUoTng

31

ddng nhat djnh dfi'n tam ly eua NCT, 69.4% NCT cho bifi't da hay hoang
hdt. de gidt minh. tifi'p dfi'n Id khd ngu, khd tdp trung (62.9%), cung cd tdi
50% trong sd nhiJng ngudi tffng true tifi'p tham gia chifi'n da'u cho bidt hp
da tffng ed ky ffc tdi lfi hay dc mdng vl nhCitig gi da chffng kifi'n trong chiln
trdn. Vific chffng kifin canh tuong ngudi thdn md'i ddt ngdi trong chiln
tranh eung khifin cho hdu hfit NCT cho bill hp tffng ed cam giac khd ngu,
khd tdp trung (82.9%) (\cm Bang 3).
Dl cd till thd'y ro hem dupe sir tde ddng cua yfi'u td "tffng trai qua cac
sit kifin thdi chifi'n" dfi'n kha ndng nhan bifi't eua NCT hifin nay. trfin eo sd
eae dff kien hifin cd. tac gia \;i\ dung bifi'n mdi "Iffng bi tdn thuong bdi
chifi'n tranh". Bifi'n nay dupe xdy dung trfin co sd 6 bifi'n: tffng true tifi'p
chifi'n dd'u, tffng chiu dimg sir qua ddi ddi ngdt eua ngudi thdn, tffng sd'ng
trong vffng ehidn su. tffng chffng kifi'n canh tuong gifi't ngudi hang loat,
timg lam ngudi khac bi thuong hay chfi't \'a ximg tifi'p xuc vdi chdt ddc hda
hpc. Nhu da phdn tfch d trfin, vice timg irai qua cae su kifin ndy ft nhilu
ciing khidn cho NCT tffng cd ede cam giac nhu ed ky ffc tdi te hay dc
mdng. hoac khd cam nhdn nhffng cam xuc ddi thudng nhu yfiu thuong,
hanh phuc. md'i hffng thii vdi vific tffng ydu thuong .. Day cung Id co sd de
tac gia dua ra gia dinh. khi trai qua ba trong sau su kifin ndy, NCT ft nhieu
cung cd nhffng anh hudng tdm ly, cd thi coi nhu tffng bi tdn thuong bdi

Bang 3. Tffng trai qua cac trang thai tam ly sau cac sir kien \a} ra (%)

Ky li'c loi te
hay ac mong

Trai nghiem

Kho cam

nhan cam
xuc diri
thuong

Mat humg
thii vdi vice
titng yeu
thuong

Kho ngu,
kho tap
trung

Hay hoang
hot, de giat
minh

gia

50.11

35,5

6.9

62.9

69,4

Tirng phai chm dung su qua

den cua ngutii than (N = 203)

59.1

55,7

56,7

K5,2

69,5

Tirng song trong vung chien
su(N-233)

56,1

.34.5

32.5

70.6

72,5
74.6

Tirng tnrc lie'p tham
chiS'n da'u (N = 62)

Tirng chttng kift'n canh giei

ngirdi hang l o a l ( N = 126)

65.9

46.0

3K.I

75.4

Tirng lam ai bi ihuang hoac
tir vong {N = 39)

23,1

5,1

5,1

I2.K

17.9

Timg tiep >LiJc v6i cha't ddc
hoa hoc (N = 47)

2H,9

6,4

10.6

38,3

25,5


3e

Nghl6n cffu Gia dinh vd Gidi. Quyft'n 22, sd'6, tr. 26-37

I t i l u du I. Khii nang nhdn l>ii'l tul cua ngutn cao luoi
Iheo yfiu let mffc sdng vd sdng ciing con (%)
ai 1

liiii
•

Kh.i (;i.i

54 1

Trung hinh

Ngheo

^^

Khnng Ming I

"^'n^

Mi?c Ming

chifi'n tranh. Ket qua phdn tfch sd lifiu cho thd'y. c6 .^6.8% NCT d Khanh
Mdu tffng bi tdn thuong bdi chiln tranh. Nhung NCT (ffng bi idn thuong
bdi chidn tranh lai cd kha ndng nhdn bie't cao hon so vdi nhung ngudi ehua
tffng bj tdn thuong bdi chifi'n iranh (39.4'^f so vdi 47.8'"f).
Nhdm yen to gia dinh
Giai cdp xa hdi ed tac ddng nhd't dinh ddn sue khoe tinh thdn cung nhu
sffc khde Ihfi chdt cua eon ngudi. CJ giai cdp thd'p hon. vdi diiu kidn kinh
id thd'p hon thi cae thdnh vifin rd'l dfi rdi loan cam xuc hon cac thdnh vifin
thudc giai cdp cao hon nhu trung luu. thupng luu. Bfin canh dd. cudc sdng
vdt ehd't CLia con ngudi ddy du hon thi hp ed khuynh hudng phuc hdi nhanh
hon khi gdp cac rdi loan cam xuc (John J. Maeionis. 1987:325). Trong
nghifin cffu nay, mffc sd'ng cua gia dinh dupe dua trfin lifiu chi ddnh gia eua
ngudi tra Idi vfi mffc thu nhdp vd kha ndng chi tifiu. Kfi't qua nghien cffu
cho thd'y, mffc sd'ng cua gia dinh cd quan he chat ehe vdi kha nang nhdn
bifi't td't cua NCT. CJ nhdm cd mffc sdng edng khd. NCT cang cd xu hudng
ed kha ndng nhdn bidt tdt hon (chdnh Ifich giffa nhdm cd ty lfi cao nhd't va
nhdm cd ly lfi thd'p nhd't la hon 20 dilm %). Viee sd'ng eiing hay khdng
sd'ng cung eon chau khdng ed quan hfi chdt vdi kha nang nhdn bifi't id't eua
NCT (xem Bilu dd 1).
Cdc yen id lac dgng qua mo hinh hdi quy logistic
Nham xde dinh eac yfi'u id lac ddng tdi kha nSng nhan bie't eiia NCT
cae md hinh hdi quy logistic dupe xdy dung dua trdn cac 1^ ihuyfi't hpc hoi


Lo Viet PhUoTng

33

xa hdi vd tidp cdn tdm \^ hpe. Theo Iy thuyfi't hoc hoi xa hdi, nhdn thffc va
hanh vi eiia mdi ca nhdn dua trfin ca sd hpc hdi tff nhffng ngudi xung
quanh. eac nhdm ban hode eac phuong liOn thdng tin dai ehiing. Nhdm
ban vd phuong tifin truyin thdng cd kha ndng diiu chinh nhdn thffc va
hdnh vi cua con ngudi dl ed thi giiip ho cd kha ndng hda nhdp vd Id thanh
vifin ciia nhdm. Vific NCT thudng xuyfin tham du ede budi hpp cua thdn
xdm hay trd chuyfin vdi ban be hay xem livi/nghe ddi ed tdc ddng nhu thd
nao dfi'n kha ndng nhdn bifi't ciia NCT? Bfin canh dd. each tifi'p cdn tdm I^
hpe eung cung cdp them ludn chffng dl giai thi'ch vl vific nhung ngudi tffng
chffng kifi'n cac su kifin chdn ddng cd thd gdy ra nhihig sang chdn tdm ly.
va cac sang ehd'n nay cd xu hudng tai diln va Idp lai trong nhilu ndm. Vay,
kha nang nhdn bifi't cua NCT chiu tac ddng bdi cac yfi'u td ndo? Ngodi cac
dac trung ca nhdn va gia dinh, klia nang nhdn bifi't ciia NCT cdn chju anh
hudng bed cdc yfi'u td kh>ic nhu: cd tham gia hoat ddng edng ddng, va cd
tifi'p cdn vdi cdc phuong tifin thdng lin dai chiing. Kfi't qua phdn ti'eh tuong
quan hai bifi'n eho thd'y, NCT tham gia cang nhilu vdo cae hoat dpng cpng
ddng vd thudng xuyfin giao tifi'p vdi ban be hang xdm thi kha ndng nhan
bifi't cua hp cd xu hudng tdt hon. Tuong tu, hay vdi nhffng NCT tffng bi
chdn ddng linh ihdn bdi chidn tranh cung cd kha ndng nhdn bifi't td't hon.
Cdc ye'u td nay can dupe kifi'm chung trong cac md hinh hdi quy logistic
de thd'y rd su tac ddng ciia nd dd'i vdi bidn sd kha ndng nhdn biet cua NCT.
Trfin cosddd, ba mdhinh hoi quy dupe xay dung gdm: (1) Md hinh 1:
cac yfi'u td lifin quan dfi'n dac dilm ca nhdn va gia dinh cua NCT; (2) Md
hinh 2: ben canh nhdm yfi'u td ddc dilm ea nhdn va gia dinh, edn cd eae
yfi'u td thudc nhdm "mffc dd giao tifip cua NCT" gdm: tham gia hoat ddng
edng ddng, giao tifi'p vdi ban be/hang xdm va mffc dp xem livi/nghe dai;
(3) Md hinh 3 (md hinh ddy dii): bd sung thfim yfiu id tffng bi tdn thuong
bdi chien tranh. Vdi gia dinh, dd'i vdi NCT, vide thudng xuyfin tifi'p xiic vdi

eac phuong tien iruyen thdng dai chiing, eung nhu vific thudng xuyfin giao
tilp vdi ban be/hang xdm hay tham du cac budi hpp thdn xdm se giup eho
NCT ludn ed dupe trang thai tdm ly thoai mai nhd't, vd chfnh dieu nay se
gidp cho hp cd kha nang nhan bifi't lot nhd't. B6n canh dd. vific limg bi tdn
thuong ve tdm ly do chifin tranh cd Ihl cung se cd tde ddng tdi kha nang
nhan bidt. Bien sd phu thudc la: "kha nang nhdn bie't ciia dng/bd?" (1 - Td't;
0 - Khdng).
Kfi't qua md hinh 1 cho thd'y, trong nhdm yfi'u id lifin quan dfi'n ddc trung
ea nhan ctia NCT thi ydu td gidi tfnh, tinh trang hdn nhdn vd sffc khde ihfi
chdt khdng ed tde ddng tdi kha ndng nhdn bifit eiia ngudi cao ludi. Kha
nang nhdn bidt cua NCT chiu lac ddng bdi dd tudi, hoat ddng chinh trong


34

Nghidn cffu Gia dinh va Gidi. Quy^n 22, s o 6, tr. 26-37

ndm qua vd mirc sd'ng. Cu thi, xdc sud't dl nhdm NCT tff 60-69 cd kha ndng
nhdn bifii td't cao gd'p 1,5 Idn .so vdi nhdm ludi 80 trd Idn. Nhdm ngudi cao
tudi tdn tdt. gid yd'u khdng Idm vific cd kha ndng nhdn bidt kim hon so vdi
nhdm NCT huu trf va hifin cdn trdng giff chdu.
Cac bifi'n sd lifin quan rieii gia dinh dupe dua vdo md hinh phdn tfch
gdm cd mffc sd'ng vd sd'ng ciing con. Xde sudt nhdm NCT ed mffc sdng
kha cd kha nang nhdn bifi't tdt eao gdp gdn 4 Idn so vdi nhdm cd mffc sd'ng
nghfio. Nhdm NCT cd mffc sd'ng trung binh cung cd xu hudng cd kha ndng
nhdn hifii td't hon vdi nhdm nghfio nhung tac ddng khdng rd rfit. Trong khi
dd. yfi'u td sdng hode khdng sd'ng cfing eon lai khdng cd tdc ddng ddn kha
ndng nhdn bifi't cua NCT,
Md hinh 2 dupe bd sung thfim nhdm yeu id "giao tifi'p ciia NCT" gdm
cac bifi'n sd: xem livi hode nghe dai. giao tifi'p vdi ban be/ hang xdm va di

du cae budi hpp d thdn/xdm. Trong sd' dd yfi'u td cd di du cac budi hpp cua
thdn/ xdm giup lam tdng kha ndng nhdn bifi't cua NCT.
Su xud't hifin ciia nhdm bifi'n sd "giao tidp eua NCT" khifin yfi'u td "hoat
ddng ehinh trong ndm qua" khdng cdn cd lac ddng tdi kha nang nhdn bifi't
eiia NCT Nhu vdy, ddi vdi NCT. giao tifi'p cd vai trd quan trpng hon eae
hoat ddng lao ddng/thi chdt trong vific giup cho NCT giffa dupe kha nang
nhdn bifi't td'l.
Ket qua d md hinh 2 cdn eho thd'y, yfi'u td nhdm ludi va mffc sd'ng vdn
cd lac ddng tdi kha ndng nhdn bifi't cua NCT. Cd thfi ndi, tudi tac thuc su cd
anh hudng tdi kha ndng nhdn bidt cua NCT, tudi cdng cao, kha ndng nhdn
bifi't cang ed xu hudng kim di.
Kfi't qua ciia md hinh ddy dii (md hinh 3) vl cae ydu id tdc ddng tdi
kha ndng nhan bifi't eua NCT cho thd'y, yfi'u id nhdm tudi. mffc sd'ng vd mffc
dd tham gia cdc budi hpp cua thdn/xdm Id eae yd'u id cd tdc ddng tdi kha
nang nhan bifi't td't. Kha ndng nhdn bidt cua nhung NCT d nhdm cd dd ludi
60-69, nhung ngudi ed mffc sd'ng kha vd nhiing ngudi tfch cue tham gia
vao cdc eude hpp ciia thdn/xdm td't hon so vdi nhffng NCT trong nhdm dd'i
chung. Vific dua thdm bidn sd "tffng bi tdn thuong bdi chie'n tranh" d md
hinh ddy dii hdu nhu khdng Idm lhay ddi mffc dp anh hudng cua cac bifi'n
sd d md hinh 2 tdi kha nang nhdn bidt cua NCT. Cd thi do chifi'n tranh da
liji xa mdt khoang thdi gian khd ddi, du dl hdn gdn su ton thuong vl iSm
ly, vd do vdy ft tac ddng den kha nang nhdn bidt eiia NCT.


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36

Nghidn cffu Gia dinh vk Gidi. QuyS'n 22, so 6, tr. 26-37

3. Mot so van de ddt ra
Kfii qua phdn tfch cho thd'y yfi'u td tudi tdc cd tac ddng manh den kha
ndng nhdn bifi't eua NCT. mac dff khdng phai ngffdi cao tudi nao cung cd
vd'n dl vl iri nhd. nhung d dd tudi edng cao, kha ndng nhdn bidt cua ho
edng gidm siit.
Sffc khde tinh thdn ciia NCT chiu su anh hudng ro rfit iff ydu id mffc
sd'ng. nhdm NCF cd mffc sdng kha hon thi cd xu hudng cd kha nang nhan
biet tdt hon. Theo Link. Dohrenwend vd Skodol (1986). sffc khde linh thdn
ciing nhu sffc khde thd chat diu Ii6n quan ddn giai ctfp xa hdi (irich lai
John J. Maeionis. 1987:325). Bdi diiu ki6n sdng td't hon dnni: nghia vdi
vice NCT ed kha ndng tidp cdn vdi cdc dieh vu chdm sde sffc khde tdt hon.

Ydu id sffe khde thi chd'l khdng ed tde ddng rd rfit ddn kha nang nhdn
bie't cua NCT. Vific thudng xuyfin tham du cac budi hpp thdn/xdm cd tac
ddng dfi'n kha ndng nhdn bidt td't hon d NCT. Trong khi dd. vide thudng
xuyfin xem livi hoSe nghe ddi hay giao tifi'p vdi ban bd/hdng xdm khdng
lam tdng kha nang nhan bifi't eua NCT.
Dang chii y la cdc yfi'u td linh trang hdn nhdn vh sd'ng cung con khdng
cd tac ddng manh dfi'n sffc khde tinh thdn cua NCT. Dieu nay khic vdi mdt
sd nhdn dinh iff nghifin effu trudc ddy khi cho rdng. tinh ff-ang hdn nhdn cd
vai trd rd't quan trpng dd'i vdi sue khde tinh thdn ciia NCT Su cd lap xa hdi
do cai ehe't ciia ngudi ban ddi khifin eho mdt sd NCI cam thd'y cdng thang.
cd ddc (John J. Maeionis, 1987:431). Nfiu \cm \et tff quan didm "Idy gia
dinh Idm trung tdm trong vific chdm sue ngudi cao ludi" trong cac van ban.
chfnh sach phap luai ve ngudi cao tudi U-c Ngoc Van. 2009:54). ihi kfi't
qua tff nghifin cffu nay gpi ra rdng khdng phai idt ca NCT sdng ciing con
chau se dupe cham sde td't vl mat sue khde linh thdn. ma ngupc lai cd thd
la mdi trudng thue ddy su cd ddc ciia NCT ndu hp khdng nhdn dupe sir
cam thdng. chia .se ciia con cai; ddng thdi nd ddt ra trach nhifim cham sde
NCT khdng chi rifing tff phi'a gia dinh md cdn Id ff-ach nhifim chung ciia
cdng ddng vd xa hdi.
Theo eac nhd tdm ly hpc. \ifie tffng chffng kidn cdc su kifin chdn ddng
irong eude ddi ed thi gdy ra nhung sang ehd'n tdm ly vd cac sang ehd'n nay
ed Ihl ldp di ldp lai nhilu ndm liln d mdi ngudi. Tuy nhifin. kfi't qua cua
nghifin cffu nay lai eho thd'y vific ttrng bi tdn thuong bdi chie'n ff-anh khdng
cd tac ddng dfi'n sffc khde tinh thdn eua NCT d Khanh Mau cd the do chifi'n
tranh d Vifii Nam da kfi't thffc vdi khoang thdi gian khd dai, du dl xda md
nhiing tdn thuong tam h . •


Lo Viet Phi/rfng

37

Tai lieu t h a m k h a o

Bp Van hoa. T h i thao va Du lich va cdc co quan. 2008. Ket qud dieu tra Gia
dinh \ iet Nam 2006, Ha Nfii.
Duy Nam. 2008. Site khde tinh thdn la tdt cd. hllp://danlri.com.vn/c7/s7214357/suc-khoe-Iinh-lhan-la-lal-ca.hlm.
Hoang Ba Thinh. 2008. Gido ti inh Xd hen hoc ve gidi. Nxb. Dai hoc Qudc gia Ha
Noi. Ha Noi
John J. Maeionis, 1987. Xa hfii hpc. Nxb. Thdng lie. Ha Noi.
Le Ngpc Van. 2009. Mot sd vdn de cO bdn trong chinh sach xd hoi ddi vdi ngUdi
cao tuoi. Dfi lai cSp B6. Ha Npi.
L 6 Viet Phuong, 2011. Sifc khde tinh thdn cua ngifcYi cao ludi d ndng thdn: Moi
sdye'n tdtdc dgng (Qua phdn lich sdlieu dieu tra thUc dia "Khdo sdt ve Sifc
khde vd Phitc hn ciia ngudi cao tudi d Viet Nam "). LuSn van cao hoc. Hgc
vifin Chmh tri - Hanh chinh qudc gia Ho Chi Minh. Ha Npi.
Ngo Van Luong. 2009. Tdc dgng cua thdm hoa den sifc khde tdm thdn vd cdc
bien phdp cham sde. liS trg Idm ly.
htlp://www. ykhoanet.com/yhocphothong/tamthan/tamthanll.htm.
Trung tam Nghifin cffu va Phat trien cong dong. 2011, Sifc khde tdm than.
WHO. 2003. InvesUng in the mental health. Geneva.