Situations of Non-Communicable Diseases among Adults and Older Adults Living in Urban Community, Bangkok, Thailand

Abstract

Introduction Non-communicable diseases (NCDs) are increasing as a health concern in urban Bangkok communities. The Princess Agrarajakumari College of Nursing at Chulabhorn Royal Academy is dedicated to serving communities experiencing diverse socio-economic challenges associated with NCDs. It is therefore crucial to study the situation of non-communicable diseases in the community in order to develop proactive care plans. 

Objective To describe the situations of NCDs in the communities, including health problems, the impact of NCDs, and health practices to control and prevent the severity of NCDs in adults and older people living in communities of a district in the Bangkok metropolitan. 

Design A descriptive study using the framework of non-communicable disease surveillance and control concepts of the World Health Organization, the Ministry of Public Health, and literature review. 

Methodology The sample consisted of 1,360 adults and older adults with NCDs registered at a public health center in the study area of Bangkok. They were selected through simple random sampling from the list of adult and older people with NCDs registered from 68 communities, with 20 participants from each community who met the inclusion criteria. Data were collected using questionnaires on health problems, the impact of NCDs, and health practices to control and prevent the severity of NCDs. The questionnaires were developed by the researchers and assessed for content validity, revealing a content validity index of .90. The reliability of the questionnaire on the impact of NCDs was assessed using Cronbach’s alpha, resulting in a coefficient of .90, while the questionnaire on health practices to control and prevent the severity of NCDs yielded a Cronbach’s alpha coefficient of .91. Data were analyzed using descriptive statistics, including percentage, mean, standard deviation, median, minimum, and maximum values. 

Results Most of the sample were female (62.50%), with ages ranging from 20 to 95 years, and a mean age of 57.80 years (SD = 14.6). The majority of the sample utilized universal health coverage (87.36%), while over half had a monthly income below 1,000 baht (56.47%) and were overweight (67.96%). The top three prevalent NCDs were hypertension (61.76%), dyslipidemia (46.18%), and diabetes (30.74%). Most of them had two or more chronic diseases, with complications such as heart disease, stroke, and chronic kidney disease. More than 40% of the sample experienced moderate to severe impacts on daily activity disturbance due to their conditions, including knee pain, back pain or shoulder pain, headache, insomnia, fatigue, distracted, irritable mood, anxiety, fear of burdening family, despair, bored, reduced daily activities, and decreased income. Additionally, there were challenges in health practices to control and prevent severity of NCDs including lack of exercise, poor dietary control, insufficient sleep, alcohol consumption, and smoking. Concerning medication adherence, nearly half of the sample (47.46%) did not regularly visit healthcare professionals but self-medicated, while 29.7% shared medications with neighbors experiencing similar symptoms. 

Recommendations The findings of this study provide an initial recommendation for developing health behavioral modification programs for those with NCDs in the community focusing on dietary consumption, physical activity, and medication adherence. This includes improving health service systems to ensure continuous access to healthcare services for this population.