Development of Elderly Quality of Life Based on the Fourfold Cultivation at Primary Health Care in Na Noi District, Nan Province

Abstract

This research aimed to: 1. study the quality of life of the elderly at Sub-district Health Promoting Hospitals in Na Noi District, Nan Province; 2. examine the relationship between the Four Foundations of Mindfulness (Phavana 4) and the quality of life of the elderly at these health centers; and 3. propose a model for enhancing the quality of life of the elderly based on the Four Foundations of Mindfulness. This was a mixed-methods research. The quantitative component involved 258 elderly participants from Sathan and Santha sub-districts, selected using Taro Yamane's formula. A questionnaire with a reliability coefficient of 0.749 and an IOC (Index of Item-Objective Congruence) of 0.783 was used for data collection. Data were analyzed using frequency, percentage, mean, Pearson’s correlation coefficient, and significance testing. The qualitative component involved in-depth interviews with 10 key informants, including Sub-district Health Promoting Hospital administrators, local leaders (such as village headmen and sub-district chiefs), Buddhist practitioners, public administration officers, and community leaders. A structured interview guide was employed, and data were analyzed using descriptive content analysis.

The findings revealed that: 1) the overall quality of life of the elderly at Sub-district Health Promoting Hospitals in Na Noi District was at a high level ( = 3.72), and the application of the Four Foundations of Mindfulness to quality of life development was also at a high level ( = 3.92); 2) there was a statistically significant moderate positive correlation between the Four Foundations of Mindfulness and the quality of life of the elderly (R = 0.443**, p < 0.01); and 3) the proposed model for enhancing elderly quality of life based on the Four Foundations of Mindfulness involves a holistic approach—addressing physical, economic, social, and spiritual dimensions. The model promotes health literacy, encourages self-care, and fosters active participation of the elderly in community activities. It also aims to enhance mental resilience, enabling the elderly to adapt positively to physical changes and live with dignity as respected senior citizens in society.