Population, setting and sampling

The target population of this study was primary caregivers of people with

dementia in communities in the Hanoi area, Vietnam. The sample consisted of dyads

of persons with dementia and their primary family caregivers.

Family carers of people with dementia met the following criteria for inclusion,

which are similarly defined in Australia (Australian Bureau of Statistics, 2008) and

America (Fredman et al., 2012):

- Live in area of 10 inner districts of Hanoi during data collection;

- Identified as the current primary carer of a person with a medical

diagnosis of dementia;

- Care for at least the last three months;

- Able to speak and understand Vietnamese;

Exclusion criteria included caregivers who had a cognitive impairment, or an

intellectual disability. Children and young people (< 15 years) and people with

intellectual or mental impairment were not included in this survey because it was not

likely that group of people would have sufficient understanding to complete the

study.

A randomised sampling method was utilised to recruit participants. The list of

names with the contact addresses of the people with dementia and their carers was

retrieved from the National Institute of Gerontology, based on patient records from

2005 – May 2011. The contact addresses of those people registered from January 1,

2010 onwards were withdrawn from patients’ documents from the Vietnamese

National Institute of Gerontology, the specialized hospital for elderly health care, and

the only institution in the North of Vietnam providing such services. This is a public

hospital which has a 170 bed capacity for inpatients, and it has an out-patient

department that provides health check-ups and medical consultations in both

gerontological and general areas. With approximately 80 medical physicians, 12

pharmacists, 80 nurses and a small number of administrative staff, the Institute

provides treatment for most common aging health problems and diseases, such as

hypertension, diabetes, stroke, dementia, COPD, cancer, and renal failure. The

National Institute of Gerontology is the only health care facility in the North of

Vietnam that provides services for the diagnosis, treatment and follow-up for

dementia. This institute is located in Hanoi, the Capital of Vietnam. Dementia

treatment and services are provided for people from both rural and urban areas.

People from the countryside and rural areas have to travel to hospital to receive the

The sample size was calculated according to the formula provided by Lwanga

and Lemeshow (1991):

n: sample size

1- α: Confidence level

P: Anticipate population proportion

d: Absolute precision required

With α = 0.05, Z1-/2 = 1.96 and P of quality of life at 0.87, these statistics were

taken from the study conducted by Huong, Ha, Nhung, and Chi (2009), where

d=0.055 and n= 144. The absolute precision is defined as, “the closeness with which it can be expected to approximate the relevant population value” (Brown, 2007). Relevant to this study, with absolute required precision at 0.055, the estimate of

quality of life among the dementia caregivers population (generated from the

mentioned sample) might vary from 0.815 to 0.925. The theoretical sample size was

144 participants, with a type I error of 5%. To account for a possible attrition rate of

20%, to increase the external validity and to reduce the possibility of Type II errors,

an additional 28 participants were recruited for a total sample size of 172 people.

Although the list of names of participants was drawn from the National

Institute of Gerontology, all of the research settings in this study were community

based. The National Institute of Gerontology agreed to provide the list of names with

the contact addresses of people with dementia and their caregivers for the study. The

supporting letter from the Director of the Institute was obtained before data

collection commenced, because people with dementia in the North of Vietnam

mainly get their prescriptions and treatments as out–patients.

In Vietnam, dementia diagnosis has typically been made following the criteria

setting was nationally accepted and guided by Vu and Nguyen (2012) and covers 4

domains

- Assess the stage of memory loss by using MMSE, Neuropsychiatric

Inventory (NPI)

- Mental health assessment performed by the medical practician

- Blood tests include complete blood count, glucose fasting, electrolysis,

functional of thyroid (T3, T4, FT3, TSH) and syphilis screening with

TPHA

- Screening the brain with MRI

After receiving the diagnosis of dementia, people with dementia were

prescribed with medication to continue to live in their communities and homes. The

bulk of care for people for people with dementia was mainly the dementia sufferers’

family members and children. The study venue, Hanoi, was chosen because of the primary researcher’s understanding of the health system in that province. Hanoi is divided into 10 inner districts, 1 town and 18 outer districts. It is the Capital of

Vietnam and the country’s second largest city. Hanoi’s population in 2009 was

estimated at 2.6 million for urban districts and 6.5 million for the metropolitan

jurisdiction. The percentage of more than three generations of Hanoian households is

likely to be very small compared to the overall population of the city. The primary

data collection process for the survey was conducted within the participants’ homes

between October 2011 and January 2012.