Elderly holistic health management model According to the principle of threefold in Thai society

The purposes of this research article were 1) to study the state of holistic well-being management, 2) to develop a holistic well-being management model, and 3) to propose a model of holistic well-being management of the elderly according to the threefold training in Thai society. Mixed methods research was designed. Quantitative data were collected from 500 monks and the elderly, and were analyzed by descriptive statistics consisted of percentage, mean, standard deviation including Pearson correlation analysis and model analysis with computer package programs. Qualitative data were collected by interview 10 key informants and focus group discussion with 10 experts. Results indicated that the state of holistic well-being management of the elderly in all 4 aspects was at a high level. All the variables were shown the correlation with statistically significant at the .001 level, and the correlation coefficients ranged from .664 to .839. The correlation matrix between factors was significantly different from the identity matrix. Holistic health management model was developed which consisted of 4 parts: Part


Introduction
Elderly trends during the last 25 years of the 20th century, the elderly population in Thailand grew by 3.7 percent annually, the highest rate in East and Southeast Asia [1]. In 2000, Thailand had 9.6 percent of the elderly population, which is the largest in Southeast Asia. This proportion rose to 11.5 percent in 2010, compared with the United Nations designation. Considered that Thailand has entered the aging society initially. It is estimated that the proportion of the elderly will increase to 19.1 percent in 2025 and 26.4 percent in 2050. This increase in the aging population is faster than it was in many western countries times [2]. The Ministry of Social Development, Human Security, states that advancing to an aging society is a problem in which the government has to formulate strategies for planning to support it because while the number of older people increases. The number of children and laborers will be reduced. The proportion of the labor force (aged 15-59) in the total population will drop from 67.6 percent in 2010 to 65.9 percent and 61.4 percent in 2020 and 2030, respectively. The proportion of elderly people (age 60 years and over) will increase from 11.9 percent to 17.5 percent and 25.1 percent over the same period. As a result, workers will have to bear the burden of taking care of the elderly more . 6 In 2007, 6 workers have burden to care for the elderly, but it is expected that in the year 2027, 3 workers will have to take care of the elderly .1 elderly. In addition, demographic change is a pressure to make the Thai elderly a major risk group. In addition to the health risks that create limitations in our daily life, Thai elderly also have economic risk, because there is no income guarantee and have insufficient income to live and has a high proportion that fall under the poverty lime in the future, caring for the elderly by grandchildren is part of Thai culture [3]. While the population structure of Thailand has changed dramatically, evolution of medical and public health technology causing the Thai people to live longer, the number of elderly population increasing childhood and labor population declining during the 11th National Economic and Social Development Plan (2012-2016) from the proportion of child population: labor: elderly 20.5%: 67.6: 11.9% in 2010 to 18.3%: 66.9: 14.8% in the year. The index results in planning to develop the country to accommodate the growing elderly in the future [4]. Health (promoting good health) and setting indicators for 5 years (2013-2017) to it is a guideline to drive effective implementation at the local level and achieve the next goal [5]. Phra Promkhunaporn (P.A.Payutto) [6] explains that "wellbeing" or "health" is the same word in Pali, but the Thai language praises "W" as "Ph" as "health" when the meaning of health is physical, mental, social and intellectual health, so it means near happiness. The state of being unhappy is a perfect state. The modern term is called "Holistic", Buddhist happiness or Buddhist health consisting of transcendence (Brightness) Wimutti (liberation) Wisutti (purity, not frustrated, gloomy) Peace (not anxious, anxious), which is a condition that is the goodness of life. [7] Mentioning the well-being of the holistic life that can be enjoyed must manage the mind to have a positive mental state True health must follow the truth of the nature of life. What is the body of a healthy life? How do body and mind relate to the environment? To be successful, you must develop your mind and intelligence. Intelligence is a key element in the way we relate to the environment and the state of mind with wisdom to illuminate the pathway to guide the principles of human development of Buddhism, holistic development is therefore directly about well-being which is consistent with the threefold principle in terms of human development in the book of Buddhism that "If speaking in the language of modern scholars or according to the principles of education in the Eastern line, Athisilasikkha, Athichittasikkha and Athipanyasikka covers the realization of social development, emotional development, and intellectual development, respectively. It is, but will differ in scope of meaning and Sikkha 3 has a specific purpose in line with Buddhism. A person must be trained to discipline (including responsibility and good social relationships) to grow emotionally. (The monk said that the mind is strong, refined, has good quality and competence) and the cognitive growth (beginning with a rationale) Sikkha 3 together and complement each other threefold is a training system from outside to find inside from the rough, go to the fine parts. And from the simpler parts to the harder and deeper parts. When practicing in the inner detail, the mental and intellectual stages. As a result, it returns to help living outside, such as having a stable and honest behavior, selfdiscipline, not having to reluctance or concentrate on controlling, maintaining, thinking, solving problems and doing various activities with pure wisdom by implication, when practicing throughout the system of science and then the whole life system became the system of Makkah, they're all consistent inside and out. " [8] The development of training for the elderly is another way to prepare for the structural changes of the population to enter the aging society. It is an issue that is gaining great attention, both nationally and globally, due to its widespread impact at the macro level: impact on gross domestic product (GDP), per capita income, savings, investments, government budget, employment, labor productivity, and micro levels, including their impact on various markets, products and services, especially in the financial and health aspects; it is urgent that systematic planning is needed and take action in advance as measures in many respects, they take time to implement. Before seeing tangible results [9].
From the background and importance of the problem Therefore, the researcher is interested in studying the holistic health management model of the elderly according to the three-Sikkha principle in Thai society as a guideline for promoting. Developing the overall well-being of the elderly through the three-fold principle for better quality Able to carry on with their daily life.

Research Objectives
The purposes of this research article were 1) to study the state of holistic well-being management, 2) to develop a holistic well-being management model, and 3) to propose a model of holistic well-being management of the elderly according to the threefold training in Thai society.

Research Methods
Step 1: To study the overall well-being of the elderly in Thai society, there are 3 steps: 1) Study documents on the study of the overall health management of the elderly in Thai society. Research textbook website Results: Information on the overall health management status of the elderly in Thai society 2) Study of the holistic health management of the elderly according to the Tri-sikkha principles in Thai society distribute questionnaires on the overall health management status of the elderly in Thai society from monks and elders in temples of Thailand using a 1: 20 parameter based on the concept of Hair, 500 samples were obtained. Distribution coefficient (C.V.), skewness and kurtosis with a program, interviewed 10 Key informants on the overall health management of the monks and the elderly in Thai society. The second step is to develop a model of the holistic wellbeing of the elderly according to the Tri-Sikkha principles in Thai society, there are 2 steps: Developed by discussing resource groups: qualified persons / scholars / seniors by purposive sampling, specifying criteria for the selection of 10 key informants. The third step is to propose a model of holistic health management for the elderly according to the Tri-Sikkha principles in Thai society from objective item 2, the results of the examination of the holistic health management model for the elderly according to the Tri-Sikkha principles in Thai society. The holistic health management model was analyzed the elderly according to the Tri-Sikkha principles in Thai society to examine the consistency of the holistic health management model of the elderly according to the three-sided principle of the Thai society with empirical data. Analysis of confirmation elements (Confirmatory Factor Analysis: CFA) to examine the consistency of the holistic health management model of the elderly according to the Tri-Sikhism principles in Thai society with empirical data by using computer program. Results were obtained from data analysis to examine the consistency of the elderly holistic health management model according to the Tri-Sikkha principles in Thai society. Improve and present the model of holistic well-being management of the elderly according to the Tri-Sikkha principles in Thai society. ISSN: 00333077 3813 www.psychologyandeducation.net

Research Results
1. Results of the study of the overall health management status of the elderly in Thai society. The research results were found that the monks over the age of 60 and the elderly had opinions on the overall health management of the elderly in Thai society in all four areas. Considering each side found that all aspects were at a high level in descending order is physical well-being (3.88), social well-being (3.78), cognitive / spiritual well-being (3.66) and mental well-being (3.62), respectively, as shown in Table 1. The results of the preliminary statistical analysis of the state of the holistic health management of the elderly in all four aspects of Thai society were found to be at the high level of all considering the skewness of the overall health management status of the elderly in Thai society. Most of them had a negative skewness value show that the monks aged 60 years and over and most of the elderly had opinion that was above average and the distribution of the data is similar to the normal curve and considering the value, it was found that the overall health management condition of most of the elderly in Thai society was negative, indicating that the distribution characteristics of the data were less than the normal curve. The information is not distributed much and when considering the distribution coefficient (C.V.), it was found that the data were similar. There is little distribution of information as in Table 2 as follows. Table 2 The overall health management status of the elderly in Thai society using descriptive statistics.
The correlation analysis results of the overall health management status of the elderly in Thai society were all statistically significant at the level of .001. The relationships between the elements were significantly different from the identity matrix and the overall health management status of the elderly in Thai society is sufficiently related able to analyze the model of the holistic health management of the elderly according to the three-sided principles in Thai society as shown in Table 3: Table 3 Mean, Standard Deviation and Pearson Correlation Coefficient The overall health management of the elderly in Thai society.
The results of interviews with the monks and the elderly in Thai society, 10 key informants, with specific qualifications were those who played a role in promoting the holistic wellbeing of the elderly or people over 60 years of age with complete physical health. There are four aspects of the overall health management of the elderly in Thai society: 1) physical well-being, 2) psychological well-being, 3) social well-being, 4) cognitive / spiritual health. The elderly should follow 5 states: food, vegetables, fish, food, should eat about 80% will improve our health, weather, mood, exercise and danger, not consuming things that are not beneficial to the body able to adapt to society and environment accept the truth about yourself. Understanding the differences between individuals take responsibility stay with family spend time with children, avoiding sympathizers. There is a rule by visiting relatives once a week, knowing and understanding separately. In the reason of good, evil is a good example for children, has a public mind, respectfulness, honoring the 5 precepts will be good for health by letting the elderly pray Samatha-concentrates on the activities of the community every week. 2) psychological well-being and develop the potential of the elderly "Security in life", 3) social well-being, knowledge book, self-care and develop the potential of the elderly "Social learning", 4) health, intellectual/spiritual, self care knowledge book and develop the potential of the elderly "have a job" 3) Management Process: Elderly care according to the rights of the elderly according to the United Nations on the care of the rights of the elderly. If it optimized for Thailand, the researcher opines that the government should set guidelines for the development of the elderly in various forms with the basic concept of today's elderly. Part 3 steps to apply it consists of 1) Structure is the mutual link between various elements. This will help make the elderly holistic health management model in accordance with the Tri-sikkha principles of Thai society to be effective. 2) Decision -making process or well assessed that as a way to achieve the objectives and the goal of the pattern which has the criteria for making decisions, which are fundamental factors that enable people in society to take care of managing the overall well-being of the elderly successfully implemented the holistic health management model of the elderly according to Tri-Sikkha principles of the Thai society for the benefit of checking how much the format functions as designed. These three principles are simply called precept (Sila), meditation (Samadhi), and total wisdom (Panna) called "Tri-Sikkha" depending on the context of Thai society, such as the physical condition of the elderly, psychological condition of the elderly, social conditions of the elderly, economic conditions of the elderly, and government policies. Part 4 conditions for success depends on the context of Thai society, such as the physical condition of the elderly, psychological condition of the elderly, social conditions of the elderly, economic conditions of the elderly, and government policies. 3. Propose a model of holistic well-being management of the elderly according to the threefold training in Thai society. A complete model of the holistic well-being of the elderly in Thai society consists of 4 parts: Part 1: The leading part is 1) environment, both internal and external environment must be favorable including the difference between the characteristics of the elderly. 2) Principle including the basic concept and conditions of use. Conditions for successful implementation of the pattern and precautions to prevent problems that may arise including viewing and the elderly in 4 ways: family care, institutional care, community care, caring in special situations. 3) Objectives: 8 objectives for caring for the elderly. Part 2: The model consists of 1) system including 1) elements of holistic well-being. There are 5 key components: 1) physical well-being, 2) psychological wellbeing, 3) social well-being, 4) cognitive/spiritual well-being and health conditions according to the Tri-Sikkha principles; development of "good health" abilities for the elderly; 2) psychological well-being and develop the potential of the elderly "security in life", 3) social well-being, knowledge book, self-care and develop the potential of the elderly "Social learning", 4) health, intellectual/spiritual, self care knowledge book and develop the potential of the elderly "have a job" 3) Management Process: elderly care according to the rights of the elderly according to the United Nations on the care of the rights of the elderly. If it is optimized for Thailand, the researcher opines that the government should set guidelines for the development of the elderly in various forms with the basic concept of today's elderly. Part 3 steps to apply it consists of 1) structure is the mutual link between various elements. This will help make the elderly holistic health management model in accordance with the Tri-sikkha principles of Thai society to be effective. 2) Decision Making process or well assessed that as a way to achieve the objectives and the goal of the pattern which has the criteria for making decisions, which are fundamental factors that enable people in society to take care of managing the overall well-being of the elderly successfully implemented the holistic health management model of the elderly according to the Tri-sikkha as in Fig.1.

Discussions
The researcher found the following important points to discuss the results of the elderly holistic health management model in the Thai society as follows: 1. The results of the study of the overall health management status of the elderly in Thai society found that the monks aged 60 years and older and the elderly had opinions on the overall health management of the elderly in Thai society.
Overall, there were opinions at a high level in all aspects and variables considering the skewness of the overall health management status of the elderly in Thai society. Most of them had a negative skewness value showed that the monks aged 60 years and over and most of the elderly had opinion that was above average, the distribution of the data is similar to the normal curve, considering the value, it was found that the overall health management condition of most of the elderly in Thai society was negative, indicating that the distribution characteristics of the data were less than the normal curve. The information is not distributed much, considering the distribution coefficient (C.V.), it was found that the data were similar that had little distribution of information. All of them were statistically significant at the 0.001 level. The correlation coefficient range was between .664 and .839. The correlation matrix characteristics between the elements were statistically significant different from the identity matrix and the overall health management status of the elderly in Thai society is sufficiently related able to analyze the model of the holistic health management of the elderly according to the Tri-Sikkha principles in Thai society, which is consistent with the results of interviews with the monks and the elderly in Thai society. The elderly should follow 5 states: food, vegetables, fish, food, should eat about 80% will improve our health, weather, mood, exercise and danger, not consuming things that are not beneficial to the body Able to adapt to society and environment accept the truth about yourself. Understanding the differences between individuals take responsibility stay with family spend time with children, avoiding sympathizers. There is a rule by visiting relatives once a week, knowing and understanding separately. In the reason of good, evil is a good example for children, has a public mind, respectfulness, honoring the 5 precepts will be good for health by letting the elderly pray Samatha-concentrates on the activities of the community every week. Elements of holistic well-being. There are 5 key components: 1) physical well-being, 2) psychological wellbeing, 3) social well-being, 4) cognitive/spiritual well-being and health conditions according to the Tri-Sikkha principles; development of "good health" abilities for the elderly; 2) psychological well-being and develop the potential of the elderly "Security in life", 3) social well-being, knowledge book, self-care and developing the potential of the elderly "Social learning", 4) health, intellectual/spiritual, self care knowledge book and develop the potential of the elderly "have a job", 3) Management Process: elderly care according to the rights of the elderly according to the United Nations on the care of the rights of the elderly. If it optimized for Thailand, the researcher opines that the government should set guidelines for the development of the elderly in various forms with the basic concept of today's elderly. Part 3 steps to apply it consists of 1) Structure is the mutual link between various elements. This will help make the elderly holistic health management model in accordance with the Tri-sikkha principles of Thai society to be effective.
2) Decision-making process or well assessed that as a way to achieve the objectives and the goal of the pattern has the criteria for making decisions, which are fundamental factors that enable people in society to take care of managing the overall well-being of the elderly Successfully implemented the holistic health management model of the elderly according to the three-sided principle of the Thai society for the benefit of checking how much the format functions as designed. These three principles are simply called precept (Sila), meditation (Samadhi), and total wisdom (Panna) called "Tri-Sikkha" depending on the context of Thai society, such as the physical condition of the elderly, psychological condition of the elderly, social conditions of the elderly, economic conditions of the elderly, and government policies. Conditions for successful implementation of the pattern and precautions to prevent problems that may arise including viewing and the elderly in 4 ways: family care, institutional care, community care, caring in special situations 3) Objectives: 8 objectives for caring for the elderly. Part 2: The model consists of 1) system, including 1) elements of holistic well-being. There are 5 key components: 1) physical well-being, 2) psychological wellbeing, 3) social well-being, 4) cognitive/spiritual well-being and health conditions according to the Tri-Sikkha principles; development of "good health" abilities for the elderly; 2) psychological well-being and develop the potential of the elderly "Security in life", 3) social well-being, knowledge book, self-care and develop the potential of the elderly "Social learning", 4) health, intellectual/spiritual, self care knowledge book and develop the potential of the elderly "have a job" 3) Management Process: Elderly care according to the rights of the elderly according to the United Nations on the care of the rights of the elderly. If It optimized for Thailand the researcher opines that the government should set guidelines for the development of the elderly in various forms with the basic concept of today's elderly. Part 3 steps to apply it consists of 1) Structure is the mutual link between various elements. This will help make the elderly holistic health management model in accordance with the three-sided principle of Thai society to be effective.
2) Decision Making process or well assessed that as a way to achieve the objectives and the goal of the pattern has the criteria for making decisions, which are fundamental factors that enable people in society to take care of managing the overall well-being of the elderly successfully implemented the holistic health management model of the elderly according to the three-sided principles of the Thai society for the benefit of checking how much the format functions as designed. These three principles are simply called precept(Sila), meditation (Samadhi), and total wisdom (Panna) called "Tri-Sikkha" depending on the context of Thai society, such as the physical condition of the elderly, psychological condition of the elderly, social conditions of the elderly, economic conditions of the elderly, and government policies. There are four sets of knowledge of self-care and development of the elderly in life security including 1) physical health, self-care knowledge book and developing the potential of "healthy" elderly, 2) psychological wellbeing and develop the potential of the elderly "Security in life", 3) social well-being, knowledge book, self-care and developing the potential of the elderly "Social learning" 4) health, intellectual / spiritual, self-care knowledge book and developing the potential of the elderly.  [12] In line with the research of Sri Muang Phangrit, studied the quality of life development of the elderly by themselves, their families and communities in Ayutthaya Province. It consists of 5 areas: physical, mental, environmental, social relations and satisfaction and found that all 16 independent variables were able to explain the variation in the quality of life of the elderly. The social, environmental, psychological, and satisfaction relationships were 33.8%, 17.9, 13.2, 9.7 and 9.3% respectively. The guidelines for developing the quality of life for the elderly required at the individual level consisted of preparation of knowledge and practice in health from adulthood. Children until old age financial preparation by saving money since working age to facilitate being an elderly person who can rely on themselves. At the family level, children should have gratitude, love, warmth providing support to the elderly for the community level elderly should be encouraged to play roles and participate in community activities build a strong community, motivate community, leaders, and people to think together to create activities according to the needs and in harmony with the way of life by relying on local wisdom and resources being a good example focus on being proactive In the development of knowledge and cooperation work to improve the quality of life of the elderly [13].

Conclusion
The development of the holistic well-being of the elderly according to the three-fold principle is physical well-being having a healthy body without disease, not starving, there are four factors that are sufficient for the convention, psychological well-being. To think for a systematic reason having a heart that is fresh, cheerful, radiant, peaceful, known to let go in various problems complete with mental health, having a strong mind, stability, social well-being, having relationships with family members, having a supportive relationship with the environment, having a good life, having the right to freedom that is protected able to adapt to change cognitive / spiritual well-being, training for intellectual development, enhancing knowledge, and thinking, having the knowledge and good idea, the job and the right, having good mental health. There is a sacrifice benevolence. There is religion as an anchor of the mind, integrated with three principles: 1) The precepts are the development of social relations, having a supportive relationship with the social environment, having good behavior in relation to fellow human beings with discipline. The elderly can adjust to live well with their family and society with precepts as a factor for good health, 2) Meditation is to develop the mind to be more prosperous, good, strong, happy, the elderly who have faith in Buddhism will develop compassion and follow meditation. This will help to have a more peaceful mind ready to develop intelligence, 3) Intelligence is the development of intelligence, training to develop wisdom to create knowledge, thinking, and understanding to think, consider and solve problems with intelligence. having a happy heart, without suffering, wisdom is the real solution to problems by virtue of a solution to life problems to live with the family, a peaceful and sustainable society.