Accessing rural health services: Results from a qualitative narrative gerontological study

Abstract

Objective Explore how older adults’ talk about accessing rural community health services. Methods A qualitative narrative gerontological approach explored issues related to accessing health services in their community. Semi‐structured digitally recorded individual interviews were undertaken with 32 community‐dwelling older people aged between 75 and 93 years. A narrative data analytic process was undertaken. The COnsolidated criteria for REporting Qualitative research guidelines were followed to ensure rigour in this study. Results Three collective narratives resulted from the data analytic process: (a) “accessing local health services”; (b) “accessing specialist services”; and (c) “accessing emergency services.” Conclusions Narrators identified a number of issues related to accessing rural health services. These included long waiting times, lack of continuity in care provision by doctors and difficulties accessing specialist and emergency services. Nurses were frequently cited as a reliable point of contact for these older people. Expansion of nursing roles would enhance the provision of rural health‐care services.

Age‐friendly interventions in rural and remote areas: A scoping review

“…54 Older people in rural communities face changing and challenging environments, which require a whole-ofsociety approach to ensure that policies and environments address their needs. 7 Despite the original intention of the Age-friendly Cities framework, some characteristics and strategies that promote an age-friendly city, such as stakeholder collaboration, government commitment, effective governance, and the involvement of older people in addressing social and physical environmental challenges, are also pertinent to rural and remote environments. 55,56 However, they may require additional considerations for rural and remote contexts.…”

“…6 There is also an increased focus on active ageing in the context of communities where older people live, since their experiences of ageing are dependent on the services and support structures that are available and accessible to them. 7 In urban areas, the concept of agefriendly cities was pioneered in consultation with the World Health Organization (WHO) and stakeholders from various countries. 8 Age-friendly cities are characterised by eight domains that promote active ageing: transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; community support and health services; and outdoor spaces and buildings.…”

Atenção primária à saúde em áreas rurais: acesso, organização e força de trabalho em saúde em revisão integrativa de literatura

“…Na Tabela 2 apresenta-se os temas dos artigos classificados nas categorias acesso (23), organização da atenção à saúde (25) e força de trabalho em saúde (21). Cada artigo foi classificado em apenas uma categoria.…”

“…Sobressaiu o fato de a população rural contornar o serviço local ou viajar além do necessário para buscar cuidados em saúde. Por vezes, mesmo com disponibilidade de serviços mais próximos, observou-se que usuários deixavam de utilizar serviços locais e preferiam buscar os de centros maiores, situação referida pelos autores como bypass dos serviços locais 19,20,21,22,23,24 .…”

“…Não obstante, observaram-se barreiras mais intensas para populações rurais específicas de maior vulnerabilidade. Estudos envolvendo idosos 21,22 , pobres ou pessoas com deficiência 23 apontaram desafios adicionais de acesso aos serviços de saúde, transportes e custos para usuários e acompanhantes. Também foram citadas iniquidades no acesso relacionadas ao gênero feminino e a comportamentos de risco em adolescentes 24,25,26,27,28 .…”