Health-Disease-Care Process in Older Adults Living in Rural Areas: Perspective of Culturally Coherent Care

Abstract

Objective: to understand the health-disease-care process of the older adult living in rural areas. Method: a qualitative research study from the perspective of Madeleine Leininger's Theory of Diversity and Universality of Cultural Care, carried out with the participation of 19 older adults living in the rural area of a municipality in southern Brazil. Data collection took place in July and August 2018 by means of semi-structured interviews and simple observation. And data analysis was performed following Laurence Bardin's Content Analysis proposal. Results: the conceptions of health and disease of the older adult living in rural areas are mainly related to the ability and inability to perform the activities of daily living and work, especially with the land and animals. We highlight the care practices of older adults living in rural areas with regard to the use of medications, food consumption and the practice of physical exercise. In addition, the notion about their health condition and the capacity for self-management and adaptation to the challenges of the health-disease-care process. Conclusion: the health-disease-care process of older adults living in rural areas is influenced by social and cultural factors of the context in which they are inserted. This suggests the planning, implementation, development, evaluation and (re)formulation of health policies, programs and actions focused on providing culturally congruent care, which encompasses more than the singularities of the rural area, in the sense of dichotomy in relation to the urban area.

Identification of the needs and priorities of older people and stakeholders in rural and urban areas of Santo Andre, Brazil

“…Perhaps in recognition of the fact that services and structrues may be available, but not easily accessible, the rural stakeholder group ranked structures for accessibility as being an area of importance. These findings are consistent with a recent study that sought to understand the view of the health-disease-care process presented by older adults 60 years or older, in a rural area of Southern Brazil and which highlighted the need to reorganize health services to achieve a culturally congruent health care model [ 6 ]. An earlier study, also of rural area older adults, highlighted the discrepant views of people who lived in rural areas and those of the stakeholders participating in that research [ 23 ].…”

“…Knowledge of the experiences and perceptions of older people and those who care for them, with respect to the priorities, resources, facilitators and barriers for the promotion of healthy ageing, is lacking. Existing, albeit limited data from South America (Brazil and Ecuador), are consistent with the fact that the needs and priorities of older adults may differ according to geographical location [6,7]. With respect to studies directly comparing older adults living in urban and rural locations, only two previous studies have been identified.…”

Professional Narratives about Older Adults and Health Services Responsive to Fall-Inducing Frailty

“…The demographic change has many demands but mainly requires an understanding of the aging process [36]. Besides the prevalent diseases in older adults, facts intrinsic to the illness inflict molecular and cellular damage associated with the gradual loss of physiological reserves and the natural decline in the general capacities of this population to defend themselves against external agents, increasing the risks for all types and causes of accidents, including falls from standing height (FSHs) [27,[37][38][39][40].…”

Older Adults and Fall-Inducing Frailty: Bourdieu’s Analysis of Field Narratives

“…The demographic change mobilizes many demands but mainly requires understanding the aging process [4]. Besides the prevalent diseases in older adults, facts intrinsic to the illness inflict molecular and cellular damage associated with the gradual loss of physiological reserves and the natural decline in the general capacities of these people to defend themselves against external agents, increasing the risks for all types and causes of accidents, including Fall from Standing Height (FSH) [5,6].…”