What resources do elderly people choose for managing their symptoms? Clarification of rural older people’s choices of help-seeking behaviors in Japan

Abstract

Background Appropriate help-seeking behavior (HSB) that involves lay and professional care may moderate the usage of medical resources and promote good health, especially among the rural elderly. However, there is little evidence regarding the rural elderly’s HSB choices for mild symptoms. Therefore, this study attempts to bridge this gap. Methods The participants were patients living in rural areas and over the age of 65, who attended Japanese clinics and general hospitals. In Phase 1, monthly diaries and one-on-one interviews about their mild symptoms and HSB were used to establish checklist items and assess content validity. Content analysis helped determine the items. In Phase 2, participants were asked to complete the checklist to measure HSB. The checklist answers and HSB mentioned in the diaries were compared to evaluate construct validity. Retests were conducted to examine the content’s reliability and test-retest reliability. Results Phase 1 included 267 participants (average age = 75.1 years, standard deviation [SD] = 4.3; 50.1% male). The diary collection rate was 97.6%. Of the participants, 70.4% used lay care and 25.4% used professional care. Content analysis identified eight types of lay care and four types of professional care. Phase 2 included 315 participants (average age = 77.7 years, SD = 8.27; 46.0% male). In terms of validity, the results of the checklists and the diaries were correlated (Spearman p 0.704; p < 0.001). The most common behavior with mild symptoms was consulting with primary care physicians, followed by self-care and using home medicine. The test-retest reliability for mild symptoms found kappa values of 0.836 for lay care and 0.808 for professional care. Conclusions The list of rural older people’s choices of HSB for mild symptoms had high validity and reliability. Therefore, it can be used to assess the relationships between HSB and health conditions and the effectiveness of health promotion on HSB among rural elderly people.

Potential Help-Seeking Behaviors Associated with Better Self-Rated Health among Rural Older Patients: A Cross-Sectional Study

“…The choice of lay care included doing nothing, self-care (enduring it, sleeping, resting, or taking a bath), seeking information, consulting family and friends, consulting community members, using complementary medicine, using home medicine, and buying over-thecounter drugs. The choice of professional care included consulting pharmacists, consulting primary care physicians, visiting medical institutions (other than primary care physicians), and visiting the emergency rooms of general hospitals (including calling an ambulance) [21]. The following background information was included: age, sex, work conditions, exercise habits, eating habits, sleeping habits, smoking, habitual alcohol drinking, educational levels, living conditions, SRH [22], social support [23], and social capital (regarding whether they could completely rely on neighbors in communities, using a 10-point Likert scale) [24], socioeconomic status (SES), and the 14-item Health Literacy Scale for Japanese Adults (HLS-14) [25].…”

Rural Easy Japanese as a Method of Mitigating Language Barriers Among Foreigners Seeking Medical Care in Rural Japan

“…In addition, they should share these problems in interprofessional collaboration to improve the future of rural medicine and the rural community [17,18]. Each rural community has a different background regarding issues with foreigners and health-seeking behaviors [19,20]. Hence, the methods in Easy Japanese should be further reviewed based on the challenges faced by foreigners and indigenous people in rural contexts, with rural primary care professionals and family physicians playing a leading role in facilitating communication.…”

Severe Immune Thrombocytopenic Purpura Following Influenza Vaccination: A Case Report

“…This situation may need improvement of the primary care system regarding education and prevention of diseases among older patients. Rural older people tend to endure their symptoms because of the lack of help, causing the delay of diagnosis [17][18][19]. On the other hand, primary care is respected by them and used for various symptoms [19].…”

“…Rural older people tend to endure their symptoms because of the lack of help, causing the delay of diagnosis [17][18][19]. On the other hand, primary care is respected by them and used for various symptoms [19]. The role of primary care physicians can be vital for vaccination and follow-up of their symptoms.…”