Objective-Explore use, cost, and satisfaction with the quality and effectiveness of complementary therapy among older rural adults.
Design-Descriptive survey.Sample-A random sample of 325 older adults from rural communities throughout Montana and North Dakota.
Measurements-Participants were interviewed by telephone.Results-Only 57 participants (17.5%) had used complementary providers and most sought this care for chronic problems, heard about providers through word-of-mouth information, and were satisfied with the care. A total of 35.7% (116) used self-directed complementary practices and most used these practices for health promotion, heard about them through informal sources, and found them to be at least somewhat helpful. Of the 325 participants, 45.2% (147) used some form of complementary care, e.g., providers, self-directed practices, or both. Participants used as much complementary care as is found in national studies. Most spent relatively little out-of-pocket for complementary care.Conclusions-Understanding the health care choices that older rural residents make, including complementary health care, is paramount for a comprehensive approach to meeting their health care needs.
Keywords alternative therapy; complementary therapy use; older adults; rural healthIn the past several decades, there has been extraordinary growth in the attention paid to complementary therapy, in both the popular and the research arenas. Complementary therapy has been defined as a group of diverse health care systems, practices, and products that are not presently considered an integral part of allopathic health care (National Center for Complementary and Alternative Medicine, 2004; http://nccam.nih.gov/health/whatiscam/). Examples include therapies provided by practitioners such as chiropractic, acupuncture, and
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript massage therapy, as well as self-directed practices such as nutritional and herbal supplements, meditation, and use of magnets.The fact that U.S. residents are using complementary therapy and that this use has grown over the past several decades is well documented in the literature (Astin, 1998;Eisenberg, Davis, Ettner, & Appel, 1998;McFarland, Bigelow, Zani, Newson, & Kapian, 2002;Paramore, 1997;Wolsko et al., 2000). Between 1990 and 1997, the use of complementary therapy in the United States increased by 25%, and 1997 expenditures grew to approximately $21.2 billion, with more than half of this amount out of pocket (Eisenberg et al., 1998). This exceeded the 1997 out-of-pocket spending on hospitalizations. Complementary therapy has become sufficiently mainstreamed for coverage by several health insurance plans ("Hospital plunges," 1996). Therapies that, in the past, were used as a last resort for chronic illnesses are now used as primary treatments (Paramore, 1997). These trends have far-reaching implications for community/public health nurses and other health care professionals who assist communitydwelling clients with the management o...
