The complex health, socioeconomic, and environmental problems experienced by many American elders often place them at high risk for disease and disability. Over time, acutely or chronically ill older persons experience numerous transitions across various health care settings. Although availability of health services is improving in rural areas, barriers such as distance, geography, and poor distribution often limit access to health care. In a longitudinal rural ethnography, the health care transition experiences of older adults, families, and health care providers were examined. A major ethnographic theme emerged from analysis data from interviews, participant observations, and photographs: the crisis nature of health care transitions experienced by rural older adults and their families and observed by rural nurses and other health care providers. Several patterns were observed including the crisis was compounded by surprise; limited knowledge of local resources exacerbated the crisis; inconsistent discharge planning disrupted transitions; changing family support necessitated admission to nursing homes; continuity of care in nursing home discharge lessened transition crisis; and rural home health care was identified as a strength. Recommendations were made for community-based interventions to improve the transition experience. Comprehensive care management services provided by public health nurses (PHNs) in the local rural community were recommended.
Health and spiritual phenomena are viewed differently depending on the cultural perspective. This study describes spirituality as perceived and experienced by older Thai persons. Specific aims were to describe how spirituality helped older Thai persons maintain their health and to describe what they valued most as they aged. A qualitative, descriptive study informed by ethnographic methods was utilized. The sample included 9 older Thai persons from an urban U.S. community. Data were generated using ethnographic interviews and participant observation. Data analysis incorporated coding, categorizing, and theme development. Rigor was guided by Lincoln and Guba. Five major themes emerged from the data: Connecting with spiritual resources provided comfort and peace, finding harmony through a healthy mind and body, living a valuable life, valuing tranquil relationships with family and friends, and experiencing meaning and confidence in death. For these Thai participants, health and spirituality coexisted and were linked to all of life.
The use of photography is described as a method embedded within an ethnographic investigation of rural home care for older adults. Photography fostered data generation, elicited participants' stories, and illustrated patterns of rural aging. Analysis of photographic data pooled with interview and observational data facilitated an in-depth understanding of rural aging and home health care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.