Health Care Choices
Table of Contents
This project is applied research which seeks to discover the use of, cost of, and satisfaction with complementary therapy by older adults in rural communities.
Interest in the use of complementary therapies, those neither taught widely in medical schools or generally available in hospitals, has increased greatly over the past decade. In 1990, out-of-pocket spending by the U. S. population for complementary therapy exceeded that for hospitalizations. Since that time, complementary therapy has achieved greater acceptance within the health care community and is included in some health care plans. This trend has far-reaching implications for health care professionals because complementary therapy can be effective alone in combination with traditional care, or even contraindicated. Also, use of complementary therapy is not reported to traditional health care professionals by the individual 72% of the time.
Research thus far has not explored the use of complementary therapy in specific populations; therefore, this three-year study targeted the use of complementary therapy by older (60+) rural dwellers. It is possible that the use of complementary therapy by this population may be even higher than that of the general population because elder rural dwellers have been shown to be more independent and to engage in more self-care than their urban counterparts; also they have less access to traditional health care.
Because complementary therapy is often self-care in nature and is generally provided by non-traditional providers, it is important to explore the question, "What impact does complementary therapy have on the health of older people living in rural areas?" The Aday & Andersen model of health care utilization is used as an organizing framework for this cross-sectional survey of older people living in the rural areas. Data were collected through telephone interviews on selected characteristics of the respondents, their health care practices, and utilization of and satisfaction with traditional and complementary health services. The sample consisted of 325 rural older people randomly selected from rural counties in North Dakota and Montana using a nested sampling design. Subject recruitment was enhanced by targeting information about the study to the selected communities. Descriptive and inferential statistical methods, including graphical techniques and estimation and testing procedures, were used to describe and quantify the use, cost, and satisfaction. Exploratory data analysis techniques including logistic regression and correlation analysis are being used to investigate potential relationships between levels of use and other explanatory variables.
Dissemination of findings will extend well beyond the duration of the project. Of primary consideration is the dissemination of information that will contribute to the education of advanced practice nurses and other health care providers. This will lead to improved client care through increased communication about all of their health care practices--traditional, complementary, and purely self-help.