Paper
Monday, November 5, 2007

441
This presentation is part of : Strategies for Disease Management
Caregiving in the Rural South: How Caregivers of Heart Failure Patients Make Decisions about their Personal Health
Julie T. Sanford, DNS, RN, College of Nursing, University of South Alabama, Mobile, AL, USA, Judith Townsend Rocchiccioli, PhD, RN, Department of Nursing, James Madison University, Harrisonburg, VA, USA, and Patricia Hall, PhD, CRNP, Cardiology, Diagnostic and Medical Clinic, Mobile, AL, USA.
Learning Objective #1: Identify 3 patterns of decision making experienced by rural caregivers of HF patients.
Learning Objective #2: Discuss the process that caregivers of HF patients use to make decisions about their personal health.
Rural caregivers face great challenges in caring for their family members. Rural communities offer fewer physicians, nurse practitioners, and hospitals from which to seek care.  Home care agencies are often smaller and provide fewer services than their urban equivalents often impacting the adequacy of care.  Economic barriers prevent rural residents from receiving adequate healthcare.  Rural residents have relatively high rates of chronic disease and are less likely to have health insurance coverage (United States Department of Agriculture Economic Research Service, 2006). 

The relationship between caregiver burden, stress, and diminished physical health outcomes has been supported by findings in the literature.  To date, there are few studies that examine how caregivers of patients with HF make decisions about their personal health.  This gap is significant based on the projected numbers of elders and the cost and incidence of HF.  Heart failure is increasing in prevalence in the United States (Peacock, 2006).  Five million Americans have the disease with more than 500,000 new patients diagnosed each year (Peacock, 2006).  In the South, cardiovascular disease is the leading cause of death (CDC, 2005).  The purpose of this study was to describe decision-making by caregivers of patients with HF regarding their personal health.  IRB approval was obtained.  Purposive sampling was used to select 20 rural caregivers of patients with HF (5 from each stage of HF classification) (Hunt et al., 2005).  Caregivers were interviewed either individually or in focus groups of up to five participants, depending on their preference and availability.  Data were analyzed using grounded theory and revealed a process of decision making and patterns of decision-making regarding the caregiver’s health.  To assist caregivers in making decisions about their personal health, nurses must understand how such decisions are made.

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