2.50
Hdl Handle:
http://hdl.handle.net/10755/211509
Type:
Research Study
Title:
DEVELOPING A CARE MANAGEMENT PLAN FOR AGING IN PLACE IN RURAL COMMUNITIES
Abstract:
Purposes/Aims: Building on a previous qualitative study [1 R15 NR08217-01A2], the aims of the proposed study are to (1) define constructs and measurements for complementary quantitative analysis; (2) use combined evidence to identify and quantify disparities; and (3) establish and test a pilot program of services to ameliorate disparities for community-dwelling multicultural elders. The purpose of the proposal is to design and implement a program for improving access/acceptance of upstreamed discussion of advanced care planning in a population of elders facing potential compromise of function in the coming years. Rationale/Conceptual Basis/Background: Rural elders often face inadequate access to health care resources, marginal ability to navigate the complexities of the managed care system, food insecurity, and further barriers related to history, culture, language, health literacy, geographic isolation, weather, and traditional norms. Multicultural elders living near the US–Mexican border suffer disproportionate morbidity and mortality related to geography, economics, cultural marginalization, and social isolation. Despite these barriers and inequities, elders with function-compromising diagnoses face the same eventual need for advanced care planning as any other vulnerable geriatric population. The theoretical background for this project draws strongly from Community-Based Participatory Research (CBPR), particularly the sequence formulated by Stringer, of Looking, Thinking, and Acting. Methods: The overall research design for the study is a simple Concurrent Embedded Design, driven conceptually by quantitative elements, supported by an embedded qualitative component. This design is also referred to as a QUAN-qual project, reflecting the relative drive and prominence of both approaches. The mixed methods design involves a brief demographic questionnaire, quantitative and psychometric measurements, and ecological momentary assessment (EMA), along with critical ethnographic techniques, all in the context of community based participatory research (CBPR). Data analysis will include statistical and slope parameter calculations, EMA data summaries and frequencies, qualitative critical reflection, thematic analysis, and matrix analysis. Significance: There are few effective, efficient programs for late life care/symptom management and community-based palliative care in rural settings. The knowledge base for this increasingly important content area is evolving, and this innovative mixed methods project may be able to contribute favorably to its development, given the increase in older adults as part of our population. If successful, this project will lead to improved assessment and self-management, better outcomes for elders wishing to age in place at home in rural America, and lower care costs to the health care system.
Keywords:
Advanced care planning; Community dwelling multicultural elderly
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5334
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleDEVELOPING A CARE MANAGEMENT PLAN FOR AGING IN PLACE IN RURAL COMMUNITIESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211509-
dc.description.abstractPurposes/Aims: Building on a previous qualitative study [1 R15 NR08217-01A2], the aims of the proposed study are to (1) define constructs and measurements for complementary quantitative analysis; (2) use combined evidence to identify and quantify disparities; and (3) establish and test a pilot program of services to ameliorate disparities for community-dwelling multicultural elders. The purpose of the proposal is to design and implement a program for improving access/acceptance of upstreamed discussion of advanced care planning in a population of elders facing potential compromise of function in the coming years. Rationale/Conceptual Basis/Background: Rural elders often face inadequate access to health care resources, marginal ability to navigate the complexities of the managed care system, food insecurity, and further barriers related to history, culture, language, health literacy, geographic isolation, weather, and traditional norms. Multicultural elders living near the US–Mexican border suffer disproportionate morbidity and mortality related to geography, economics, cultural marginalization, and social isolation. Despite these barriers and inequities, elders with function-compromising diagnoses face the same eventual need for advanced care planning as any other vulnerable geriatric population. The theoretical background for this project draws strongly from Community-Based Participatory Research (CBPR), particularly the sequence formulated by Stringer, of Looking, Thinking, and Acting. Methods: The overall research design for the study is a simple Concurrent Embedded Design, driven conceptually by quantitative elements, supported by an embedded qualitative component. This design is also referred to as a QUAN-qual project, reflecting the relative drive and prominence of both approaches. The mixed methods design involves a brief demographic questionnaire, quantitative and psychometric measurements, and ecological momentary assessment (EMA), along with critical ethnographic techniques, all in the context of community based participatory research (CBPR). Data analysis will include statistical and slope parameter calculations, EMA data summaries and frequencies, qualitative critical reflection, thematic analysis, and matrix analysis. Significance: There are few effective, efficient programs for late life care/symptom management and community-based palliative care in rural settings. The knowledge base for this increasingly important content area is evolving, and this innovative mixed methods project may be able to contribute favorably to its development, given the increase in older adults as part of our population. If successful, this project will lead to improved assessment and self-management, better outcomes for elders wishing to age in place at home in rural America, and lower care costs to the health care system.en_GB
dc.subjectAdvanced care planningen_GB
dc.subjectCommunity dwelling multicultural elderlyen_GB
dc.date.available2012-02-20T11:59:18Z-
dc.date.issued2012-02-20T11:59:18Z-
dc.date.accessioned2012-02-20T11:59:18Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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