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Rural Work Ethic Curbs Elderly Heart Care

Research study at University of Alberta ,shows a strong work ethic and sense of place appear to influence how elderly rural Albertans with congestive heart failure manage their illness , in that these values may delay them from seeking help at critical times.

Elders in our study tend to view their work as a lifelong endeavour, and there is an ethic of stoicism with an attitude of I can wait it out or not go to the hospital, said Alex Clark, lead researcher on the study and a professor in the Faculty of Nursing at the University of Alberta in Edmonton, Canada.

The ongoing study is supported by the Alberta Centre on Aging. Research assistant Nicole Freydberg interviewed 30 patients 65 to 85 years old (70 per cent of them male), 24 unpaid caregivers including spouses and other family members, and 22 health professionals in rural communities in Alberta. Focus groups were also conducted with home care nurses in the health region.

During the interviews, patients were encouraged to retrace their illness experience, explore what their heart conditions meant to them, and identify both barriers and facilitators to managing chronic illness in a rural setting.

During this process, more than half of the patients recalled times when they had waited days for heart-related symptoms to subside, or gotten used to the discomfort and delayed seeking medical care until symptoms were severe.

During our discussions, rural elders expressed a pride in their ability to avoid care-seeking for seemingly minor ailments, Freydberg said. Many did not want to burden what they viewed as an already stressed health care system. However, many of their symptoms became difficult to control successfully at home.

Because the patients often associated the causes of their heart conditions with a lifetime of hard labour and stressful work conditionsusually farm and manual labour--they felt they had little control over the progres
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