Care in Rural Settings: A Genuine Approach to Nursing - Essay Example

? Care In Rural Settings: A Genuine Approach To Nursing of the of the Introduction Chronic illness has become one of themajor health problems of the United States (Pierce& Lutz, 2009, p.191). Sadly, the US is experiencing an increase in chronic diseases despite of the efforts to control it (Pierce& Lutz, 2009, p.191). Moreover, disparity suffered by people with disadvantageous social, financial and geographical conditions in accessing the health care services, worsens the overall health condition of the population. People living in rural areas face a lot of problem in managing chronic diseases as they find it difficult to get access to health care services. They also lack knowledge and training about the caring regimen needed for the family members suffering from chronic disease (Smith-Campbell, 2009, p.562). Hence, it is extremely important for health care professionals to design the services which are not only easily accessible to people living in rural areas but also help them in being capable of providing proper care to their family members suffering from chronic conditions. The Obstacles A study by ‘The Dartmouth Atlas Project’ (2006) has found that the chronic diseases like diabetes, heart disease and cancer have affected the health of more than 90 million people in the US (Pierce& Lutz, 2009, p.191). Shapiro (2002) has found that the chronic condition is prevalent in more than one third of young adults aged between 18 to 44 years (Pierce& Lutz, 2009, p.191). A study by AHRQ (2002) has revealed that more than 75% of elder population is suffering from either one or more chronic conditions (Pierce& Lutz, 2009, p.192). These studies show how serious is the issue of prevalence of chronic conditions in the US population. It is evident that chronic condition is not limited to a particular age group but is affecting people from every age group. Hence, health care by family members is going to play a vital role in controlling the increase of the chronic diseases in people. However, families from rural setting are facing many obstacles in getting the access to health care services. Inadequate Health insurance Inadequate health insurance has proved to be one of the major problems in accessing proper health care services. A study by Lottero et al. (2007) found that even after having a long term relationship with the health care providers, people from farming profession were denied health care as they were not financially capable of paying the bills for their treatment (Smith-Campbell, 2009, p.562). The major problem with the families seeking health care services for chronic conditions in rural areas is that they are either uninsured or underinsured (Smith-Campbell, 2009, p.562). Hence, they avoid the treatment for chronic conditions unless it is an emergency (Smith-Campbell, 2009, p.562). The lack of financial resources and sufficient insurance also make them to avoid getting health screening and preventive measures for chronic conditions (Smith-Campbell, 2009, p.562). Hence, instead of getting under control, the lack of proper resources is leading to growth in the prevalence of chronic conditions. Lack Of Facilities There are many obstacles that people living in rural area face in taking advantage of the medical facilities. They cannot utilize the medical facilities due to lack of follow up facilities required for different kind of chronic condition treatments. A qualitative research, conducted to study the obstacles in implementation of lifestyle and pharmacological changes to improve the chronic condition of ischemic heart disease, found that the use of ACE inhibitors was not possible in case of rural patients as it required follow-up blood tests (Putnam, Twohig, Burge, Jackson, & Cox, 2004, p. 401) Unfortunately, people living in the rural area, who suffer from hypertension and congestive heart diseases, cannot use ACE inhibitors as they cannot get an easy access to the blood test facility. Similarly, the facilities for physical exercise are also not accessible to the patients from rural areas as their areas are isolated (Putnam et al., 2004, p. 401). Hence, the chances of decreasing the risk of chronic diseases like hypertension and cardio-vascular conditions are very low for people living in rural areas. Unfortunately, the case for other chronic diseases is also same. The chronic disease like diabetes, which can cause other related mental and physical problems in the patient, is also not getting proper care and attention needed. The health centers in the rural areas are not equipped to provide care to the vulnerable people suffering from diabetes (Chin et al., 2001, p. 268). The federally funded clinics in the rural areas are incapable of handling the continuous treatment needed for diabetes patients as they do not have access to “integrated delivery system” (Chin et al., 2001, p. 269). Also, these clinics have fewer resources than the private clinics (Chin et al., 2001, p. 268). Moreover, the lack of strong financial and educational background makes patients living in rural areas incapable of accessing the facilities in high maintenance clinics. It was also found that patients living in rural areas were not aware of the risks related to the chronic conditions they were suffering from (Chin et al., 2001, p. 271). Hence, it is necessary on care giver’s part to educate them about the health risks involved in the disease. However, the lack of communication between the physician and the patients has created a major obstacle in the path of behavior and attitude change of the patients (Chin et al., 2001, p. 271). Hence, the only option that people living in rural areas have is to depend on self-care regimen and care from the family members. Surprisingly, different researches have found that care from family members and primary care givers in the rural settings plays more important role in helping the patients to cope with the chronic diseases than the medical facilities. Family Care People suffering from chronic conditions, who live in rural areas, prefer their setting despite of many disadvantages attached to it. This is because most of the population living in rural areas is elderly and they feel comfortable in being with people they know from long time, and they have positive relationship with primary care givers (Goodridge, Hutchinson, Wilson & Ross, 2010). A qualitative research conducted to study the conditions of people suffering from chronic respiratory illness, who live in the rural areas, revealed that the rural health care centers were not equipped with enough facility to take care of their conditions (Goodridge et al., 2010). Hence, patients in rural areas who are suffering from incurable and progressive respiratory diseases were at greater risk of mortality due to remote chances of getting access to the proper treatment at right time (Goodridge et al., 2010). However, it was found that the access to primary care providers helped people living in rural areas to manage and control the chronic illness like COPD quite adequately (Goodridge et al., 2010). Different studies have found that the close bond and the trust shared between the primary care givers and the residents of rural areas have helped people living in rural areas to maintain their health even when they lacked the medical resources needed for their chronic conditions. Hence, no reports of differences between rural and urban residents regarding “the use of physical services, hospitalization rates, unmet health care needs, or number of days to obtain appointments” have been found (Goodridge et al., 2010). The patients who participated in the research preferred the primary care providers like family physicians and nurses in rural areas as they felt that while caring, they treat them as a ‘person’ and not as a ‘patient’(Goodridge et al., 2010). This approach makes a lot of difference in their attitude and also helps the patient to develop trust in the care giver. Moreover, the support they get from their family, friends and business relations in coping with their illness plays a major role in their decision to live in their own setting (Goodridge et al., 2010). They know that the urban settings lack this kind of community support and hence, they prefer to stay in rural areas. From these findings, it can be said that what really matters in the management of chronic illness is the support the patients get from their family members and the primary care givers. The importance Of Genuine Approach Managing chronic disease mostly depends on the knowledge of handling the responsibilities related to it. According to Strauss et al.(1984), self management by people suffering from chronic illness depends on their education, support from primary care givers (like family, friends and health care providers) and ability to handle the uncertainties associated with the illness (Winters & Sullivan, 2010, P. 179). People born in the rural areas are brought up in a cultural setting where people in the community know each other, form close bonds with each other and care for each other. They have enough time to spend with other people and to provide help to others whenever needed. Even if the family identity and structure changes due to some reason or other, they still continue the job of ‘caring’ for the family by adopting different ways of caring (Meiers, Eggenberger, Krumwiede, Bliesmer, & Earle, 2010, p. 142). People living in the rural areas display care for their family members by monitoring their actions, keeping in touch with them, ensuring safety and listening patiently (Meiers et al., 2010, p.142). These things make the patients suffering from chronic illness feel safe and ‘cared for’. The families in rural settings create and maintain health by working together towards better health and relationships (Meiers et al., 2010, p.142). Also, people living in rural areas can cope easily with their chronic conditions as their primary care givers maintain good communication and positive relationships with them (Winters & Sullivan, 2010, P. 187). A research on women living in rural areas suffering from different chronic diseases revealed that trust, faith and the bonding with the primary care givers played an essential role in them coping and managing their chronic conditions (Winters & Sullivan, 2010, P. 187). Hence, from different qualitative researches discussed above, it is clear that ‘human’ touch and ‘genuine’ care plays more important role in managing the chronic conditions in rural settings than the advanced medical facilities available in urban settings. Conclusion The caring behavior and attitude displayed by primary care givers in rural areas encourage people to stay there despite of having inadequate medical resources to cope with their chronic diseases. With the help of genuine care by family members and primary care givers, they manage their chronic conditions very well. Hence, the genuine care practiced by primary care givers in rural areas should be adopted by all the primary care givers in the country. The genuine approach to care will not only ensure coping with the chronic condition but will also work as a preventive measure. References Chin, M.H. , Cook, S., Jin, L., Drum, M. L. , Harrison, J.F. , Koppert, J., ……Chiu, S. (2001). Barriers to Providing Diabetes Care in Community Health Centers. Diabetes Care,24 (2), 268-274. Goodridge, D., Hutchinson,S., Wilson,D. & Ross, C. (2010). Living in a rural area with advanced chronic respiratory illness: a qualitative study. Primary Care Respiratory Journal, 19. doi:10.4104/pcrj.2010.00062 Pierce, L.L. & Lutz, B.J. (2009). Family Caregiving. In P.D. Larsen & I.M.Lubkin (Eds.), Chronic Illness: Impact and Intervention (191-230) (7th ed.). Sudbury, MA: Jones & Bartlett Publishers. Putnam, W., Twohig, l., Burge, F.I., Jackson, L.A., & Cox, J.L. (2004). Evidence-based cardiovascular care: Family physicians’ views of obstacles and opportunities. Canadian Family Physician, 50,1397-1405. Meiers, S.J., Eggenberger, S.K., Krumwiede, N.K., Bliesmer, M.M. & Earle, P.A (2010). Rural Family Health: Enduring Acts Of Balancing. In. C.A. Winters & H.J.Lee (Eds.), Rural Nursing: Concepts, Theory, and Practice (179-192) (3rd ed.). New York, NY: Springer Publishing Company, LLC. Smith-Campbell, B. (2009). Family Caregiving. In P.D. Larsen & I.M.Lubkin (Eds.), Chronic Illness: Impact and Intervention (191-230) (7th ed.). Sudbury, MA: Jones & Bartlett Publishers. Winters, C.A. & Sullivan, T. (2010). The Chronic Illness Expereince of Isolated Rural Women: Use of an Online Support Group Intervention. In. C.A. Winters & H.J.Lee (Eds.), Rural Nursing: Concepts, Theory, and Practice (179-192) (3rd ed.). New York, NY: Springer Publishing Company, LLC. Read More