Why do the elderly seek or avoid care? A qualitative analysis.
OBJECTIVE
This study attempts to understand why the elderly seek or choose not to seek health care. Most studies on barriers to health care have measured obstacles defined by the researchers. We attempt to define variables that are relevant to the elderly but have not yet been articulated.


METHODS
Using grounded theory, open-ended interviews of 15 non-housebound elderly were conducted and coded. The data obtained were analyzed to discover and characterize the subjects' perceptions of barriers.


CONCLUSIONS
The major theme that emerged involved the interactions among autonomy, self-esteem, and the degree of illness or health. The study generated two hypotheses: 1) Self-esteem is directly correlated with the willingness of the elderly to seek care, especially as illness increases and autonomy decreases. 2) The individual's perception of health status, the perceived roles of the physician and the patient, the physician-patient relationship, and systems issues contribute to the dynamic paradigm that positions the elderly patient to seek or avoid seeking health care.
Koval
M
M
Department of Family Medicine, St Mary's Hospital, University of Wisconsin, Madison, USA.
Dobie
S
S
D000368:Aged; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006297:Health Services Accessibility; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D012649:Self Concept; D012803:Sick Role; D016312:Treatment Refusal