title: Quiet pride: the experience of chronic illness by rural older adults.
abstract: OBJECTIVE
  To explore how chronic illness is experienced and managed by rural Hispanic and non-Hispanic older adults and their families, and to identify how the health care system and community facilitate or inhibit the ability to manage chronic illness in a changing health care environment.
  
  
  METHODS
  Descriptive ethnography with purposive sampling.
  
  
  METHODS
  Data-generation methods included audiotaped interviews from 42 Hispanic and White, non-Hispanic participants, participant observations, examination of documents and artifacts, and photography in rural Colorado. Interpretive ethnographic methods were used to identify an overarching cultural theme.
  
  
  RESULTS
  Living with chronic illness was a proactive, reciprocal learning process shaped by interrelationships in the context of multiple, diverse communities. Participants expressed living with chronic illness as a quiet pride on the journey toward living a meaningful life.
  
  
  CONCLUSIONS
  Findings provide an understanding of the webs of relationships that constitute the experience of elders living with chronic illness in rural communities. Viewing life as meaningful in the context of a broader understanding of health and well-being is important for nursing practice and future models of care.
authors.affiliation: School of Nursing, Hawaii Pacific University, Kaneohe, HI, USA. renel@lava.net
authors.forename: R
authors.initials: R
authors.lastname: Davis
authors.forename: J K
authors.initials: JK
authors.lastname: Magilvy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing* / Q000523:psychology*; D003120:Colorado / Q000208:ethnology; D003466:Cultural Characteristics; D005260:Female; D006299:Health Services for the Aged; D006630:Hispanic or Latino; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D012423:Rural Health; D011795:Surveys and Questionnaires