Perceived Barriers to Rural Elderly Women’s Health-Promoting Behaviors: An Ecological Perspective
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Data Collection
2.4. Ethical Considerations
2.5. Data Analysis
- In order to identify the meaning, the data were labeled with the language expressed by the participants in the raw materials.
- Data were organized in order to derive the main themes.
- The themes were designated in a language that reflected the unique and detailed characteristics of the sample.
- By identifying the relationship between the identified themes and the four factors (intrapersonal-, interpersonal-, community-, and public policy-level factors) of the ecological theory, comparisons with and connections to other themes were made.
2.6. Rigor and Trustworthiness
3. Results
3.1. Intrapersonal Factors
3.1.1. Functional Decline
“I take three breaks to get here (senior center), because my back hurts (…) I work in the field, and my back hurts so I’m weak. It hurts everywhere, and it’s killing me (…) It is difficult because my body hurts. Even now, my back hurts. When I wake up in the morning, it hurts. It’s killing me.”(Participant 2–5)
“It must’ve been a little over 25 years. I can’t walk because it hurts all of a sudden. I can’t even go this far. Now I’m trying to lose weight by 10 kg, but my knees hurt, too. I am in a lot of pain because of my spinal stenosis. I’m okay on the outside, but when I go to the hospital, even the university hospitals say ‘a big university general hospital.’ I can barely cook rice and go back and forth around here. I walked last year... but I couldn’t even sit down in 2003 because of the pain. It hurts when I’m just there, and it hurts when I’m lying down. It’s tense and it hurts.”(Participant 1–8)
3.1.2. Passive Attitude
“I also fell on the floor and hurt my ankle and back. I would fall while going somewhere and trip while going somewhere else, so I got a surgery on my ankle. (…) I’m careful, because I can’t fall again. (…) I tripped while bringing my 4-year-old grandson, so now I’m careful (when I walk or move around since the fall). (Because I can’t fall again) since I’m weaker now. So, I should be careful.”(Participant 2–4)
“Oh well, there’s no need to think about it too much. I am over 80 (years old) so I just eat what I eat (and don’t pay too much attention).”(Participant 2–2)
“If I was more diligent, I can just walk around, but I’m lazy and don’t move much so that’s uncomfortable.”(Participant 2–3)
3.1.3. Lack of Implementation
“If it’s too hard, I try not to do it... I can do exercises that I can do while sitting down. I only do things while sitting down. I won’t do them [exercises] while standing.”(Participant 1–9)
“My doctor told me to do 100 repetitions of the leg exercises while lying down. I can’t do 100 repetitions, but I about 20–30 [when] I lie down every evening.”(Participant 2–2)
3.2. Interpersonal Factors: Interpersonal Processes and Primary Groups
Lack of Social Support
“I really want to go out and do these exercises, and do yoga with you [other participants]. But none of old adults including me want to because we are all in pain. Really, I would if many people did it together. But no one does it at all.”(Participant 1–9)
“[Exercising] is a bit difficult now. (Laughing) It is difficult even if I live with my daughter-in-law and grandson, because I am old.”(Participant 2–2)
3.3. Community Factors
3.3.1. Restrictive Conditions
“For me, it is difficult to go exercise at those places like gyms in the rural regions. I’m tired if I go out. I am too (tired) from farming. I have to rest when I can, but I don’t come back out. I farm a lot, and I only go out during off-season.”(Participant 1–9)
“I go to the hospital often and get acupuncture because of my back. My back isn’t so bad that it needs surgery, but it needs consistent care. But is that possible in a rural village?”(Participant 2–8)
3.3.2. Accessibility Issues
“I go on the bus. The bus schedule is not frequent. It comes every two hours. So, it’s very (difficult) to go to Janghowon (a place with relatively higher number of clinic-level medical facilities). It’s iffy, because the bus doesn’t come often. (…) But it’s hard to go because you have to walk there.”(Participant 2–4)
“It’s inconvenient because I have to keep track of time to go (to the hospital). I have to wait two or three hours if I miss the bus.”(Participant 3–4)
3.3.3. Lack of Infrastructure
“It has been less than 2 years since I moved (to the rural area). I came from the city. I love everything here, including the people that live in the neighborhood. It’s only that it’s the winter now, and I’m not able to engage in cultural activities. If I was more diligent, I can go (far by driving), but it’s inconvenient because I’m a bit lazy and I end up not going.”(Participant 2–3)
3.4. Public Policy
Lack of Policy Support
“I would like it if I could get more. Before, public health clinics and health clinics made some money so I was able to use them, like drugs and products…. But now that the city is managing it, I think the budget is tight. I used to get heating pads when I visited. But now, there’s nothing like that.”(Participant 1–8)
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Type of Question | Application | Question |
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Opening questions | We started with an easy question so that the participants could engage in the interview in a comfortable state. |
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Introductory questions | We let the participants know about the general direction of the interview topic and let them speak their mind naturally. |
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Transition questions | We asked leading questions so that participants knew about the specific subject within a wide-ranging topic. |
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Key questions | As these questions constitute the core of the research and are the primary focus of analysis, we allocated sufficient time so that the participants could thoroughly talk about their thoughts and experiences. |
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Ending questions | At the end of the group interview, we asked the participants whether there was anything to add. |
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Variables | Mean ± SD (Range) or N (%) | |
---|---|---|
Age (years) | 78.81 ± 7.34 (65–91) | |
Family arrangement | Spouse | 11 (42.3) |
Son | 7 (26.9) | |
Daughter | 1 (3.8) | |
Alone | 7 (26.9) | |
Education | Never attended school | 14 (53.8) |
Elementary school | 8 (30.8) | |
Middle school | 4 (15.4) | |
Number of chronic diseases | 1 | 2 (7.7) |
2 | 19 (73.1) | |
3 | 5 (19.2) |
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Moon, H.; Cha, S.; Park, E. Perceived Barriers to Rural Elderly Women’s Health-Promoting Behaviors: An Ecological Perspective. Int. J. Environ. Res. Public Health 2020, 17, 6107. https://doi.org/10.3390/ijerph17176107
Moon H, Cha S, Park E. Perceived Barriers to Rural Elderly Women’s Health-Promoting Behaviors: An Ecological Perspective. International Journal of Environmental Research and Public Health. 2020; 17(17):6107. https://doi.org/10.3390/ijerph17176107
Chicago/Turabian StyleMoon, Hyunjung, Sunkyung Cha, and Eunyoung Park. 2020. "Perceived Barriers to Rural Elderly Women’s Health-Promoting Behaviors: An Ecological Perspective" International Journal of Environmental Research and Public Health 17, no. 17: 6107. https://doi.org/10.3390/ijerph17176107