The purpose of this study was to understand the perceptions and experiences of illness among American Indians (AI) in southeastern NC and to describe their decision making processes when accessing and using health care services. Most AIs in North Carolina live in rural areas, where chronic illnesses are a growing concern. Illnesses such as cardiovascular diseases and diabetes have crippled this population physically and emotionally and have resulted in undue financial hardship for AIs.
Focused ethnography methodology was used to guide the study and the Social-Ecological Model (SEM) aided in the analysis of the data. AI gatekeepers recruited eighteen participants from rural areas to participant in one of four focus groups or one of three semi-structured interviews. After data analysis, confirmation of findings was received from the participants.
These participants describe illness as having a medical diagnosis and the experience of being ill as having signs and symptoms, for example, breathing difficulty, pain, bleeding, inability to attend social functions, and the inability to be active. Many of these participants reported seeking care for primary, secondary and tertiary prevention. Factors that influenced their decision making involved all of the SEM levels. The two most significant factors that influenced their decision making to seek health care were adequate insurance and a relationship with the provider. With the exception of an emergency, without these two factors, there was a delay in seeking health care.
|Advisor:||Bartlett, Tracy R.|
|Commitee:||Bell, Ronny, Kohlenberg, Eileen, Wallace, Debra|
|School:||The University of North Carolina at Greensboro|
|School Location:||United States -- North Carolina|
|Source:||DAI-B 77/10(E), Dissertation Abstracts International|
|Subjects:||Nursing, Public health, Native American studies, Health care management|
|Keywords:||American indians, Decision making process, Health care access, North Carolina, Patient-provider relationships, Perception of illness, Utilization of health care|
Copyright in each Dissertation and Thesis is retained by the author. All Rights Reserved
The supplemental file or files you are about to download were provided to ProQuest by the author as part of a
dissertation or thesis. The supplemental files are provided "AS IS" without warranty. ProQuest is not responsible for the
content, format or impact on the supplemental file(s) on our system. in some cases, the file type may be unknown or
may be a .exe file. We recommend caution as you open such files.
Copyright of the original materials contained in the supplemental file is retained by the author and your access to the
supplemental files is subject to the ProQuest Terms and Conditions of use.
Depending on the size of the file(s) you are downloading, the system may take some time to download them. Please be