Dissertation/Thesis Abstract

A qualitative study to understand the perception of illness and the decision making process for accessing and utilizing health care for American Indians in Southeastern, NC
by Nance-Floyd, Betty, Ph.D., The University of North Carolina at Greensboro, 2016, 222; 10123685
Abstract (Summary)

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.

Indexing (document details)
Advisor: Bartlett, Tracy R.
Commitee: Bell, Ronny, Kohlenberg, Eileen, Wallace, Debra
School: The University of North Carolina at Greensboro
Department: Nursing
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
Publication Number: 10123685
ISBN: 978-1-369-00198-3
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