Overcoming Rural Cultural Barriers to Service Delivery: The Perspective of Informal Caregivers

Author

Kayla Hand, Southern Illinois University CarbondaleFollow

Date of Award

12-1-2010

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Chwalisz, Kathleen

Abstract

It is well documented in the caregiving literature that caregivers do not utilize services that may aid in their ability to provide care and help maintain their own well-being. There have been several barriers identified that may deter caregivers from seeking services, especially in rural areas. However, there is less known about how caregivers work to overcome those barriers. The purpose of this study was to increase understanding about how rural caregivers overcome barriers to service utilization. The research was designed to be exploratory, rather than of a confirmatory nature. It is hoped that having rural caregivers identify ways to overcome the barriers themselves will ultimately be more meaningful as their suggestions might then be used to change how services market and deliver services to rural caregivers. This study was a qualitative investigation of what rural caregivers identify as barriers to seeking services and how to overcome those barriers. Eight rural caregivers were interviewed over the phone. Through the interview process, caregivers identified barriers and shared their personal experiences of how to overcome barriers or offered suggestion about how others may overcome barriers. Grounded theory (Strauss & Corbin, 1998; Corbin & Strauss, 2008) was used to analyze the qualitative data. The core phenomenon of this study, often referred to as a storyline, revolved around the concept of caregivers not seeing a need for services. Caregivers' cultural beliefs of staying independent and taking care of others because it is their familial responsibility were prevalent throughout the interviews. The findings from this study ultimately illustrate how caregivers do not seek services because they do not see a need to or chose not to need services. Although barriers to service utilization have previously been identified in the caregiving literature, the greatest barrier for each of the caregivers in this study was their inability to see a need for help or services. This emerged as a higher-order barrier. Although caregivers were able to offer suggestions to overcome some of the other barriers, none were able to offer suggestions on how to help caregivers perceive a need as they themselves had attitudes and/or beliefs that contributed to their not believing they needed services. Awareness of this higher-order barrier or core belief may translate into agencies and services changing the way they market to rural caregivers.