Sage Journals: Discover world-class research

Abstract

Objectives

Obtaining the voices of older adult patients with atrial fibrillation (AF) about their health and healthcare has become increasingly important in providing quality care. The purpose of this study was to understand the unique contributions of photographs in the healthcare journeys of rural living older adults with AF.

Methods

As part of a larger mixed methods study 10 older adults with AF living in rural communities were recruited through two rural primary care physicians’ practices. They were followed over six months through a combination of face-to-face and telephone interviews. Photographs were submitted along with personal journey logs to report healthcare interactions. A photographic analysis was conducted.

Results

Collectively photos illuminated aspects of older adults AF journeys (stable, chronic unstable, and acute crisis) less explicit in the narrative accounts. Three themes emerged: focus of attention, life-space, and support. Shifts in illness as a focus of attention and life-space paralleled patients at different points in their AF journeys while a range of formal and informal supports were available to them.

Discussion

Photographs were valuable in shedding light on older adults’ rural healthcare experiences. They offer a nuanced approach for gaining insights into the subtleties characterizing the journeys of older adults with AF.

Keywords

Photographs patient journey atrial fibrillation older adults rural

Get full access to this article

View all access options for this article.

References

World Health Organization. Global health and aging, 2011. Available at: http://www.who.int/ageing/publications/global_health.pdf (accessed 6 February 2014).

Marinigh

Lip

GYH

Fiotti

. Age as a risk factor for stroke in atrial fibrillation patients. J Am Coll Cardiol 2010; 56: 827–837.

Rahman

Kwan

Benjamin

. Global epidemiology of atrial fibrillation. Nat Rev Cardiol 2014; 11: 639–654.

Dandy K and Bollman RD. Seniors in rural Canada 2009. Ottawa: Statistics Canada.

Ekblad

Ronning

Bridlund

. Patients' well-being: experience and actions in their preventing and handling of atrial fibrillation. Eur J Cardiol Nurs 2009; 12: 132–139.

McCabe

Schad

Hampton

. Knowledge and self-management behaviors of patients with recently detected AF. Heart Lung 2008; 37: 79–90.

Cramp

. Development of an integrated and sustainable rural service for people with diabetes in the Scottish Highlands. Rural Remote Health 2006; 6: 422–422.

Rix EF, Barclay L, Stirling J, et al. ‘Beats the alternative but it messes up your life’: aboriginal people’s experience of haemodialysis in rural Australia. Brit Med J Open 2014; 4: e005945.

Momen

Kendall

Barclay

. Using timelines to depict patient journeys: a development for research methods and clinical care review. Prim Health Care Res Dev 2013; 14: 403–408.

10.

Beecroft

Durham

Thomson

. Retrospective examination of the healthcare ‘journey’ of chronic orofacial pain patients referred to oral and maxillofacial surgery. Brit Dent J 2013; 214: E12–E12.

11.

Wong

Kozan

Sinnott

. Tracking the patient journey by combining multiple hospital database systems. Aust Health Rev 2014; 38: 332–336.

12.

Jackson

Oelke

Besner

. Patient journey: implications for improving and integrating care for older adults with chronic obstructive pulmonary disease. Can J Aging 2012; 31: 223–233.

13.

Panazzola

Leipert

. Exploring mental health issues of rural senior women residing in southwestern Ontario, Canada: a secondary analysis photovoice study. Rural Remote Health 2013; 13: 2320–2320.

14.

Stephenson

. My community, my voice: rural older adults speak through photography. J Extension 2012; 50: 1–9.

15.

Genoe

Dupuis

. Picturing leisure: using photovoice to understand the experience of leisure and dementia. Qual Rep 2013; 18: 1–21.

16.

Wiersma

. Using Photovoice with people with early-stage Alzheimer’s disease: a discussion of methodology. Dementia 2011; 10: 203–216.

17.

Yankeelov

Faul

D’Ambrosio

. “Another day in paradise”: a photovoice journey of rural older adults living with diabetes. J Appl Gerontol 2013; 34: 199–218.

18.

Frith

Harcourt

. Using photographs to capture women's experiences of chemotherapy: reflecting on the method. Qual Health Res 2007; 17: 1340–1350.

19.

Rush KL, Oelke NO, Shay M, et al. The diverse journeys of rural older adults with atrial fibrillation. Eur J of Patient-Centered Healthc 2015; 3: 487–495.

20.

Statistics Canada. From urban areas to population centres, 2011. Available at: http://www.statcan.gc.ca/subjects-sujets/standard-norme/sgc-cgt/notice-avis/sgc-cgt-06-eng.htm (accessed 24 March 2015).

21.

Creswell

. A concise introduction to mixed methods research, Los Angeles, CA: Sage, 2015.

22.

Borson

Scanlan

Brush

. The mini-cog: a cognitive ‘vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychol 2000; 15: 1021–1027.

23.

FileZilla KT. Available at: https://filezilla-project.org/ (accessed 29 May 2016).

24.

Wang

Burris

. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav 1997; 24: 369–387.

25.

NVivo qualitative data analysis Software. QSR International Pty Ltd., Version 10, 2012.

26.

Oliffe

Bottorff

Kelly

. Analyzing participant produced photographs from an ethnographic study of fatherhood and smoking. Res Nurs Health 2008; 31: 529–539.

27.

Paterson

. The shifting perspectives model of chronic illness. J Nurs Sch 2001; 33: 21–26.

28.

May

Nayak

Isaacs

. The life-space diary: a measure of mobility in old people at home. Int Rehabil Med 1985; 7: 182–186.

29.

Tung

Rose

Gammada

. Measuring life space in older adults with mild-to-moderate Alzheimer's disease using mobile phone GPS. Gerontology 2014; 60: 154–162.

30.

Liddle

Ireland

McBride

. Measuring the lifespace of people with Parkinson’s disease using smartphones: proof of principle. JMIR mHealth uHealth 2014; 2: e13–e13.

31.

Rush KL, Hatt L, Shay M, et al. The stressors and coping strategies of older adults with persistent atrial fibrillation prior to and following direct current cardioversion. J Appl Gerontol. Online First: first published on 30 September 2015.

32.

Clark

Leipert

. Strengthening and sustaining social supports for rural elders. Online J Rural Nurs Health Care 2007; 7: 13–26.

33.

Nummela

Sulander

Karisto

. Self-rated health and social capital among aging people across the urban–rural dimension. Int J Behav Med 2009; 16: 189–194.

34.

National Seniors Council. Scoping review of the literature: social isolation of seniors, 2014. Available at: http://publications.gc.ca/collections/collection_2015/edsc-esdc/Em12-7-2014-eng.pdf (accessed 29 March 2015).

35.

McCabe

Rhudy

DeVon

. Patients’ experiences from symptom onset to initial treatment for atrial fibrillation. J Clin Nurs 2014; 24: 786–796.

Seeing the rural healthcare journeys of older adults with atrial fibrillation through a photographic lens