Health beliefs of Haitian elders related to influenza prevention.

OBJECTIVE: Each year, about 20% of the persons living in the United States gets influenza, and the majority of those who die as a consequence are over 65. Many of these deaths may be preventable. In this study, the health beliefs, attitudes, and cultural practices related to the prevention of influenza by Haitian elders are studied. DESIGN AND SAMPLE: Using a focused ethnographic approach, 10 adults above the age of 55 and born in Haiti were interviewed. METHODS: Data were collected using interviews and participant observation. Interviews were conducted in Creole by the primary author. Participant observation occurred for the length of a "flu season" in a neighborhood nurse-managed clinic during the provision of routine health care. RESULTS: Themes of competing paradigms, fear of sickness, taking care of oneself, and cautious willingness emerged. CONCLUSIONS: The participants described what is known in western medicine as influenza, as "a cold," or "a big cold." While they were uncertain of influenza immunizations, there was an overwhelming willingness to accept one if recommended by respected others and trusted health providers. The results of the study can serve as a springboard for future attempts to better understand this unique and at-risk population.

Imposed versus involved: different strategies to effect driving cessation in cognitively impaired older adults.

In the lives of persons with cognitive impairments, a time comes when it is necessary to give up driving. This may be a particularly difficult issue for the driver, his or her family members, and their health care professionals. In this study, the phenomenon of unsafe driving by cognitively impaired older adults and the process of affecting driving cessation, was explored through guided interviews with 216 persons throughout the state of Florida. Participants included professionals working in the aging network, mobility counselors, safety officers, individuals with a mild degree of cognitive impairment and their family members. The strategies employed to influence or effect cessation could be categorized as those that involved the individual affected and those that were imposed on the individual. Conditions that appeared to influence whether driving cessation would occur were observed. There were distinct pros and cons to each strategy. In this article, specific information is provided to guide nurses working with cognitively impaired people who have become unsafe drivers. It is expected that driving cessation can be voluntarily effected in many cases but may have to be imposed in others. The skilled nurse will know when and which type of recommendation is appropriate.

The meaning of aging and the celebration of years among rural African-American women.

This study considers the meaning of aging from the perspective of a group of frail, rural African-American women living alone in north Florida. They defined aging as both an accumulation of years (eg, up-in-years old) and/or the result of functional impairment (eg, worn-out old). The former is a cause for celebration and the latter often the result of omissions or commissions on the part of the individual and society. Geronotologic nurses are encouraged to observe the client's cultural perspective and incorporate it into the plan of care and consider aging from many perspectives.

Making the connection: seeking and receiving help by elderly African Americans.

The process of help seeking and help giving by older rural African Americans was studied using interviews, conversations, and participant observation of 41 informants, including 9 key informants. The author used an inductive analytical approach to examine the data, and a culturally constructed pattern of behavior was identified as help seeking. The circumstances under which, and language with which, help is sought and received was explained, and insight as to who is likely to receive help was provided. The elders believed that receiving help in late life is a reward for a good life. By understanding and following the rules of help seeking, formal helpers might more efficiently and effectively meet the needs of this vulnerable group.