This proposed study, planned for a two year period, aims to (1) identify and evaluate the self-care practices of different age groups among older adults in response to common symptoms, and (2) identify factors which explain self-care practices. Self-care will be defined as intentional behavior by an individual in response to own health problem or symptom, exclusive of current professional advice. Self-care includes diagnosing or naming the health problem or symptom, deciding on a course or courses of action, and tending to oneself with the intention of alleviating or palliating the symptom or problem. The knowledge basis for self-care includes any information except that which has been gained currently from a health professional. A cross-sectional survey will be conducted using a probability sample of 900 older adults, stratified by age (45-59, 60-74, and 75 to 89), and size of community (metropolitan, middle-sized city, and small city). The sample will be secured by random digit dialing to identify eligible individuals. Subjects will be paid for their participation. Trained interviewers will conduct home interviews eliciting self-care practices for symptoms experienced. Major explanatory variables will include age cohort, attitudes toward medicine and the medical profession, health locus of control, level of psychological distress, and health system factors such as accessibility and costs of care. Demographic characteristics, health conditions and social supports constitute control variables. One special feature of this research will be the addition of an indepth prospective study of the process of recognizing and dealing with symptoms and health problems, including the selection of self-care behaviors, modeled after the work of other investigators who studied younger persons. Ninety persons, 30 from each age stratum, will be compensated for keeping a diary during a four week period, recording health problems/symptoms experienced and their methods of dealing with these health problems/symptoms. A second special feature is a planned cross-national comparison. This research has been formulated in consultation with Dr. Kay Dean in Denmark; the utilization of identical measures of key variables will permit analysis of elderly self-care in the two societies with different histories and health care systems.
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