Self-care has proliferated since the early nineteenth century. These activities range from nutritional changes to bed rest. Self- are essentially involves any actions undertaken by an individual to restore, promote and maintain health. Dean suggest that there are a range of potential behavioral responses to illness behavior: the decision to seek professional consultation, self-medicate, do nothing, or self-treat without the involvement of medications. An important area in need of research is the factors or determinants shaping the response to symptoms by older individuals specifically those living in rural areas. Little is known about the range of self-care responses to illness. A descriptive model for self- care behavior in response to symptoms is proposed. The study population of interest are elders living in rural arcs. Andersen and Newman's Health Service Utilization Model will serve as the conceptual framework for this study . This model conceptualizes health service utilization as a three- stage sequence of predisposing factors, enabling factors and illness level. The target population are rural elders in the state of Ohio. The accessible population are rural elders living in Vinton County, Ohio. This county was selected because the county is classified as rural by both the United States Census Bureau and the Office of Management and Budget . Rural elders were selected because these individuals have less access to formal health care services than their urban and suburban counterparts. Rural elders have more acute conditions, more restricted days of activities, more chronic health conditions and poorer overall health state when compared to elders living in urban areas. Because of the health state of rural elders and the limited accessibility of health care services in rural areas, the study of self-care behavior in response to symptoms is needed among this population. The purpose of the study is to identify determinants influencing self-care behavior among a sample of rural elders and evaluate those determinants in a conceptual framework. The specific objectives of the study are (1) to determine if there is a relationship between predisposing factors and self- care response to symptoms; (2) to determine if there is a relationship between enabling factors and self-care response to symptoms; (3) to determine if there is a relationship between illness level and self-care response to symptoms; (4) to determine if there are interrelationships between the sets of independent variables; and (5) to assess the amount of variation in self-care behavior in response to symptoms that can be explained by the modified Health Service Utilization Model. Data will be collected from a random sample of noninstitutionalized elderly individuals aged sixty-five and older. Data collection will be performed through telephone interviews. Log-linear regression analysis will be the statistical application used to examine multivariate and bivariate relationships between response to symptoms and the sets of independent variables, predisposing factors, enabling factors and illness level.
