Health beliefs and practices of 'regulars' at the rural bar

Abstract

Montana has one of the highest per capita rates of alcohol consumption. While alcohol use in rural areas has not been documented to be higher than in urban areas, rural residents have been recognized as having unique perspectives on health. This study was designed to explore the health beliefs and practices of rural men who regularly frequent the local bar. Understanding the perspective of this group may add to the body of knowledge used by Advanced Practice Nurses to work effectively with these men. Interviews with ten men from four rural communities with no local health care facility were undertaken to explore the health beliefs and practices of this group. Bandura's Cognitive Social Theory was chosen as the theoretical framework to address how these men perceived health, health care, and health care providers as well as their own ability to control their wellness. The participants identified lack of pain and ability to function in daily tasks as being healthy. Most of the participants (90%) believed they had a great deal of control over their own well-being with physical activity being the most common self care activity. They avoided health care until unable to manage the illness or injury themselves then would choose a provider based on word of mouth, convenience, cost, and "knowing" the provider. Participants demonstrated an ability to change lifestyle patterns if they perceived the change to be important. Participants would avoid or not return to a provider who was rude, judgmental, or did not provide adequate pain control. Most named the bar as a place for socialization. Subjects were aware of the risks of smoking and excess alcohol but did not plan to change these activities in the absence of symptoms of disease. This study suggests that providers would be well served to a) assess the health care priorities of the 'regular' and tailor care to those perceived risks, b) make an effort to 'know' the patient by assessing social situation and lifestyle, c) portray an open, friendly, non-judgmental demeanor, and d) provide specific, clear information about personal risks/symptoms of disease with individualized suggestions about self-help measures.