Elderly Patients' Health Beliefs INTRODUCTION TO THE PROPOSED RESEARCH

According to Strain (1991), utilization of health services by the elderly (aged 60+ years) is, at least in part, a function of their perceptions of their need for these services and this perception of need is itself determined by patients' various health beliefs. For example, in her study of 743 elderly patients, Strain found that the utilization of health services was linearly related to two health beliefs: degree of medical skepticism; and belief in the value of health maintenance activities.

Similar findings have been reported by several researchers (Bauwens & Anderson, 1984; Hallal, 1982; Nemcek, 1990). Indeed, Ward (1987) has stated that the relationship of health beliefs to utilization of health services has been fairly well established by psycho-medical research. However, one area of the health beliefs/utilization of services relationship that has not been well examined is the extent to which the relationship is affected by other variables such as patient demographics.

Because the literature indicated an association between health beliefs and utilization of health services, it was decided to examine for this relationship in a sample of elderly COPD patients. COPD patients were selected because existing research (Johnson, 1988; Reed & Stanley, 1989) reported that COPD affects substantial numbers of elderly patients. Moreover, a review of this investigator's emergency registration log book revealed that 46 percent of patients over 65 years of age s

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estigation of health beliefs is conceptually derivative of the Health Belief Model which states that the decision to seek medical care depends upon: (1) motivation (level of health concern); (2) susceptibility (level of perceived threat); and (3) perceptions of the cost of care versus the benefits. Because of the increasing importance of this model in terms of explaining heath behaviors, there has been a growing interest in researching health beliefs. This section of the review examines studies of health beliefs relevant to elderly populations followed by a review of studies investigating the contribution of patient demographics to health beliefs. Studies of Health Beliefs in Elderly Populations Leventhal (1983) tested the hypothesis that health behavior was influenced by age, symptomatology and health beliefs. Health beliefs and behaviors were examined in relationship to six specific diseases: the common cold; colon-rectal cancer; lung cancer; heart attack; high blood pressure; and senility. Subjects in the study consisted of 396 adults (196 males and 200 females) divided into three age groups: (1) Subjects 20 - 39 years old (N=173); (2) Subjects 40 - 59 years old (N=111); and (3) Subjects 60 years old and above (N=112). A

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