Older rural women's pre-visit planning and involvement in South Australian general practices : A candidacy theory perspective

Objective
To explain older rural women’s participation in clinical decision-making with GPs and explore factors associated with their pre-visit planning and involvement in treatment processes.

Methods
A sequential, theory-driven mixed-method study was conducted. Women aged 65 years or above who had visited a GP three months prior were recruited from five rural towns in South Australia through the local Rotary Club. Data collection utilised an 18-item scale and a semi-structured interview guide. Quantitative data were analysed using chi-square tests and multinomial logit models, whereas qualitative data were coded into themes. As applied in the discussion, the candidacy theory provided a framework for further adding meaning to the results.

Results
Seventy-one older rural women completed surveys. Across the domains, including health knowledge, GP visit preparation, participation in discussion, and attitudes towards shared decision-making, most items indicated a moderate level of women's health knowledge and involvement in GP treatments. Multivariate analysis revealed having less than a basic education, not speaking English at home, and being in the youngest-old age group (65–74 years) were positively associated with low levels of pre-visit planning and involvement in GP treatments. Analysis of interviews with 21 women identified three themes: capacity for health planning and preparedness, communication styles and preferences, and accessibility and continuity of care.

Conclusion
The findings of this study underscore the urgent need for redesigning GP services. By considering the intersection between behavioural and clinical aspects of older rural women’s pre-visit planning and involvement in GP treatment processes in rural South Australia, we can inspire positive change in healthcare delivery.

Practice Implications
Practice Implications: our study provides actionable insights on how and where to intervene to enhance older rural women’s capacity to engage in pre-visit planning for successful GP consultations. This knowledge can empower healthcare professionals and policymakers to implement effective strategies.

© 2024 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).