Change in Health-seeking Behaviour among Elderly during the COVID-19 Pandemic in Rural Areas of Central Kerala: A Cross-sectional Study

Abstract

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has had a significant impact on the elderly population, leading to both fatalities from the virus and delayed treatment of acute emergencies. Additionally, many elderly individuals have demonstrated poor health-seeking behaviour in managing chronic conditions. Reasons for this include fear, access barriers, and strain on healthcare resources and personnel. Aim: To evaluate the change in health-seeking behaviour among the elderly in rural areas of central Kerala during the pandemic and identify the associated factors. Materials and Methods: A community-based cross-sectional study was conducted in the rural field-practice areas of the Department of Community Medicine at a tertiary care Medical College in Kerala, India from May 2021 to August 2021. A total of 252 elderly individuals aged 60 years and above were interviewed using a structured pretested questionnaire. Socio-demographic details and responses on health-seeking behaviour during the pandemic were documented. Data were summarised using frequencies and percentages for categorical variables or mean and standard deviation for continuous variables. Associations were tested using the Chi-square test. Results: The study revealed that 83.73% (211 out of 252) of the elderly participants had Non Communicable Diseases (NCDs), with hypertension in 130 (51.59%) and diabetes in 90 (35.71%) being the most prevalent. A significant change in the preference for healthcare facilities was noted (p<0.001), with a decline in appropriate health-seeking behaviour by 16.16%. Moreover, 9.13% (23 participants) resorted to self-treatment at home, and 49.21% (124 participants) opted for traditional remedies to boost their immunity. The type of family was significantly associated with the decline in health-seeking behaviour (p<0.05). Of the 16 participants who indicated a lapse in their regular follow-up since the onset of the pandemic, the primary reasons for missing appointments were fear of contracting COVID-19 in 14 cases (87.50%), lockdown restrictions in six cases (37.50%), and transportation challenges in three cases (18.75%). Conclusion: The study revealed a high prevalence of chronic diseases like hypertension, diabetes, osteoarthritis, and Coronary Artery Disease (CAD) among the elderly. There was a decline in health-seeking behaviour by 16.16% among the elderly with chronic diseases due to various challenges posed by the pandemic. Implementing strategies such as utilising social media, promoting telemedicine, and adopting a comprehensive technological approach is crucial to enhance healthcare accessibility for elderly populations in rural areas.