2068. Cultural Barriers to
Access of VA Blind Rehabilitation Services
MD Williams, Southern Arizona VA Health Care System; doctoral
student, College of Nursing, University of Arizona, CS Wilkinson,
Southern Arizona VA Health Care System and College of Nursing, University of
Arizona, RA Moreno, Southwestern Blind Rehabilitation Center and Southern
Arizona VA Health Care System, J Glittenberg, Colleges of Nursing and
Anthropology, University of Arizona
Objectives: Objectives of
this research were to describe attitudes and beliefs about blindness and blind
rehabilitation among Hispanic and American Indian blind veterans, and to explore
relationships between attitudes/beliefs and utilization of blind rehabilitation
services.
Methods: The design of
this study is a qualitative, ethnographic research approach. Hispanic and
American Indian blind veterans in Arizona were recruited through purposive
sampling to saturation of attitude and belief domains emerging from the data.
Informed consent was obtained, consistent with Human Subjects Committee and
tribal processes. Data consists of transcriptions of field notes and 28 audio
taped interviews conducted with 15 key cultural informants. Fourteen of the
informants are blind, thirteen are veterans, eight are Hispanic, and seven are
American Indian. Context data was collected through participant observation, and
interviews of key blind rehabilitation service providers. Data analysis included
a repetitive cycle of immersion in, and abstraction of, themes from individual
cases, synthesis of common themes and patterns, key informant challenge of
conceptualizations, and validation through expert panel review
Results: A predominant
emergent taxonomy organizes conceptual meanings into layers of connection.
Blindness is the most critical group-related connection and is an indicator of
service provider credibility. Within blindness, a second taxonomy organizes
conceptual meanings into staged processes that influence types of service
sought, willingness to openly access services, and means for accessing service.
Connecting to the larger veteran brotherhood is represented as figuring more
prominently in service access decisions than specific barriers to service access
identified by individuals.
Conclusions: Blindness is
a significant connection crossing other group identities, and represents
credibility in blindness-related service provision. Failure to address
disconnectedness with the larger veteran community may contribute to
ineffectiveness of interventions to overcome specific barriers to service
access.