Seeing the rural healthcare journeys of older adults with atrial fibrillation through a photographic lens.

Objectives Obtaining the voices of older adult patients with atrial fibrillation (AF) about their health and healthcare has become increasingly important in providing quality care. The purpose of this study was to understand the unique contributions of photographs in the healthcare journeys of rural living older adults with AF. Methods As part of a larger mixed methods study 10 older adults with AF living in rural communities were recruited through two rural primary care physicians' practices. They were followed over six months through a combination of face-to-face and telephone interviews. Photographs were submitted along with personal journey logs to report healthcare interactions. A photographic analysis was conducted. Results Collectively photos illuminated aspects of older adults AF journeys (stable, chronic unstable, and acute crisis) less explicit in the narrative accounts. Three themes emerged: focus of attention, life-space, and support. Shifts in illness as a focus of attention and life-space paralleled patients at different points in their AF journeys while a range of formal and informal supports were available to them. Discussion Photographs were valuable in shedding light on older adults' rural healthcare experiences. They offer a nuanced approach for gaining insights into the subtleties characterizing the journeys of older adults with AF.