Exploring Chronic Illness in Isolated Rural Women Pilot Project

Exploring Chronic Illness in Isolated Rural Women

Charlene Winters, DNSc, APRN, BC
Principal Investigator

Montana State University-Bozeman
College of Nursing

Overview:

The incidence of chronic illness in the United States has increased dramatically during the last six decades affecting a disproportionate number of women. Chronic illnesses are permanent, leave residual disability, require long term health care, and special adaptation on the part of the ill individual. Self management of chronic conditions involves controlling symptoms and adapting to physical, psychological, and social changes. Uncertainty has been identified as a constant accompaniment of chronic illness that can negatively influence individual’s adaptive behaviors and psychosocial outcomes. Although one-fourth of America's population lives in rural areas, little is known about how middle-aged women living in isolated rural areas manage their illness. The goal of this qualitative study was to conduct a secondary analysis of existing data on isolated middle-aged rural women with arthritis, cancer, diabetes, and multiple sclerosis to: a) identify common themes related to illness uncertainty and illness management; b) explore the impact of demographic factors, length of illness, health status, degree of rurality, psychological adjustment to illness, and social support on identified illness themes; and c) compare findings with previously completed research including preliminary studies that explored the experience of chronic illness and illness uncertainty in older men and women with heart disease living in urban areas of a rural state.

An analysis of the data showed that QOL scores increased over time (15.69 - 19.13), PRQ scores for perceived support increased over time (128.80-138.16), PAIS scores for psychological adjustment remained unchanged (77.54-78.00), and self-reported health status slightly improved (2.80-3.00) during the study period. Uncertainty, searching for answers (symptoms, diagnosis, and treatment), maintaining balance (family, home, work, and illness), isolation (physical and emotional), vigilance (financial and physical), coping (faith, humor, and social support), and family first were common themes identified among the women. Four themes, uncertainty, the search for answers, vigilance, and coping, were similar to themes found among men and women with chronic heart disease.

Team:

	Clarann Weinert, SC, PhD, RN, FAAN Co-Investigator Montana State University-Bozeman College of Nursing cweinert@montana.edu

	Therese Sullivan, PhD, RN Co-Investigator Montana State University-Bozeman College of Nursing thereses@montana.edu

Dissemination:

Publications

Winters, C., Sullivan, T., & Weinert, C. (2003). Exploring Chronic Illness in Isolated Middle-Aged Rural Women [Abstract]. Communicating Nursing Research, 36, 74.
Winters, C. & Sullivan, T. (2006). The chronic illness experience of isolated rural women. In H. Lee & C. Winters (Eds.), Rural nursing: Concepts, theory, and practice (2nd ed.), New York: Springer.

Presentations

"Chronic illness, research, and rural dwellers: Opportunities and challenges." 36^th Annual Communicating Nursing Research Conference, Western Institute of Nursing, Scottsdale, AZ, April 2003.
Acord, L. "Chronic illness, research, and rural dwellers: Opportunities and challenges."
Weinert, C. "The CRCHC: Why, what, and who."
Shreffler-Grant, J. "Quality of care assessment in rural hospitals: Realities and challenges."
Zulkowski, K. "Pain management and telehealth use for Crow Indians."
Winters, C. "Exploring chronic illness in isolated middle-aged rural women."
Winters, C. (2003, April). Exploring chronic illness in isolated rural women [poster]. 36th Annual Communicating Nursing Research Conference, Western Institute of Nursing, Scottsdale, AZ.
Winters, C. (2003, May). Exploring chronic illness in isolated rural women [poster]. Research in Montana Research Reception, Bozeman, MT.