Relationships among self-efficacy, social support, social problem solving, and self-management in a rural sample living with type 2 diabetes mellitus.

Self-management behaviors are important for control of type 2 diabetes mellitus. Therefore, determining factors that promote effective self-management behaviors may be significant for improving the well-being of patients with type 2 diabetes mellitus. This study examined relationships among self-efficacy, social support, social problem solving, and diabetes self-management behaviors. Further, this study evaluated whether social support and social problem solving were mediators of the relationship between self-efficacy and diabetes self-management behaviors in those living with type 2 diabetes mellitus. Using a cross-sectional, descriptive correlational design, data from a convenience sample of 152 rural people living with type 2 diabetes mellitus were examined. Findings indicated that self-efficacy was a strong predictor of diabetes self-management. The effect of social support on diabetes self-management differed among men and women in the sample. Social support and social problem solving were significantly associated with diabetes self-management in men. Neither social support nor social problem solving were mediators of the relationship between self-efficacy and diabetes self-management in this sample. These findings suggest that nurses need to consider implementing interventions to improve patients' self-efficacy and potentially influence diabetes self-management.

Reflective journaling and development of cultural humility in students.

Cultural humility requires self-evaluation and the awareness that one's own culture is not the only or best one. Teaching health care providers to become culturally humble includes the development of critical thinking skills and the ability to reflect on practice. Journaling as a teaching strategy helps students develop these skills. This article describes the use of reflective journaling as students progressed through four semesters of a community clinical experience. This qualitative, descriptive study was based on the principles of naturalistic inquiry with person-centered written reflections.Two hundred journal entries from 50 students were reviewed, and II themes were identified. Cultural humility cannot be learned merely in the classroom with traditional teaching methods. Reflection on experiences over time leads to the development of cultural humility.

Perceptions and predictions of cardiovascular disease of Alabama women in a rural county.

PURPOSE: The aim of this project was to gain a better understanding of cardiovascular disease (CVD) as a women's health issue among Alabama women in a rural county. RESEARCH QUESTIONS: 1. What are the risks and perceptions of CVD of Alabama women in a rural county? 2. What demographic and study variables predict CVD? METHODS: One hundred twelve women participated in this descriptive, prospective study. FINDINGS: Thirty percent identified CVD as the greatest health problem facing women and the leading cause of death in women. Ninety percent believed that they had a 41% or greater chance of developing CVD. The variables in the study explained 60% of the participant's coronary heart disease risk prediction scores. CONCLUSIONS: The understanding gained in this study will be used to find ways to increase the awareness of CVD and to design interventions that improve the cardiovascular health of women in a rural area of Alabama.

Implementing a physical activity program for underserved African-American women.

To develop solutions to the public health challenges of inactivity, obesity, and cardiovascular disease in minority women, community/education partnerships bring together different groups, each contributing their unique strengths and sharing responsibilities. This paper describes how an academic/community partnership resulted in the development of a gym to promote physical activity for underserved African-American women. For over 10 years, Auburn University School of Nursing (AUSON) has partnered with the Auburn Housing Authority Community. Based on feedback from community focus groups, the physical activity project was started at a local gym. With participation from various groups, a fully functioning gym is in place. Women from the community have made fitness gains and serve as role models for their families and the community. Lessons learned in establishing the program include the need to provide for accessibility and flexibility and the importance of giving encouragement and promoting ownership.

Knowledge and risk of cardiovascular disease in rural Alabama women.

PURPOSE: The purpose of this study was to describe rural women's knowledge of cardiovascular disease (CVD) and actual risk of CVD. The research question guiding this study was: "Are there relationships between demographic factors, women's knowledge of CVD, and women's CVD risk score?" DATA SOURCES: Demographic data were collected from a convenience sample of 112 women at a full-service, rural medical clinic in Alabama. Two questions assessed women's knowledge of their risk factors for CVD. The Coronary Heart Disease Knowledge Test measured knowledge of coronary heart disease (CHD). Framingham CHD prediction scores were calculated to assess the actual heart disease risk of subjects. CONCLUSIONS: Knowledge of CVD in rural Alabama women is inadequate. The mean score for the knowledge test was 8.50 out of 20. This population of women has significant risk for CVD. Women recognized that smoking and obesity are issues, but are less aware of factors such as race, personality types, oral contraceptive use, hypertension, diabetes, age, hyperlipidemia, and family history. IMPLICATIONS FOR PRACTICE: The majority of women in the study could list only one or two CVD risk factors. New strategies for educating women about CVD should be explored by nurse practitioners (NPs). For example, NPs interested in CVD in women could organize and offer to teach in local schools, colleges, universities, churches, and at sites where women work. Collaboration with the local American Heart Association and Health Department in educating women may be appropriate. By increasing women's knowledge, their actual risk may change and thus improve their chance to live free of CVD or have it later in life or to a lesser extent.

Lessons learned: integrating a service learning community-based partnership into the curriculum.

Auburn University School of Nursing (AUSON) has been in a partnership with the Auburn Housing Authority (AHA), a low-income public housing provider, for several years by providing a weekly nursing care clinic. AUSON was convinced expansion of the clinics would be beneficial to all. This article describes the process and lessons learned in expanding the scope and depth of the partnership and how this service learning experience was integrated throughout the nursing curriculum. Journaling by students revealed that interactions with a different culture over time changed their perceptions. Residents have been empowered to take control of their health. A community partnership takes persistence, perseverance, and consistency. This partnership has been beneficial to residents, students, and faculty. The university's land-grant mission of service and access is demonstrated through a partnership that offers opportunities for students and faculty to address the community's needs.

Community-based service learning in the engaged university.

The engaged university expands the concept of service learning to include a redesigned approach to teaching, research, and service functions that leads to a productive involvement with communities. This article describes an ongoing community partnership that models the best-practice aspects of the engaged university.