Promoting heart health in rural women.

PURPOSE: To compare 2 strategies, stage-matched nursing and community intervention (SMN+CI) and community intervention (CI) alone in changing cardiovascular risk factors in up to 3 behavioral areas: diet, physical activity, and/or smoking among rural women. METHODS: A 14-month, multisite randomized controlled trial of 117 rural women was conducted. Transtheoretical model was used in identification of stage of change and development of the SMN+CI nursing interventions. A social-ecological model was used to address issues of rurality in the development of interventions. FINDINGS: The SMN + CI group was superior on 4 outcomes. There were significant increases in 2 measures of dietary intake; improvement in dietary stage of change for fruits and vegetables; and reduced diastolic blood pressure (DBP) in the SMN + CI group. After log transformation DBP significance was lost. The CI group had a significant reduction in change in total cholesterol; however, significance was lost after control for the initiation of lipid lowering medications. There was a significant reduction in Framingham risk scores pre- to postintervention, regardless of group. CONCLUSIONS: There continues to be a need to improve cardiovascular risk factors in rural women. There should be an exploration of whether intensified dose and fidelity of the intervention strategies of diet and physical activity are effective in improving anthropometric and laboratory values. Further investigation is warranted into factors influencing the pre- to postreduction in Framingham risk scores.

Pain management topics of interest for nurses in rural Appalachia.

BACKGROUND: Continuing education for registered nurses is a component of safe, effective pain management in every clinical setting. METHODS: Two hundred ninety-one registered nurses from seven counties in rural southwestern Virginia completed a 22-item survey that assessed their interest in pain management topics. RESULTS: The mean interest score for all respondents was 4.04 (range = 1 to 5). Mean interest scores did not differ significantly between younger and older respondents (t = 1.034, p = .302) or between clinical settings (t = 0.479, p = .632). The mean interest scores for nurses with an associate's degree in nursing/diploma and those with a bachelor of science in nursing or higher were 4.19 and 3.88, respectively, and the difference was statistically significant (t = 3.535, p < .001). CONCLUSION: Nearly 300 registered nurses from communities in the southwestern Virginia area of Appalachia indicated interest in a wide variety of pain management topics. Nurses with at most an associate's degree in nursing/diploma were significantly more interested in pain management education than those with a bachelor of science in nursing or higher degree. The overall interest scores were high, indicating that the respondents found the topics salient to their clinical practice.