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The rural context and women's self-management of chronic health conditions

College of Nursing, Montana State University, Missoula Campus, 32 Campus Drive 7416, Missoula, MT 59812-7416, USA, winters{at}montana.edu

Shirley A. Cudney

College of Nursing, Montana State University, Bozeman Campus, PO Box 173560, Bozeman, MT 59717-3560, USA

Therese Sullivan

College of Nursing, Montana State University, Bozeman Campus, PO Box 173560, Bozeman, MT 59717-3560, USA

Alta Thuesen

College of Nursing, Montana State University, Missoula Campus, 32 Campus Drive 7416, Missoula, MT 59812-7416, USA

Objective: To examine the rural context and describe its influence on the self-management of chronic illness by women living in a rural setting.

Methods: The Women to Women (WTW) project is a research-based computer intervention that provides health education and peer support to rural women with chronic health conditions. Messages posted to the online support and health education chat rooms were examined to determine the characteristics of the rural context in relation to the women's illness self-management.

Results: `Distance' was the overarching characteristic of the rural context that influenced the women's ability to self-manage their chronic health problems. The effect of distance was woven throughout each of the four predominant themes that emerged from the data as having influence — physical setting, social/cultural/economic environment, nature of women's work, and accessibility/quality of healthcare. These influences affected the women's self-management abilities both negatively and positively.

Discussion: The rural context profoundly influenced the ability of rural women to self-manage their chronic conditions. From the data, health professionals and policy-makers can glean information about the barriers to healthcare faced by rural women who are trying to manage their chronic health problems in comparative isolation.

Key Words: Chronic illness • Healthcare • Rural context • Self-management • Women

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