Bette Ide

Health Care Choices Complementary Therapy, Chronic Illness, and Older Rural Dwellers

Purpose: To better understand elderly rural dwellers use of complementary and alternative therapies (CAM), perception of efficacy, and their sources of information. Method: Ten participants between ages 60 and 80 years were interviewed by telephone. Qualitative analysis for content and themes was done. Findings: Self-directed practices such as vitamin, mineral, and herbal supplements, taken to compensate for perceived dietary deficiencies, were cited most frequently. Therapies used included biofeedback, massage, chiropractic, and podiatry. Information was obtained from the physician or nurse practitioner and supplemented with material from other sources. Conclusions:Respondents were discriminating users of the products they selected and were satisfied with the results, although they did not always have accurate understanding of the effects of the supplement or therapy. Implications:Health professionals need to have knowledge about CAMand to include questions about use during patient encounters. Providers must take time to answer questions and provide userfriendly information.

Complementary therapy and older rural women: who uses it and who does not?

Background: Despite the growing use of complementary therapy by consumers in the United States, very little is known about the factors associated with the use of these therapies among older rural women. Objective: The aim of this study was to answer the following research question using data from a portion of a larger study: What factors predict the use of complementary therapy among older rural women? Methods: Data were collected by telephone interview from a random sample of older residents of 19 rural towns in Montana and North Dakota. Interviews were conducted using a guide that included questions about the use of allopathic and complementary healthcare and related issues such as health status, health problems, and reasons for seeking care. A direct logistic regression analysis was performed on the use of complementary or alternative medicine (CAM) as outcome and eight potential predictors. Data from 156 women were included in this analysis. Results: A total of 25.6% (n = 40) of the women reported using CAM in the recent past. Rural women most likely to use CAM were those who were fairly well educated, not currently married, and in their early older years. They had one or more significant chronic illnesses and lower health-related quality of life due to emotional concerns. Discussion: By improving the existing understanding of who is or is not likely to use CAM, the results of this study can be used in giving comprehensive care for rural women, including all healthcare practices, self-care and practitioner provided, and complementary and conventional.

Research Careers for American Indian/Alaska Native Nurses: Pathway to Elimination of Health Disparities

The health status of American Indians/Alaska Natives lags behind that of the US population. American Indian/Alaska Native (AIAN) nurses are on the front lines of health services for AIAN people. They have the potential to make scientific contributions as well, but are under-represented among researchers working to understand health disparities. The AIAN MS-to-PhD Nursing Science Bridge, at the University of Minnesota, in partnership with the Universities of North Dakota and Oklahoma, provides support for AIAN nurses during the critical training transition from masters of science to doctoral programs. Partner schools collaborate with AIAN elders, medicine people/spiritual leaders, and academic consultants to (1) foster academic success and strengthen the AIAN identity of students during their research training and (2) bring about institutional change to optimize student experiences. Future research programs developed by this cadre of AIAN nurse scientists will contribute scientifically sound, culturally acceptable knowledge to effectively improve the health of AIAN people.

The Montana State University Conceptual Model of Complementary and Alternative Medicine Health Literacy

This article aims to present and describe a model of complementary and alternative medicine (CAM) health literacy. The model is the conceptual basis for CAM health literacy, which is operationally defined as the information about CAM needed to make informed self-management decisions regarding health. Improving health literacy is a national priority, and widespread use of CAM has added to the complexity of this task. There are no currently available models or measures of health literacy regarding CAM. The authors developed the model using an iterative process of deriving concepts, constructs, and empirical indicators from the literature and the authors prior work, review and critique by experts, and revision. The model of CAM health literacy can serve as the basis for future research on the use and efficacy of CAM and the constructs and concepts within it can be used to identify points of intervention for research or for clinical practice. It is anticipated that the model will have scientific and clinical application for assessing health literacy in other self care decision-making situations.

Psychometric Testing of the FACES III with Rural Adolescents.

This study tests the validity and reliability of the Family Adaptability and Cohesion Scale III (FACES III) in two samples of rural adolescents. The underlying theory is the linear 3-D circumplex model. The FACES III was administered to 1,632 adolescents in Grades 7 through 12 in two counties in a rural western state. The FACES III Scale and the Cohesion Scale demonstrated high internal consistency, although the Cohesion Scale was more consistently predictive of self-esteem and higher in internal consistency than was the Adaptability Scale. Findings confirmed previous methodological critiques regarding linearity, the correlation of factors, and internal consistency. The presence of two orthogonal factors was consistent with the original 3-D circumplex model, but items from the Adaptability Scale relating to changing of rules for childrens roles and egalitarianism tended to be problematic.

Satisfaction with and benefits of a psych-social club: development of a mixed method evaluation instrument.

There are no instruments for validation or evaluation of a members satisfaction of and benefits with psych-social clubs. This article reports on the development and testing of the mixed-method instrument entitled Benefits and Satisfaction Tool for Members of a Psych-social Club (B&ST-MPC), which evolved from findings of a qualitative research study. The alpha reliability coefficient was .92. The Kaiser-Meyer-Olkin Test yielded a value of .812. The items loaded on 3 factors. Utilization of B&ST-MPC supports development of services for rural communities through feedback from consumers. Further testing of the B&ST-MPC in settings with diverse populations is recommended.

Caring for Mexican-American Clients

There are growing Mexican-American populations in rural areas. This editorial is a continuation of the previous column on communicating with those clients. Dr. Loretta Heuer, associate professor at the University of North Dakota, again offers suggestions to help rural nurses in caring for them. One major issue is the use of an interpreter. There are two styles of interpreting, line-by-line and summarizing. Line-by-line interpretation ensures accuracy but takes more time; one can only speak few sentences at a time and must use simple language, no medical jargon. Summarizing is faster and useful in teaching relatively simple health techniques with which the interpreter is already familiar.