The Duke Activity Status Index (DASI) in Rural Rocky Mountain Women: Tailoring the Evidence-Based Perspective

Thursday, 10 July 2008: 1:55 PM
Maria Kidner, FNP-BC, MSN , Cardiology, Internal Medicine Group, Cheyenne, WY
Janice Unruh Davidson, PhD, INS, RN, CNAA, FNP-BC, FAANP , Rocky Mountain University of Health Professions, Provo, UT

Learning Objective 1: Articulate the importance of tailoring population-specific evidence-based practice findings.

Learning Objective 2: Differentiate cardiac functional capacity assessments and their predictive value in population-specific healthcare.

Rural women frequently underestimate their health risks and symptoms, yet they are commonly at risk for cardiac disease. Moreover, rural women are not often tested for functional capacity because they tend to present later in the disease process due to: poor detection, poor utilization of healthcare services, or lack of provider knowledge, resulting in poor outcomes and increased mortality. When these problems are combined with the geographical challenges of rural healthcare, having a valid and reliable tool for such women could augment the capability of rural providers to provide population-specific evidence-based practice, leading to enhanced decision-making regarding testing, risk-stratification, and treatment outcomes. Objectives: The purpose of this study was to describe the level of cardiac functional capacity using the Duke Activity Status Index (DASI) and exercise treadmill test (ETT) metabolic equivalents (METs) calculations in rural women of the Rocky Mountain region of the United States for validation of the DASI and tailoring of population-specific evidence-based practice. Design and Methods: This paper is the result of a descriptive-correlational study that utilized evidence-based practice methodology to generate the research questions and level of scientific inquiry for the purpose of the study. Population, Sampling and Setting: The population of interest was rural Rocky Mountain women who had been previously referred for an ETT to a selected specialty practice located in Cheyenne, Wyoming. Findings and Conclusions: Results of the study indicate a statistically significant relationship between the findings of previous research involving the DASI and current research supporting the validity of the DASI in rural women from the Rocky Mountain region. Implications and Recommendations: Implications for advanced nursing practice are drawn as they relate to furthering best practices of advanced practice nurses from a population-specific perspective. Recommendations for further research and those effective evidence-based practice strategies regarding population-specific cardiac care are proposed.