What Women Want to Know: Using Mixed Methods to Assess the Value, Relevance, and Efficacy of a Self-Management Intervention for Rural Women with Coronary Heart Disease (CHD)

Wednesday, July 13, 2011: 11:10 AM

Holly Evans Madison, PhD, RN
RN to BS Nursing, Maria College, Albany, NY

Learning Objective 1: Discuss how mixed methods design can be used to assess the value and efficacy of a self-management educational intervention.

Learning Objective 2: Describe how this study contributes to knowledge of the informational needs of rural women with coronary heart disease (CHD).


Women have experienced increased mortality from CHD over the last two decades, while men’s rate has declined (AHA, 2020).  This suggests that current treatment and prevention strategies are less effective for women and alternatives to these programs are needed. The purpose of this study was to assess the value and relevance of a self-management educational intervention for rural women with heart disease. Additionally, pilot data regarding the efficacy of the intervention was obtained through the use of mixed methods.


Mixed methods was utilized in this longitudinal study.  Focused qualitative interviews provided data regarding the self-management program.  The program’s efficacy was determined through in-depth interviews and a self-efficacy scale.  The self- and family management framework underpinned this study (Grey, et al., 2006). Ten women from rural New England, diagnosed with CHD, comprised the purposeful sample.


Refinement of the intervention, based on the women’s feedback, included an emphasis on the psychosocial aspects of disease management.  The interviews indicated that the women were confident in their ability to manage their disease; findings that were congruent with the self-efficacy scale results.  Improvement was seen in five of six items on the scale from pre- to one month post intervention.  The women’s confidence in managing other symptoms or health problems and management of problems related to heart disease saw a statistically (> .05) significant increase post intervention. 


This study demonstrated that it's important to involve patients in the design of educational interventions, since they are experts. The pilot data suggests that a self-management program, focusing on the needs of women, assists them in managing their disease.


American Heart Association (AMA). (2010). Heart disease and stroke statistics. http://www.americanheart.org?presenter.jtml?identifier=4977.

Grey, M., Knafl, K., &  McCorkle, R. (2006). A framework for the study of self-and family management of chronic conditions. Nursing Outlook,54(5), 278-286.