Rural women, technology, and self-management of chronic illness

Abstract The objective of this study was to determine the differences in the psychosocial status of 3 groups of chronically ill rural women participating in a computer intervention. The 3 groups were: intense intervention, less-intense intervention, and control. At baseline and following the intervention, measures were taken for social support, self-esteem, empowerment, self-efficacy, depression, stress, and loneliness. ANCOVA results showed group differences for social support and self-efficacy among the overall group. The findings differed for a vulnerable subgroup, with significant betweengroup differences for social support and loneliness. It was concluded that a computer-delivered intervention can improve social support and self-efficacy and reduce loneliness in rural women, enhancing their ability to self-manage and adapt to chronic illness. Keywords rural; chronic illness; computer-based intervention; psychosocial outcomes Adapting one's life to accommodate the challenges of a chronic illness and perfecting one's self-management skills require constant effort and adjustment, especially in the psychosocial realm. The meaning of this statement is clearer if it is expressed by someone who faces the challenge on a daily basis: When we have an illness that continues, we have no choice but to change. [But] I like to continue to grow and change at MY pace. When you have an illness, I think it forces you to change and grow in different ways than what we would choose normally. It is not necessarily bad, but it is against our normal will. (Kralik, 2002, p. 152) Learning to adjust, with some equanimity, to lifestyle changes imposed by long-term illness is a challenge. For rural women with chronic conditions who live in relative isolation and have limited access to support systems and health services, appropriate self-care is vital. These women often have difficulty finding the support and assistance they need in order to adapt to the alterations in physical functioning, the loss of control over life circumstance, and the attendant emotional strai