Selecting a theoretical framework for chronic cardiovascular disease self-management among rural dwelling adults

A paucity of research has examined the factors and perceptions of self-management among individuals living rurally with chronic cardiovascular disease (CCVD). Exploration of this population is prudent as CCVD continues to be the leading cause of mortality within the United States (US). As the US population ages, increased rates of CCVD and the process of managing the disease will continue to challenge patients and the health care system. Rural dwelling adults are faced with additional complexities to manage a chronic disease, resulting in higher rates of chronic disease as compared to urban dwellers. It is essential for nurses working with adults living with CCVD in rural areas to promote self-management strategies derived from a theoretical perspective. The purpose of this paper is to examine theories and models that facilitate self-management of CCVD among rural dwelling adults. Three established self-management theories and models from psychology and public health were evaluated using Walker and Avant's framework for theory analysis. Social cognitive theory was selected as a best fit for self-management of CCVD among rural dwelling adults, due to the symbiosis of chronic disease, and applicability of ruralness within the triadic reciprocal causation of person-behavior-environment of the model.