Problem: Rural women often underestimate their health risks and symptoms, yet they may be at risk for cardiac disease. However, rural women are often not tested for functional capacity largely 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 combined with the geographical challenges of rural areas. Thus, having a validated and reliable tool for these women could immensely augment the capacity of rural providers to provide tailored care based on evidence-based research enabling appropriate decisions on testing, risk-stratification, and treatment evaluations. Purpose and Scope: 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 in the Rocky Mountains to determine if the relationship of the DASI to METs is similar to that in published literature. Goal: To seek to describe the level of cardiac functional capacity using the DASI and ETT calculated METs rural women living in the Rocky Mountain West with the findings to close the gap of nursing knowledge about the need for tailoring healthcare for rural Rocky Mountain women with potential cardiac disease. Objectives: First, describe the sample cohort in terms of demographics, lifestyle, medical history, and current symptomology. Second, explore the relationships of the DASI METs to actual METs obtained in a corhort of rural Rocky Mountain women who underwent an ETT for evaluation of CVD. Third, discern whether altitude is relative to DASI METs and actual METs. Fourth, determine whether the hemodynamics of mean arterial pressure, pulse pressure, and/or heart rate recovery data impact the predictive value of DASI METs. Plan: Phase One: Conduct a needs assessment using systematic review of literature. Phase Two: Design a clinical research project for the evaluation of the DASI survey to recently obtained ETT and obtain IRB approval. Phase Three: Implement the clinical project upholding evidence-based medicine, research ethics, and protection of human rights for a project sample. Phase Four: Analyze the data for correlations of the DASI METs to actual METs and compare to outcomes in previously published literature using descriptive statistics and Pearson Correlation coefficient. Outcomes and Results: Although the DASI correlates to rural women who achieved a functional capacity greater than 7 METs, there is no correlation to women of lower functional capacity and all women over-estimated their functional capacity by the DASI. This result deviates from published literature and suggests that the DASI survey should not be used in this rural female population for risk-stratification as recommended in the 2002 ETT guidelines to identify women with poor capacity. Evidence-based practice needs to be tailored to the specific population of interest to provide the best care.
