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Background and Research Objective: Heart failure (HF) patients experience frequent episodes of decompensation. While medication and behavior change play a major role in maintaining physiological stability, patient adherence to self-care recommendations is not optimal. The Theory of Heart Failure Self-care helped to understand the concepts of self-care and chose a model of intervention. Conviction and confidence are central factors in facilitating self-care. Motivational interviewing (MI), which aims to strengthen conviction and confidence, has been shown to improve self-care. In addition, the Transtheoretical Model, based on patients' readiness to change, also has proven efficacy. The MI based on the stages of change (MISC), a combination of MI and Transtheoretical Model, offers promise for improving self-care. The goal of this pilot study was to evaluate the preliminary effect of an MISC intervention on HF patients' self-care behaviors. Subjects and Method: Thirty patients were recruited from an HF clinic and randomly assigned to an experimental (EG) or control group (n = 15/group). Patients from the EG received 3 interventions (1 in person, 2 on the phone). Data were collected at baseline and at 1 month after randomization. The effect of the intervention was assessed on 5 self-care outcomes using analysis-of-covariance models. Results and Conclusion: Significant results were obtained regarding the confidence in performing self-care behaviors specific to HF (P =.005). Although the results of the other hypotheses were not statistically significant, for the majority, trends were in the expected direction in favor of the EG. The study suggests that an MISC intervention is useful to increase patients' confidence in HF self-care and has potential to improve self-care. Further research is needed. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to evaluate the construct validity of the four-dimensional Caring Nurse-Patient Interaction-Short Scale using confirmatory factor analysis. BACKGROUND: Validating theoretical structures of caring is an ongoing challenge in the discipline of nursing. Our previous work has contributed to this literature by the exploration of the dimensionality of the Caring Nurse-Patient Interaction Short Scale via an exploratory factor analysis. The Caring Nurse-Patient Interaction Short Scale comprises 23 items reflecting four caring domains: humanistic care, relational care, clinical care and comforting care. METHOD: A methodological study was conducted involving a convenience sample of 531 nursing students in a baccalaureate nursing programme (20% were already Registered Nurses). Data were collected in 2002 and 2004. Confirmatory factor analysis of the Caring Nurse-Patient Interaction Short Scale was performed. FINDINGS: As expected with large samples and models, the chi-squared-associated P-value was statistically significant (chi2 = 811.43, d.f. = 224, P < 0.01). However, the other indices reached acceptable levels with 0.054 for the standardized root mean-squared residuals, 0.070 for the root mean-square error of approximation, 0.88 for the goodness of fit index, 0.98 for the comparative fit index and 0.97 for the normal fit index. The factor loadings for all items with their hypothesized factor were > or = 0.48 and statistically significant at the 0.01 level. CONCLUSION: The Caring Nurse-Patient Interaction Short Scale model was judged to fit the data adequately. Although further testing of the scale with different samples of patients is warranted, our model emerged as a middle-range theory during the construct validity process and still reflects Watson's theory while offering a structure that is testable in clinical research. [ABSTRACT FROM AUTHOR]

While there is a large body of literature regarding caring in nursing and some measurement tools addressing the concept have been developed, limitations of existing instruments constrain theory-driven research on nurse-patient interactions. The purpose of this paper is to describe the development and initial psychometric evaluation of the Caring Nurse-Patient Interactions Scale in a sample of 332 nurses and nursing students. The tool intended to facilitate research on the links between caring and patient outcomes. A content validity approach involving 13 expert nurses resulted in a 70-item tool sub-divided into 10 nursing carative factors. Alpha coefficients between sub-scales varied from .73 to .91 and sub-scales inter-correlations ranged from .53 to .89. Pearson correlation coefficients ranged from --.02 to .32 between the sub-scales and social desirability suggesting low to moderate bias. Results of the contrasted group approach partially supported the hypotheses while all differences were in the expected direction. Results suggest that the scale has strong potential for use in research, clinical and educational settings. [ABSTRACT FROM AUTHOR]

This paper examines the types of nursing approaches associated with reductions in psychological distress in post-myocardial infarction patients (n=275 men; 156 women) who took part in a home-based psychosocial nursing Intervention program (Montreal Heart Attack Readjustment Trial). We found that three types of emotionally supportive approaches including reassurance/encouragement, listening and the provision of advice varied in their links to reduction in distress depending on patients' types of concerns. There were also gender differences in the way directive and collaborative intervention approaches were related to changes in distress. [ABSTRACT FROM AUTHOR]

Objective: The objective of this secondary analysis was to examine the relationships between a reduction in psychological distress and long-term cardiac and psychological outcomes in post-myocardial infarction patients who participated in a randomized trial of home-based psychosocial nursing interventions (the Montreal Heart Attack Readjustment Trial [M-HART]). Gender differences were considered.Methods: We studied 433 patients (36.0% women) from the M-HART treatment group who received two home visits after achieving a high psychological distress score (ie, > or =5) on the General Health Questionnaire (GHQ). Short-term GHQ success was determined by a return to a normal GHQ score (<5) or a reduction of > or =50% after the two visits. Patients with short-term successful and unsuccessful GHQ outcomes were compared for mid-term maintenance of success, 1-year death and readmission rates, and 1-year depression and anxiety symptoms.Results: Patients with short-term GHQ success were more likely to show mid-term GHQ success (p < .001), marginally less likely to die of any causes (p = .087), less likely to die of cardiac causes (p = .043), less likely to be readmitted for any reason (p < .001) and for cardiac reasons (p < .001), and less likely to have high depression (p < .001) and anxiety (p < .001) at 1-year than patients with short-term unsuccessful GHQ outcomes. Results held for men and women and were not altered by controlling for potential confounders. However, the number of deaths prevented analysis with statistical controls.Conclusions: Post-myocardial infarction interventions that reduce psychological distress have the potential to improve long-term prognosis and psychological status for both men and women. [ABSTRACT FROM AUTHOR]