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Background The use of the Internet to administer questionnaires has many potential advantages over the use of pen-and-paper administration. Yet it is important to validate Internet administration, as most questionnaires were initially developed and validated for pen-and-paper delivery. While some have been validated for use over the Internet, these questionnaires have predominately been used amongst the healthy general population. To date, information is lacking on the validity of questionnaires administered over the Internet in patients with chronic diseases such as heart failure. Objectives To determine the validity of three heart failure questionnaires administered over the Internet compared to pen-and-paper administration in patients with heart failure. Methods We conducted a prospective randomized study using test-retest design comparing administration via the Internet to pen-and-paper administration for three heart failure questionnaires provided to patients recruited from a heart failure clinic in Toronto, Ontario, Canada: the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Self-Care Heart Failure Index (SCHFI). Results Of the 58 subjects enrolled, 34 completed all three questionnaires. The mean difference and confidence intervals for the summary scores of the KCCQ, MLHFQ, and SCHFI were 1.2 (CI -1.5 to 4.0, scale from 0 to 100), 4.0 (CI -1.98 to 10.04, scale from 0 to 105), and 10.1 (CI 1.18 to 19.07, scale from 66.7 to 300), respectively. Conclusions Internet administration of the KCCQ appears to be equivalent to pen-and-paper administration. For the MLHFQ and SCHFI, we were unable to demonstrate equivalence. Further research is necessary to determine if the administration methods are equivalent for these instruments.

A fully online prior learning assessment and recognition (PLAR) tool for internationally educated nurses (IENs) was developed and tested by an inter-professional team at Ryerson University. The tool consisted of two stages: a self-assessment component followed by a multiple-choice examination and narrative (vignette) evaluation. The purposes of the study were to describe the demographic profile of the IEN registered nurse (RN), to develop the benchmark responses that demonstrate competency at the entry-to-practice level of the typical IEN RN, and to describe the experience of completing an online PLAR tool. A mixed-method approach was used. Findings demonstrated that IEN RNs who immigrate to Ontario, Canada, are of various ages and come from a wide spectrum of countries. The PLAR process holds promise for an objective assessment of IEN's eligibility to write the Canadian Registered Nurses Examination (CRNE) and to meet a global need. Further testing of the tool across a broader sample is required. (Contains 5 figures and 2 tables.)

Behavior changes can significantly improve outcomes for patients in the cardiac rehabilitation population. The authors examined the influence of time perspectives on health-promoting behaviors of patients for whom the future might be perceived as limited, although goal-directed behavior changes are crucial. Measures included the Zimbardo Time Perspective Inventory and the Health-Promoting Lifestyle Profile II (HPLPII). In this study of 74 cardiac participants with a mean age of 60.2 years, the preponderant time perspective was found to be past-positive orientation. The authors discuss the effects of a life-threatening event and older age on time perspective and health-promoting behaviors and consequent implications for cardiac rehabilitation programs. Index Terms: cardiovascular disease, health behavior, time perspective, Patients with coronary artery disease are at high risk of morbidity and mortality. (1,2) Among those patients who have had a myocardial infarction, the risk of reinfarction is between 5% [...]

In this article, we highlight the use of music as an interpretive lens to understand patients' experiences of discharge following open-heart surgery. We adopted an arts-informed narrative methodology and interviewed participants at 1 and 4-6 weeks following discharge. Our secondary analysis followed an aesthetic approach that involved application of musical principles including rhythm, timing, and tone to frame our interpretation. We found that the tensions, harmony and relational dynamics between patients and practitioners were best elucidated when viewed through the lens of a solo concerto; this is orchestral work that features a soloist. Our findings have an impact on the discourse of patient-centered care and the need to re-orient communication measures so that practitioners can access the internalized space of patients' mind and body. Since music as an interpretive lens is embryonic in its development, its use has expansive implications for fostering aesthetic knowing in research and health care. [ABSTRACT FROM AUTHOR]

A fully online prior learning assessment and recognition (PLAR) tool for internationally educated nurses (IENs) was developed and tested by an inter-professional team at Ryerson University. The tool consisted of two stages: a self-assessment component followed by a multiple-choice examination and narrative (vignette) evaluation. The purposes of the study were to describe the demographic profile of the IEN registered nurse (RN), to develop the benchmark responses that demonstrate competency at the entry-to-practice level of the typical IEN RN, and to describe the experience of completing an online PLAR tool. A mixed-method approach was used. Findings demonstrated that IEN RNs who immigrate to Ontario, Canada are of various ages and come from a wide spectrum of countries. The PLAR process holds promise for an objective assessment of IEN's eligibility to write the Canadian Registered Nurses Examination (CRNE) and to meet a global need. Further testing of the tool across a broader sample is required. [ABSTRACT FROM AUTHOR]

The design of current educational initiatives for heart surgery patients is based on feedback from individuals of Western European origin. The relevance of these initiatives is unknown when provided to individuals from non-Western European cultures. This study examined the cultural relevance of heart surgery patient educational initiatives delivered to individuals of diverse backgrounds. It used a non-experimental descriptive design involving 252 participants. Cultural relevance was assessed through self-care behaviours performed as recommended in the educational initiative. The participants of non-Western European origin were found to engage in more work-related activities and fewer self-care behaviours than their Western European counterparts in the first week following hospital discharge, indicating lack of adherence to educational recommendations. The study provides preliminary evidence suggesting that current self-care educational initiatives may not be culturally relevant. Continued evaluation to determine reasons why specific cultural groups engage in specific types of behaviour is needed.

Objective: The study's objective was to evaluate patients attending a cardiac secondary prevention clinic on their accessibility to the Internet and to investigate their perceptions on using the Internet to obtain educational information for secondary prevention., Design: This was a prospective, descriptive, cross-sectional project., Setting: The study took place at a tertiary care hospital in Southern Ontario, Canada., Subjects: The subjects were 50 individuals attending a cardiac secondary prevention clinic. They were primarily male (80%) with an average age of 60 years., Measures: A self-administered questionnaire was used that identified demographics, current Internet access, experience with using the Internet for health care information, and perceptions of the utility of Internet information., Results: Sixty-six percent had Internet access at home, and 51% said they used the Internet daily. A significant number of participants indicated they would access an Internet site for continued educational support after discharge from a secondary prevention cardiac clinic., Conclusion: The results from this project evaluation suggest that Internet-based education would be a valuable adjunct to current secondary prevention care delivery models.

Little attention has been given to the dietary patterns of new immigrant women in Canada. Research suggests that before migration, many immigrants, especially those from non-Western countries, consume a healthy diet, but this changes on migration. This paper presents information from a recently completed literature review conducted for the Women's Health Council of the Ontario Ministry of Health and Long-Term Care. The paper includes a review of the major determinants of food choice and health promotion strategies appropriate to new immigrant women. Our findings suggest that nutrition intervention for new immigrant women must consider the social context of these women's lives, address cultural, linguistic, economic and informational barriers and consider how these change over time. Recommendations are also made on how to best promote healthy eating in this group.