Implementation of Efficacy Enhancement Nursing Interventions with Cardiac Elders

Abstract

Intervention strategies based on social cognitive theory and encompassing the bio-psycho-behavioral domains are proposed to enhance self-efficacy in men and women 65 years and older recovering from myocardial infarction and coronary artery bypass grafting. This paper describes a study in which the theory-based development of efficacy enhancement (EE) nursing interventions and their implementation and utilization with interventions from the Nursing Interventions Classification (NIC) were used with cardiac elders in the treatment group of the community-based randomized clinical, trial, "Improving Health Outcomes in Unpartnered Cardiac Elders." Advanced practice nurses (APNs) provided the nursing intervention to 110 participants (mean age = 76.2, SD = 6.0) for the first 12 weeks after discharge to home. After an initial introductory meeting in the acute-care setting, participant contacts by the APNs were made at a home visit and telephone calls at 2, 6, and 10 weeks. Results describe the number of participants receiving interventions at all contacts over 12 weeks, at specified contact points, and the intensity (nurse time) of the interventions. Verbal encouragement and mastery were EE interventions used with the greatest number of participants. Exercise promotion, energy management and active listening were NIC interventions used with the most participants. Variations in the use of interventions over 12 weeks and their intensities, suggest patterns of recovery in the elders. During rehabilitation EE interventions can be successfully implemented with men and women 65 years and older and individualized to the recovery trajectory. Nurses can integrate specific EE interventions with more general interventions from the bio-psycho-behavioral domains to enhance the recovery process for cardiac elders.

Cardiac Rehabilitation on Health Behaviors and Clinical Outcomes Among Myocardial Infarction Patients

“…Verbal persuasion was utilized by providing educational and sharing sessions involving the patient's family. Hiltunen, Winder, Rait, Buselli, and Al [22] also reported that encouragement and patient education was effective to promote selfefficacy of health behavior after a cardiac event. The physiological and emotional responses were provided with information about normal sensations and any possible physical discomforts.…”

Self-Management Program for People with Chronic Kidney Disease in Vietnam: A Pragmatic Randomised Controlled Trial

“…For example, some participants listed their favourite foods and were then assisted to choose appropriate food for CKD. Earlier studies also indicated that verbal encouragement and support were important for telephone coaching to enhance efficacy in people with chronic diseases (Carroll, Robinson, Buselli, Berry, & Rankin, 2001;Hiltunen et al, 2005). These studies suggested the effect of using verbal persuasion in providing further support and encouragement for people with chronic disease (Carroll et al, 2001;Hiltunen et al, 2005).…”

“…Earlier studies also indicated that verbal encouragement and support were important for telephone coaching to enhance efficacy in people with chronic diseases (Carroll, Robinson, Buselli, Berry, & Rankin, 2001;Hiltunen et al, 2005). These studies suggested the effect of using verbal persuasion in providing further support and encouragement for people with chronic disease (Carroll et al, 2001;Hiltunen et al, 2005). The use of verbal persuasion was reported in only one pre-dialysis CKD study from the existing literature (Kazawa & Moriyama, 2013), which was developed based on the National Standards for Diabetes Self-management Education.…”

“…That review revealed that none of the self-management programs in the review aimed to improve participants' self-efficacy by using all of the four information sources that are crucial to SCT. Two studies, one in diabetes in China (Ha et al, 2014) and the other in cardiac disease in the U.S. (Hiltunen et al, 2005), described the use of all four information sources to enhance the level of selfefficacy. Similar to these studies, performance accomplishment and verbal persuasion were the two main strategies used during this current study.…”

“…Participants in the intervention group reported that follow-up strategies were useful to help them better self-manage their kidney disease. Telephone support is recognised to be a useful strategy to reinforce education information and encourage participants to change their health behaviours (Carroll et al, 2001;Hiltunen et al, 2005).…”