Implementation of efficacy enhancement nursing interventions with cardiac elders

Area of Science:

• Nursing Science
• Cardiology
• Gerontology
• Health Psychology

Background:

• Older adults recovering from myocardial infarction (MI) and coronary artery bypass grafting (CABG) often experience decreased self-efficacy.
• Social Cognitive Theory provides a framework for developing interventions to enhance self-efficacy in this population.
• The "Improving Health Outcomes in Unpartnered Cardiac Elders" study aimed to address these challenges.

Purpose of the Study:

• To describe the development, implementation, and utilization of theory-based efficacy enhancement (EE) nursing interventions.
• To integrate EE interventions with existing Nursing Interventions Classification (NIC) interventions for cardiac elders.
• To enhance self-efficacy in men and women aged 65 and older post-MI or CABG.

Main Methods:

• A community-based randomized clinical trial involving 110 participants (mean age 76.2 years).
• Advanced practice nurses (APNs) delivered interventions for 12 weeks post-discharge, including home visits and telephone calls.
• Interventions were based on Social Cognitive Theory and included EE strategies and NIC interventions.

Main Results:

• Verbal encouragement and mastery were the most frequently used EE interventions.
• Exercise promotion, energy management, and active listening were the most utilized NIC interventions.
• Variations in intervention use and intensity suggested distinct recovery patterns among participants.

Conclusions:

• Efficacy enhancement interventions can be successfully implemented and individualized for older cardiac patients during rehabilitation.
• Nurses can integrate EE interventions with bio-psycho-behavioral interventions to optimize recovery for cardiac elders.
• This approach supports enhanced self-efficacy and recovery trajectories in this demographic.