Developing a scale to measure denial levels of clients with actual or potential myocardial infarctions

To refine and test the Robinson Self-Appraisal Inventory-Form D (RSAI-Form D), a self-administered scale designed to measure denial in coronary clients.

Exploratory research.

Two midwestern medical centers.

The sample was composed of 130 patients 75 years of age and younger with actual or potential myocardial infarction.

Two instruments, the Demographic Data Form and the RSAI-Form D, were completed by the participants.

Cronbach's coefficient alpha, factor analysis, t test, and stepwise multiple regression were used in the data analysis. A coefficient alpha for the 20-item scale was 0.80 for both Day 2 and Day 4. Day 2 and Day 4 oblique rotations revealed that items loaded on four factors but did not load on the same factors for both days: therefore, factors were identified for each day. There was a significant decrease in RSAI-Form D scores from the second to fourth hospitalized day (t = 5.83, p = 0.001). Two predictors, number of prior hospitalizations of chest pain, and whether or not the individual had sustained a myocardial infarction this admission (identified by stepwise multiple regression) explained 9.4% of the variance in the change in RSAI-Form D scores from Day 2 to Day 4 (F[2, 127] = 6.55, p = 0.001).

Findings of the study did provide preliminary evidence that the RSAI-Form D is a reliable and valid inventory. Four aspects of denial were extracted, thus providing supportive evidence to the nurse that the use of single specific or global criteria does not provide sufficient data for assessing denial.