Self-efficacy in women following myocardial infarction: An investigation into the effects of a cognitive -interactive nursing intervention on efficacy enhancement

Valuable and extensive research into the recovery management of myocardial infarction patients has been conducted over the past 25 years. Innovative approaches to rehabilitation have been directed at enhancing patient function across the physiological, psychological, sociological, educational, and vocational aspects of recovery. Planned outcomes within these innovative programs, however, have been generated from research on the recovery experiences of predominately middle-aged male patients. As a result, the unique recovery experiences and needs of women following myocardial infarction are not addressed in an effective and consistent manner. One successful approach to improved rehabilitation postinfarction has be documented in recent research that utilizes Bandura\u27s (1986) theory of self-efficacy as framework. It upholds the premise that strategies may be employed to effective help individuals mobilize cognitive resources that can increase one\u27s level of confidence resulting in improved recovery outcomes. It is being proposed that confidence of female patients may be enhanced if suggested lifestyle changes were reflect the specific challenges of women postinfarction. A complementary interaction dimension is being proposed to enhance the notions set forth by the cognitively-processed interventions. A Nursing Model of Efficacy and Interaction, an integration of Bandura\u27s Self-efficacy Theory and Symbolic Interaction, provides the framework through which the following hypotheses were tested: (1) Women exposed to a cognitive model of intervention and those exposed to a cognitive-interactive model of intervention win have higher self-efficacy scores following treatment than women exposed to routine treatment, when pretreatment measures of self-efficacy are statistically controlled. (2) Women exposed to a cognitive-interactive model of intervention will have higher self-efficacy scores following treatment than women in a cognitive model of intervention, when pretreatment measures of self-efficacy are statistically controlled. The three-group pretest-posttest control group design was used to test the hypothesis. Fifty-three women who experienced myocardial infarction agreed to participate in the study and were prerandomly assigned to one of the three treatment groups. Pre- and posttest measures were obtained from an instrument scale entitled Life-style Management Post-myocardial Infarction: A Self-efficacy Scale Packet for Women (LSM-PMI). Results of Analysis of Covariance (ANCOVA) revealed that there were no statistically significant differences on efficacy scores among women exposed to the three models of intervention. Additionally, there were no statistically significant differences on efficacy scores of women exposed to the cognitive and routine protocols, or between women exposed to the cognitive and cognitive-interactive treatment protocols. However, women who were exposed to the cognitive-interactive model of intervention scored significantly higher on the posttreatment LSM-PMI than women who were exposed to routine treatment