title: Comparing interventions in older unpartnered adults after myocardial infarction.
abstract: BACKGROUND
  Older adults after myocardial infarction (MI) are a vulnerable group who may benefit from interventions to improve health outcomes. The use of a peer advisor or an advanced practice nurse (APN) to provide a self-efficacy intervention is a promising method of improving health outcomes after MI.
  
  
  OBJECTIVE
  The purpose of this paper was to compare the effect of two self-efficacy interventions, a peer advisor and an APN, to a group who received standard care after MI.
  
  
  METHODS
  The study was a three-group randomized clinical trial with a peer advisor intervention group, an APN intervention group, and a standard care group. Outcome data were collected in the hospital after MI and by telephone at 12 weeks after hospital discharge, after the interventions were completed.
  
  
  RESULTS
  At 12 weeks after MI, there were no significant differences between the 3 groups in health outcomes. There were similar changes in self-efficacy for performing recovery behaviors, the actual performance of recovery behavior, physical and mental health across both intervention groups and the standard care group.
  
  
  CONCLUSIONS
  Although the data did not validate the benefits of these self-efficacy interventions, future efforts at identifying changes in health outcomes may need to use more discrete measurements that are more sensitive to changes in the older unpartnered adult after an MI.
authors.affiliation: Department of Nursing, GRB 1034, Massachusetts General Hospital, Boston, MA 02114, USA. dcarroll3@partners.org
authors.forename: Diane L
authors.initials: DL
authors.lastname: Carroll
authors.forename: Sally H
authors.initials: SH
authors.lastname: Rankin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000523:psychology; D001294:Attitude to Health; D005260:Female; D015577:Geriatric Assessment; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D010379:Peer Group; D015397:Program Evaluation; D011446:Prospective Studies; D020127:Recovery of Function; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012657:Self-Help Groups / Q000458:organization & administration*