A questionnaire on treatment satisfaction and disease specific knowledge among patients with acute coronary syndrome. II: Insights for patient education and quality improvement

Existentially Oriented Group Intervention for Patients With Heart Failure: Intervention Development and Preliminary Assessment

BACKGROUND

Patients with heart failure (HF) cope with a chronic, life-threatening, particularly disabling medical condition. Their well-being is considered to be at a greater risk than that of patients with any other cardiovascular disease, and their psychological distress is associated with a worse prognosis. These patients are often preoccupied with existential concerns such as fear of death, loneliness, and a loss of sense of meaning. However, there is a dearth of literature regarding psychological interventions that address these issues among this population.

AIMS

We, the authors of the current pilot study, present the development and initial implementation of a novel protocol: "existentially oriented group intervention for patients with heart failure." Our aims were to test the intervention's feasibility, as well as to explore patients' subjective experience of it.

METHODS

The intervention (consisting of seven 1-hour weekly sessions) was applied to 2 consecutive groups. Twelve patients coping with HF levels III and IV-according to the New York Heart Association classification-from a hospital-based HF clinic participated. The Narrative Evaluation of Intervention Interview was applied.

RESULTS

Although high dropout levels were detected, the patients who fully participated in the program reported on satisfaction and progress in the following 4 domains: personal growth, social support, self-worth, and mastery.

CONCLUSIONS

On the basis of our preliminary findings, the "existentially oriented group intervention for patients with heart failure" is recommended to be further tested among patients coping with HF.

Psychometric evaluation of a multi-dimensional measure of satisfaction with behavioral interventions

Treatment satisfaction is recognized as an essential aspect in the evaluation of an intervention's effectiveness, but there is no measure that provides for its comprehensive assessment with regard to behavioral interventions. Informed by a conceptualization generated from a literature review, we developed a measure that covers several domains of satisfaction with behavioral interventions. In this paper, we briefly review its conceptualization and describe the Multi-Dimensional Treatment Satisfaction Measure (MDTSM) subscales. Satisfaction refers to the appraisal of the treatment's process and outcome attributes. The MDTSM has 11 subscales assessing treatment process and outcome attributes: treatment components' suitability and utility, attitude toward treatment, desire for continued treatment use, therapist competence and interpersonal style, format and dose, perceived benefits of the health problem and everyday functioning, discomfort, and attribution of outcomes to treatment. The MDTSM was completed by persons (N = 213) in the intervention group in a large trial of a multi-component behavioral intervention for insomnia within 1 week following treatment completion. The MDTSM's subscales demonstrated internal consistency reliability (α: .65 - .93) and validity (correlated with self-reported adherence and perceived insomnia severity at post-test). The MDTSM subscales can be used to assess satisfaction with behavioral interventions and point to aspects of treatments that are viewed favorably or unfavorably.

Toward a Conceptualization and Operationalization of Satisfaction With Nonpharmacological Interventions

BACKGROUND

Although satisfaction is recognized as an essential aspect in the evaluation of interventions' effectiveness, there is lack of clarity on its conceptualization and operationalization. In this article, we present conceptual and operational definitions that specify the domains and attributes of satisfaction with nonpharmacological interventions.

METHODS

An integrative review of conceptual and empirical literature was conducted to generate the conceptual and operational definitions of satisfaction with interventions. Fifty-six publications were included in the review. The definitions of satisfaction and the content of instruments measuring satisfaction were reviewed, compared, and contrasted to identify the domains and attributes of the concept.

RESULTS

Satisfaction is defined as the appraisal of the interventions' process and outcome. It is operationalized in 4 domains of process: (a) suitability and utility of the intervention's components, (b) attitude toward and desire to continue with the intervention, (c) competence and interpersonal style of interventionist, and (d) implementation (format and dose) of the intervention. The outcome domain includes improvement in the health problem and in everyday functions, discomfort, and attribution of the outcomes to the intervention.

CONCLUSIONS

The conceptual and operational definitions can guide the development of instruments to assess satisfaction with nonpharmacological interventions, which can point to aspects of interventions that are viewed favorably or unfavorably.