SummaryKnowledge about their own condition is important for patients with heart failure (HF). No valid, reliable, and easily administered instrument is available to measure this knowledge in clinical practice. In this study, a HF knowledge scale was developed, and its psychometric properties were tested. Items related to knowledge about HF were extracted from relevant guidelines. Content validity of the items was confirmed by an expert panel including a cardiologist and nurses specialized in treatment and care of patients with HF. A self-administered questionnaire was then distributed to 187 patients with HF (64.0 ± 12.1 years, males 69%). In 62% patients, a left ventricular ejection fraction of < 50% was identified. Exploratory factor analysis demonstrated the one-dimensionality of the 15-item HF knowledge scale. Mean score was 10.7 ± 3.0 (range, 0-15). Known-group validity testing revealed a significant difference in HF knowledge score between patients newly diagnosed with HF and patients experienced with HF (9.4 ± 3.2 versus 10.8 ± 2.9, P = 0.043). In addition, HF knowledge scale scores were correlated with HF self-care scores assessed by the European Heart Failure Self-Care Behavior Scale for evaluation of criterion validity (ρ = −0.304, P < 0.001). Cronbach's alpha was 0.79, and item-total correlation was 0.22-0.51, thereby suggesting that the reliability of the scale was acceptable. Acceptable validity and reliability were demonstrated for the HF knowledge scale developed in this study. This instrument could be useful in evaluation of patient knowledge about HF. (Int Heart J 2013; 54: 228-233)

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Background: Mastery is a human response of gaining competence in dealing with stress and can be applied to understanding the psychological state of patients with advanced or recurrent colorectal cancer (CRC). Objective: To identify mastery in patients with advanced or recurrent CRC undergoing chemotherapy and examine associations between mastery and the patients’ sociodemographic characteristics, social support, and support from clinical staff. Methods: A self-administered survey was conducted among patients with advanced or recurrent CRC receiving outpatient chemotherapy. Participants completed the Mastery of Stress Instrument, the Multidimensional Scale of Perceived Social Support, support from clinical staff, and sociodemographic characteristics. Results: Of 76 participants, 77.6% had a stress score of ≥58 points, indicating a stress status. They achieved, in descending order, acceptance, certainty, change, and growth among mastery processes. Social support was significantly associated with mastery and all its components, and support from clinical staff was significantly associated with mastery and certainty. Conclusions: Most participants reported a high level of stress, indicating that they need support to deal with stress from a mastery perspective. Implications for Practice: Nurses should assess the stress levels of patients with advanced or recurrent CRC and provide care based on mastery to help patients come to terms with cancer-related stress. Providing emotional and social support is necessary to promote positive change and growth. Foundational: This study framed the need for nursing care for stressed patients in terms of their mastery of advanced or recurrent CRC-specific stress. Social support and clinical staff support are essential for achieving such mastery.