Dear Drs Riegel and Moser:

I read with interest Schnell-Hoehn, Naimark, and Tate's article entitled "Determinants of Self-care Behaviors in Community-Dwelling Patients with Heart Failure" in the January/February 2009 Journal of Cardiovascular Nursing. The authors rightly note the importance of self-care for heart failure patients and families in the present healthcare environment. I have one question, however. I note that the authors measured the predisposing variable "self-efficacy" from their model with the confidence subscale of the Self-care of Heart Failure Index. Although these 2 constructs may be conceptually close, I do not believe that they are interchangeable. Science advances when taxonomy is clear and precise. I would be interested to hear what the authors have to say to this issue.

Sincerely,

Harleah G. Buck, PhD, RN, CHPN

Hartford Center of Geriatric Nursing Excellence

NewCourtland Center for Transitions and Health

University of Pennsylvania School of Nursing

Philadelphia, Pennsylvania