This paper examines the types of nursing approaches associated with reductions in psychological distress in post-myocardial infarction patients (n=275 men; 156 women) who took part in a home-based psychosocial nursing Intervention program (Montreal Heart Attack Readjustment Trial). We found that three types of emotionally supportive approaches including reassurance/encouragement, listening and the provision of advice varied in their links to reduction in distress depending on patients' types of concerns. There were also gender differences in the way directive and collaborative intervention approaches were related to changes in distress.