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Self-efficacy and self-reported functional status in coronary heart disease: a six-month prospective study
M D Sullivan1, A Z LaCroix, J Russo
1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA.
Insights
Self-efficacy beliefs significantly predict physical and role function in patients with coronary heart disease. Interventions targeting self-efficacy may benefit heart disease patients more broadly than previously thought.
Area of Science:
- Cardiology
- Psychology
- Rehabilitation
Background:
- Coronary heart disease (CHD) significantly impacts patients' physical and role functioning.
- Anxiety and depression are common comorbidities that can affect functional outcomes in CHD patients.
- Self-efficacy, the belief in one's ability to succeed, is a key psychological construct potentially influencing functional recovery.
Purpose of the Study:
- To prospectively examine the role of specific self-efficacy forms in physical and role function for CHD patients.
- To determine if self-efficacy predicts function independently of anxiety and depression.
- To validate the Cardiac Self-Efficacy Scale in a CHD population.
Main Methods:
- A 6-month prospective cohort study involving 198 HMO members with significant coronary disease post-cardiac catheterization.
- Assessment of coronary disease severity, physical function, role function, anxiety, depression, and self-efficacy using validated questionnaires.
- Multiple regression analyses to identify predictors of functional outcomes.
Main Results:
- The Cardiac Self-Efficacy Scale demonstrated good psychometric properties, with two factors: maintain function and control symptoms.
- Self-efficacy scales significantly predicted physical, social, and family function.
- These predictions remained significant after controlling for baseline function, anxiety, and other covariates.
Conclusions:
- Self-efficacy to maintain function and control symptoms is a significant predictor of physical and role function in CHD patients.
- These findings hold true even after accounting for coronary disease severity, anxiety, and depression.
- Interventions aimed at enhancing self-efficacy may offer broader benefits for the heart disease population than previously recognized.
Objective:
We examine prospectively the role of specific forms of self-efficacy in the physical and role function for patients with coronary heart disease after controlling for the effects of anxiety and depression.
Methods:
A 6-month prospective cohort study was conducted after cardiac catheterization of 198 HMO members, demonstrating clinically significant coronary disease. Coronary disease severity was assessed through cardiac catheterization; physical function, role function, anxiety, depression, and self-efficacy were assessed through questionnaires.
Results:
The Cardiac Self-Efficacy Scale had two factors (maintain function and control symptoms) with high internal consistency and good convergent and discriminant validity. In multiple regression models, the self-efficacy scales significantly predicted physical function, social function, and family function after controlling for baseline function, baseline anxiety, and other significant correlates.
Conclusions:
Self-efficacy to maintain function and to control symptoms helps predict the physical function and role function, after accounting for coronary disease severity, anxiety, and depression in patients with clinically significant coronary disease. Interventions to improve self-efficacy may have a broader applicability in the heart disease population than previously appreciated.