Self-efficacy and activity level following cardiac surgery

ABSTRACT

Self-efficacy expectations were measured in 149 recovering cardiac surgery patients to determine whether in-patient education and telephone monitoring during convalescence enhanced perceptions of cardiac efficacy and reported activity Significant differences were found for experimental patients in self-efficacy expectations for walking between 4 and 8 weeks (P=0 02) and between 8 and 24 weeks (P= 0 05) following surgery Experimental patients also reported higher levels of general activity at 4 weeks (P= 0.05) and 8 weeks (P=0.02) as well as more walking and lifting at 8 weeks (P= 0 01 and P= 0.0008, respechvely) By 12 weeks, treatment differences were no longer significant except for continued higher general activity levels (P=0.03) for experimental patients Self-efficacy expectations, summed for all physical activities, at 8 weeks were found to be a significant predictor of self-reported activity at 12 weeks, contributing 14 8% of the 34 8% explained variance (R² change = 0 1479, F= 26 58, P < 0 0001) Self-efficacy expectations summed for all physical activity at 8 weeks were also significant predictors of self-reported activities at 24 weeks, contributing 8 5% of the variance (R² change = 0 0847, F= 14 48, P=0 0002) A New York Heart Association functional class at 4 and 8 weeks was an independent predictor of self-reported activity at 12 weeks, as was 8 week functional class for self-reported activity at 24 weeks Mood state did not contribute to explained variance in the regression models These findings suggest that efficacy expectahons in the recovering cardiac surgery patient (a) can be influenced by in-pahent education and further enhanced by out-patient coaching by telephone during home recovery, (b) are correlated with activity and mood state and are predictive of subsequent activity, (c) change rapidly in the first weeks after discharge, and (d) may be influenced by cardiac functional class following surgery, in that cardiac class is also predictive of activity