Association between Social Support and Physical Activity in Patients with Coronary Artery Disease: Multiple Mediating Roles of Self-Efficacy and Autonomous Motivation.

Nam-Sin Han,Mi-Hwa Won

doi:10.3390/healthcare10030425

Abstract

Physical inactivity in patients with coronary artery disease is linked to recurrent cardiac events. Given that social support may be an enduring major factor for physical activity, the mechanism underlying the multiple mediating effects of self-efficacy and autonomous motivation on the relationship between social support and physical activity in patients with coronary artery disease has hardly been examined. Therefore, this study aimed to clarify the multiple mediating roles of social support and physical activity on the relationship between self-efficacy and autonomous motivation in patients with coronary artery disease. This descriptive cross-sectional study included 190 inpatients who were diagnosed with coronary artery disease and admitted to a cardiology ward university hospital in Korea. Parallel multiple mediated models were tested using the SPSS PROCESS macro. The direct effects of social support on physical activity and the indirect effects of self-efficacy and autonomous motivation on social support and physical activity were statistically significant. Thus, positive social support from health-care providers has an important role to play in promoting physical activity by increasing self-efficacy and autonomous motivation for physical activity in patients with coronary artery disease.

Highlights

Coronary artery disease (CAD) is a chronic condition in which the buildup of plaque in coronary arteries causes narrowing or blockages [1]
Social support, self-efficacy, and autonomous motivation were positively associated with physical activity, indicating that higher levels of these variables were related to higher levels of physical activity in patients with CAD
Our main findings confirmed the multiple mediating roles of selfefficacy and autonomous motivation on the relationship between social support and physical activity in patients with CAD. These results indicate that the positive relationship between social support and physical activity was partly explained by the higher levels of self-efficacy and autonomous motivation

Summary

Introduction

Coronary artery disease (CAD) is a chronic condition in which the buildup of plaque in coronary arteries causes narrowing or blockages [1]. CAD is one of the major causes of mortality, which is steadily increasing due to an increase in the elderly population and an unhealthy lifestyle [1,2]. From 2015 to 2019, the annual prevalence of CAD increased by approximately 4.1%, and the total medical costs increased by an average of 10.5% per year in Korea [3]. Despite significant developments in medical therapy and technology, the annual mortality rate of CAD is reported to be approximately five to six times higher than that of those without CAD [2]. In Korea, it was reported that the CAD mortality rate increased by 0.7%, from 26.7% in 2019 to 27.4% in 2020 [3].

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