Abstract
Background: Little is known about the predictive role of Cardiac Self Efficacy (CSE) in the ensuing months following a coronary event. We sought to determine whether CSE predicts adverse events in the months following discharge in patients with Coronary Artery Disease (CAD). Design: Data from a prospective study of 193 patients recently hospitalized for CAD. Methods: Data were collected via participant self-report and medical records at 3-month post-discharge (baseline; T1), 6-month post-discharge (T2) and 9-month post-discharge (T3). CSE was measured using the Cardiac Self Efficacy Scale. Multi-variate regression modeling was applied to explore the association between baseline CSE scores and cardiac-related hospital admissions and functional cardiac status at T2 and T3. Other outcomes included any hospital admissions, self-reported mental and physical health at follow up. Results: Higher CSE scores at baseline significantly predicted better cardiac functioning and self-rated mental and physical health at both T2 and T3 (with one exception); this was consistent across all five models. While baseline CSE did not predict cardiac or other hospital admission at T2, CSE was a significant predictor of both outcomes at T3; higher CSE scores resulted in reductions in likelihood of hospital admissions. After adjustment for psychosocial variables however, neither association remained. Baseline depression explained the association between baseline CSE and any cardiac admissions, as well as baseline CSE and any hospital admissions at T3 follow up. Conclusions: While CSE can predict key outcomes following a CAD event, much of the association can be explained by the presence of depression.
Highlights
Self efficacy is a psychological construct which describes how one’s subjective belief in their ability to perform a task in a desired manner affects their physical engagement and subsequent completion of that task [1, 2]
Our findings provide some supports for cardiac self efficacy as a proxy measure for predicting subsequent cardiac functioning, and self-rated health in the months following Coronary Artery Disease (CAD)
While Cardiac Self Efficacy (CSE) was shown to predict both general and cardiac-related hospital admissions, these relationships were explained by the presence of depression at baseline, suggesting that depression may be a stronger mediator in the relationship between self efficacy and subsequent health outcomes than previous studies suggest
Summary
Self efficacy is a psychological construct which describes how one’s subjective belief in their ability to perform a task in a desired manner affects their physical engagement and subsequent completion of that task [1, 2] It follows that Cardiac Self Efficacy (CSE) is a cardiac-specific measure of a person’s belief in their ability to perform activities which relate to the symptoms and challenges imposed by their cardiovascular disease (CVD) [3]. Measurements of self efficacy in CVD have been demonstrated to be better predictors of outcomes including the use of analgesia, physical activity, and return to work than other variables such as age or medical status [3]. Results: Higher CSE scores at baseline significantly predicted better cardiac functioning and self-rated mental and physical health at both T2 and T3 (with one exception); this was consistent across all five models. Conclusions: While CSE can predict key outcomes following a CAD event, much of the association can be explained by the presence of depression
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