Background
Physical activity (PA) is a cornerstone of cardiac rehabilitation, particularly for elderly patients recovering after percutaneous coronary intervention (PCI). While knowledge about heart-healthy behaviors and intrinsic psychological factors (such as motivation and beliefs) influence activity, researchers increasingly recognize that a patient’s confidence to perform PA—known as physical activity self-efficacy—may mediate these effects. A cross-sectional study by Jingtao L, He S, Xiaojin Q, and colleagues examines how PA self-efficacy links knowledge, psychological factors, and early physical activity in elderly post-PCI patients, offering insights for tailoring rehabilitation strategies.
Key Concepts
- Knowledge about heart disease, exercise safety, and rehab benefits can empower patients to engage in activity.
- Psychological factors include motivation, mood, and perceived barriers, which can either facilitate or hinder early PA.
- Physical activity self-efficacy is the belief in one’s capability to perform PA despite challenges and is thought to mediate the impact of knowledge and psychological factors on actual activity.
How Self-Efficacy Mediates Knowledge and Psychology
The study highlights a mediating pathway: greater knowledge about rehabilitation and healthier psychological profiles can bolster an individual’s confidence to be active. When elderly post-PCI patients feel capable of safely engaging in exercise, they are more likely to initiate and sustain early physical activity, which is crucial for recovery, functional independence, and reduced readmission risk. Conversely, limited self-efficacy can blunt the benefits of knowledge or positive psychological factors, underscoring the need to address confidence in PA alongside information and mood interventions.
Implications for Cardiac Rehabilitation Programs
Rehabilitation programs can be optimized by incorporating strategies that build PA self-efficacy in older adults after PCI. Practical approaches include:
- Structured, progressive activities: Short, achievable exercise sessions that progressively increase in intensity help patients experience success and build confidence.
- Personalized education: Tailored information about exercise safety and benefits reinforces knowledge in a way that patients can apply.
- Psychological support: Counseling or motivational interviewing can improve mood, reduce fear, and enhance motivation to stay active.
- Self-monitoring tools: Activity logs or simple wearable devices can provide concrete feedback, reinforcing self-efficacy through visible progress.
- Social support mechanisms: Group sessions or family involvement can normalize activity and offer encouragement.
Practical Takeaways for Clinicians
Clinicians should assess not only a patient’s knowledge and mood but also their confidence to engage in PA. For patients with low self-efficacy, early steps should emphasize mastery experiences—guided, low-risk activities that demonstrate success. Integrating confidence-building elements with educational content can enhance adherence to rehabilitation and improve early activity levels post-PCI.
Limitations and Future Research
As a cross-sectional study, causality cannot be established. Longitudinal research is needed to confirm the directional relationships among knowledge, psychological factors, self-efficacy, and early PA. Additionally, cultural and healthcare system differences may influence the mediating role of self-efficacy, warranting multi-site studies across diverse populations.
Conclusion
The mediating role of physical activity self-efficacy offers a valuable lens for understanding how knowledge and psychological factors translate into real-world activity among elderly post-PCI patients. By prioritizing confidence-building strategies within cardiac rehabilitation, providers can enhance early physical activity, potentially improving recovery trajectories and long-term cardiovascular health.
