Introduction
Cardiovascular disease remains a leading cause of morbidity among the elderly. For patients who have undergone percutaneous coronary intervention (PCI), early engagement in physical activity (PA) is a key component of cardiac rehabilitation and long-term recovery. Recent research suggests that physical activity self-efficacy—an individual’s confidence in their ability to be physically active—may mediate the influence of knowledge and psychological factors on early PA participation. This article synthesizes findings from a cross-sectional study examining these relationships in elderly post-PCI patients and discusses practical implications for clinicians and rehabilitation programs.
Key Concepts
Physical Activity Self-Efficacy refers to a person’s belief in their capacity to perform and sustain PA despite potential barriers. In older adults, higher self-efficacy correlates with greater initiation and maintenance of exercise routines, which is especially vital after PCI when physical safety and fear of events can hinder activity.
Knowledge and Psychological Factors encompass patients’ understanding of exercise benefits, safety considerations, and the psychological climate surrounding rehabilitation. Psychological factors might include mood, anxiety, perceived barriers, and social support, all of which can shape motivation to engage in PA.
Understanding how these elements interact helps explain why some elderly post-PCI patients start exercising promptly, while others delay or avoid activity.
The Mediation Model: How Self-Efficacy Bridges Gaps
The study under review proposes a mediation framework: knowledge and psychological factors influence early PA partly through physical activity self-efficacy. In practical terms, even when patients have adequate knowledge about the benefits and safety of PA, or when they possess favorable psychological profiles, their confidence in sticking with activity programs may determine actual behavior in the crucial early recovery period.
Findings from the cross-sectional analysis indicate that higher self-efficacy is associated with increased likelihood of early PA participation among elderly post-PCI patients. Moreover, self-efficacy partially mediates the effect of knowledge and psychological readiness on activity levels, highlighting its pivotal role as a proximal determinant of behavior. These dynamics align with behavior change theories that emphasize self-efficacy as a core driver of health behaviors, particularly in populations facing medical and functional challenges.
Clinical Implications
1) Tailored Education: Providing knowledge about safe, incremental PA can boost confidence when delivered through trusted channels, such as cardiac rehabilitation staff or peer coaching. Educational content should be concrete, practical, and aligned with the patient’s daily routine.
2) Psychological Support: Screening for anxiety, depression, and fear of exercise can identify patients who may benefit from psychological support or counseling as part of rehab. Enhancing mood and reducing perceived barriers can lift self-efficacy levels.
3) Self-Efficacy-Enhancing Interventions: Programs that set achievable PA goals, offer supervised activity sessions, and celebrate small wins can strengthen self-efficacy. Techniques like action planning, problem-solving for barriers, and self-monitoring may be especially effective in the elderly post-PCI population.
4) Integrated Cardiac Rehab Design: Rehabilitation teams should integrate education, psychological support, and confidence-building strategies into a cohesive program. Regular check-ins to reassess self-efficacy can help tailor interventions and sustain early PA engagement.
Practical Recommendations for Practice
– Start with a comprehensive assessment: Evaluate knowledge, psychological status, and baseline self-efficacy to identify gaps and personalize interventions.
– Implement brief, frequent PA bouts: Short, safe activity increments can build confidence over time and reduce fear associated with exertion.
– Use family and caregiver involvement: Support networks reinforce self-efficacy by providing encouragement and accountability.
– Monitor progress with patient-reported outcomes: Track perceived exertion, mood, and confidence to adjust rehab plans dynamically.
Limitations and Future Directions
As a cross-sectional study, causality cannot be definitively established. Longitudinal research and randomized trials are needed to confirm whether enhancing physical activity self-efficacy directly improves early PA uptake and, subsequently, cardiovascular outcomes in elderly post-PCI patients. Future work should also explore cultural and systemic factors that influence the knowledge-efficacy-behavior chain.
Conclusion
Physical activity self-efficacy emerges as a critical mediator between knowledge, psychological factors, and early PA in elderly post-PCI patients. Interventions that strengthen self-belief in the ability to exercise—through education, psychological support, and structured activity plans—are likely to enhance early engagement in rehabilitation. This, in turn, can contribute to improved functional recovery, reduced recurrent events, and better quality of life for older adults navigating post-PCI recovery.
