Abstract
As the number of elderly patients undergoing cardiac surgery (coronary artery bypass and valve replacement) continues to increase, evidence is growing that they can do so with improved health status, functional status, longevity, and life quality. In this article, we used self-efficacy theory to explore one of the most common recovery behaviors—walking various distances. In preoperative data collected in-hospital through data collection at one, two, three, six, and twelve months postoperatively, we explored: (a) the trajectories of self-efficacy expectation (SEE) and self-reported (SR) behavior performance over the first postoperative year; (b) the relationships between SEE and SR behavior; (c) predictors of SEE; and (d) using hierarchical multiple regression, identified predictors of SR behavior at each point of time. The sample (N=199) was primarily male (76%) with a mean age of 75.8 years. SEE and SR behavior increased over time though with different trajectories; at all points in time, females had lower scores. Correlations between SEE and SR behavior were statistically significant (r values ranging from 0.67 to 0.89; p<.01) for both males and females. Predictors of SEE and SR identified were a mix of physiologic and psychologic constructs. The amount of explained variance in SR behavior scores ranged from a low of 23% at one month to a high of 64.7% at six months. The gender differences sustained one year after cardiac surgery are striking; elder females may need targeted interventions to enhance recovery.
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Preparation of this manuscript was supported in part by grant in aid #910008810 from the American Heart Association National Center to Susan R. Gortner.
The authors acknowledge the following nurse clinicians in the participating sites who were instrumental in enrolling patients and assessing their self-efficacy and activity levels following surgery: Joni Dirks, M.S., R.N.; Kathleen Low, B.S.N., R.N.; Suzanne Manning, B.A., R.N.; Terry Miller, M.S., R.N.; Robert Patterson, B.S.N., R.N.; Suzanne Reno, B.S., R.N.; and Deanna Ritchie, M.S., R.N. Follow-up was carried out during the one-year period by Judith Harr, M.S., R.N. (project director) and Heidi Jaeger, MagPharm (research associate). We thank Steven M. Paul, Ph.D., for statistical assistance, Leslie Kern, M.S. R.N., for help with this manuscript, and Jean Gaynor for assistance with manuscript preparation. Special thanks go to the recovering patients in the study who were willing to share their efficacy expectations and activities with us.
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Jenkins, L.S., Gortner, S.R. Correlates of self-efficacy expectation and prediction of walking behavior in cardiac surgery elders. ann. behav. med. 20, 99–103 (1998). https://doi.org/10.1007/BF02884455
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DOI: https://doi.org/10.1007/BF02884455