Heterogeneous trajectories of exercise self-efficacy and its predictors in patients with multivessel coronary artery disease: A longitudinal study

OBJECTIVE: The developmental trajectory of exercise self-efficacy refers to the course of change in an individual's belief in their capability to successfully perform exercise-related behaviors over time. This study aims to explore the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease, and analyze the predictors of various trajectory subgroups. METHODS: Between September 2023 to October 2024, 297 patients with multivessel coronary artery disease were recruited from three tertiary hospitals in Tangshan, China. Exercise self-efficacy was measured using the Multidimensional Self-Efficacy for Exercise Scale on the third day of admission (T1), one month after discharge (T2), three months after discharge (T3), and six months after discharge (T4). The latent class growth model was employed to identify the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease. Multinomial logistic regression was adopted to determine the predictors of trajectory subgroups. RESULTS: Three distinct trajectories of exercise self-efficacy were identified: the "Low-Efficacy Decline Group" (22%), the "High-Efficacy Ascending-Stable Group" (34%), and the "Moderate-Efficacy Continuous Increase Group" (44%). Multinomial logistic regression analysis revealed significant determinants of distinct exercise self-efficacy trajectories, when compared with the moderate-efficacy continuous increase group, the predictors for the low-efficacy decline group included having diabetes, a lack of exercise habits, low social support, and anxiety. In contrast, the predictors for the high-efficacy ascending-stable group were high average monthly household income, established exercise habits, and strong social support. CONCLUSION: The study revealed heterogeneous trajectories of exercise self-efficacy among patients with multivessel coronary artery disease, highlighting the necessity for personalized intervention strategies. These findings offer a valuable opportunity for early prevention and targeted interventions aimed at enhancing exercise self-efficacy.