# The mediating role of self-efficacy in the relationship between self-management and health-promoting behaviors in post-PCI patients

**Authors:** Zhijie Cao, Ping Yan, Fang Hou, Xin Gu, Hu Peng, Lina Ma, Li Zhang, Chiara Lazzeri, Chiara Lazzeri, Chiara Lazzeri

PMC · DOI: 10.1371/journal.pone.0341826 · 2026-01-29

## TL;DR

This study shows that self-efficacy partially explains how self-management leads to healthier behaviors in patients recovering from heart procedures.

## Contribution

The novel finding is that self-efficacy partially mediates the relationship between self-management and health-promoting behaviors in post-PCI patients.

## Key findings

- Self-management, self-efficacy, and health-promoting behaviors are positively correlated in post-PCI patients.
- Self-efficacy partially mediates the effect of self-management on health-promoting behaviors, accounting for 61.3% of the total effect.
- Healthcare professionals should focus on improving patients' self-efficacy to promote healthier lifestyles after PCI.

## Abstract

Coronary artery disease (CAD) has become one of the most prevalent diseases worldwide. Self-management and self-efficacy are critical for enhancing healthy lifestyles in patients with postoperative CAD and are strongly associated with health-promoting behaviors. However, the underlying mechanisms of this association remain unclear.

To explore the mediating role of self-efficacy between self-management and health-promoting behaviors in patients following percutaneous coronary intervention (PCI).

From November 2024 to March 2025, 400 post-PCI patients were selected by convenience sampling from a tertiary first-class hospital in Xinjiang. Surveys were administered using a general information questionnaire, a self-management scale, a self-efficacy scale, and a health-promoting lifestyle scale. Structural equation modelling was employed to investigate the pathways of action among the three variables.

The scores for self-management behaviour, self-efficacy, and health-promoting lifestyle were (96.66 ± 10.11) scores, (44.49 ± 6.10) scores, and (162.91 ± 12.24) scores, respectively, with positive correlations between each pair of items. Self-efficacy partially mediated the relationship between self-management and health-promoting behaviors, with a standardized indirect effect of 0.317, accounting for 61.3% of the total effect.

Self-efficacy plays a partial mediating role between self-management and health-promoting behaviors. Healthcare professionals should pay attention to the self-efficacy of patients post-PCI to enhance their awareness of personal health and strengthen self-management, thereby promoting proactive adoption of healthy lifestyles.

## Linked entities

- **Diseases:** Coronary artery disease (MONDO:0005010)

## Full-text entities

- **Diseases:** CAD (MESH:D003324), chest pain (MESH:D002637), overweight (MESH:D050177), functional impairment (MESH:D003072), atherosclerosis (MESH:D050197), restenosis (MESH:D023903), chronic diseases (MESH:D002908), cognitive or mental disorders (MESH:D001523), language dysfunction (MESH:D007806), visual and hearing impairments (MESH:D006311)
- **Chemicals:** carbohydrate (MESH:D002241), PONE-D-25-30248R1 (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12854456/full.md

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Source: https://tomesphere.com/paper/PMC12854456