# Factors influencing a health-promoting lifestyle in participants after undergoing repeat percutaneous coronary intervention based on the Capability, Opportunity, Motivation-Behaviour model: a qualitative study

## TL;DR

This study explores the factors that influence healthy lifestyle choices in patients who have undergone repeat heart procedures, using a model to guide healthcare improvements.

## Contribution

The study identifies unique barriers to health-promoting behaviors in patients undergoing repeat PCI, using the COM-B model.

## Key findings

- Patients face capability barriers like poor disease knowledge and inadequate medication management skills.
- Opportunity barriers include lack of family support and limited access to medical resources.
- Motivation barriers involve behavioral relapse and inertia despite willingness to improve health.

## Abstract

Coronary heart disease is a leading cause of global mortality, for which percutaneous coronary intervention serves as a critical revascularization strategy. Despite the recognized importance of health-promoting behaviors, participants face significant challenges in adopting and sustaining these behaviors post-procedurally. Current research predominantly focuses on primary PCI participants, leaving a gap in the systematic investigation of unique factors influencing health-promoting lifestyles specifically within the higher-risk population undergoing repeat PCI. This distinct subgroup often presents with a history of behavioral relapse, greater psychological distress, and altered risk perception, which may not be adequately addressed in standard care. Therefore, this study employs the (Capability, Opportunity, Motivation-Behaviour) model to elucidate the multifaceted barriers affecting the maintenance of a health-promoting lifestyle in this distinct participants cohort.

To explore the factors influencing whether participants adopt a healthy lifestyle after repeat percutaneous coronary intervention, to provide healthcare professionals with a theoretical basis from which they can develop targeted intervention programmes.

A descriptive phenomenological research method was used to develop an interview outline, using the Capability, Opportunity, Motivation-Behaviour model as a guide. Sixteen participants who underwent repeat coronary intervention were selected to participate in semi-structured interviews. Data were analysed using Colaizzi’s seven-step method to summarise and extract themes.

Capability-related factors included inaccurate knowledge of the disease, inadequate skills to manage medication, lack of physical strength and health limitations, and poor skills for psychological and emotional adjustment. Opportunity-related factors included insufficient family and environmental support, limited access to medical resources, conflicts with regional dietary habits, and the influence of work habits. Motivation-related factors included a willingness to proactively manage health, psychological and emotional regulation, behavioural relapse, and inertia.

Multiple factors influence the adoption of health-promoting lifestyles in participants undergoing repeat percutaneous coronary intervention. Healthcare professionals need to consider several perspectives to improve participants’ knowledge of how to promote their health after surgery and reduce barriers to health-promoting behaviours. This will help improve the overall health of participants in this population.