# Self-Care Agency in Cardiovascular Care: A Cross-Sectional Study on the Interplay Between Self-Efficacy, Loneliness and Physical Activity

## TL;DR

This study explores how self-efficacy, loneliness, and physical activity influence self-care in patients with cardiovascular disease.

## Contribution

The study reveals how loneliness negatively affects self-care agency and how physical activity can buffer this effect.

## Key findings

- Loneliness reduces self-care agency, especially at lower levels of self-care.
- Physical activity positively influences self-care agency, particularly at higher levels.
- Self-efficacy consistently supports self-care agency across all levels.

## Abstract

Background: Appraisal for self-care agency (ASAS) is central to cardiovascular disease (CVD) management, yet the influence of loneliness as a social stressor remains under-characterized. Methods: In patients with CVD (N = 80), cross-sectional predictors for ASAS were assessed via ordinary least squares (OLS) and quantile regression; robust methods are supplemented to buffer the sample size. Interaction effects on ASAS were tested between loneliness and physical activity, and loneliness and self-efficacy. Results: The diminishing effect of loneliness explained 10% of ASAS variance and remained significant when controlling for covariates (ß = −1.05, p = 0.031). Self-efficacy (β = 2.97, p = 0.009) and physical activity (β = 5.13, p = 0.001) were positively associated with ASAS, although quantile models indicated heterogeneity: loneliness exerts its effect at low ASAS (τ = 0.25; ß = −1.95, p < 0.001) whereas physical activity is influential at high ASAS (τ = 0.75; ß = 5.21, p < 0.001) and self-efficacy across all levels. Interactions showed a buffering of loneliness’ negative influence on ASAS via physical activity (ß = 3.29, p = 0.044). Conclusions: Self-efficacy is crucial for self-care agency in CVD. While loneliness exerts its strongest detriment at lower self-care levels, physical activity may attenuate loneliness-related vulnerability. These findings support interventions enhancing self-efficacy, promoting activity, and targeting loneliness to improve self-care.