Self-efficacy and in-patient cardiac rehabilitation.

Self-efficacy reflects an individual's perceptions or beliefs about how capable he or she is of performing a specific activity or task and measures self-confidence to perform that specific activity or task. This study investigated the effect of in-patient cardiac rehabilitation on self-efficacy scores for 3 categories of activities: routine physical activities, daily living tasks and levels of concentration and ability to cope. On discharge from the intensive or coronary care unit, patients without contraindications to early ambulation were randomized to either a ward ambulation program (n = 26) or a dedicated exercise center program (n = 25) with all patients receiving the same standardized education/counseling. There were no differences between the groups in self-efficacy at baseline, at hospital discharge or 7 days later. Significant improvements in self-efficacy scores were observed by day 28 in both groups for routine physical activities and daily living tasks with no change in self-efficacy scores for concentration or ability to cope. At that time the exercise center patients had higher self-efficacy scores for walking time (p = 0.041) and overall exertion (p = 0.024) than the ward ambulation patients. For the majority of the self-efficacy variables considered, both in-patient exercise rehabilitation programs were equally effective in improving self-efficacy scores for physical activities and daily living tasks over the first 28 days after return to home. The lower cost associated with ward ambulation programs suggests that they are more cost-effective than developing a program in a dedicated in-patient exercise center.