Annals of Behavioral Medicine

, Volume 17, Issue 4, pp 324–330 | Cite as

Effects of self-efficacy and perceived social support on recovery-related behaviors after coronary artery bypass graft surgery

  • Elsa C. Bastone
  • Robert D. Kerns
Empirical Research


This study investigated the extent to which measures of perceived internal and external resources, operationalized as self-efficacy and social support respectively, contribute to the prediction of participation in important recovery behaviors following coronary artery bypass graft surgery. Self-efficacy ratings obtained preoperatively related to the ability to rest and tolerate pain without the use of medications contributed significantly to the prediction of pain and sleep medication use postoperatively, after controlling for important demographic, medical, and surgical variables. Patients’ reports of staff and significant-other interactions regarding adherence to cued productive coughing and ambulation accountedfor significant proportions of the variance in these recovery behaviors. Results support models of recovery from surgery that emphasize the important roles of self-efficacy and social interaction.


Social Support Social Influence Pain Medication Efficacy Belief Sleep Medication 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. (1).
    Blakeslee S: Study hints of harm in heart operations.The New York Times. February 20, 1990:C1, C3.Google Scholar
  2. (2).
    Magni G, Unger HP, Valfre C, et al: Psychosocial outcome one year after heart surgery: A prospective study.Archives of Internal Medicine. 1987,147:473–477.PubMedCrossRefGoogle Scholar
  3. (3).
    Jenkins CD, Stanton BA, Savageau JA, Denlinger P, Klein MD: Coronary artery bypass surgery: Physical, psychological, social, and economic outcomes six months later.Journal of the American Medical Association. 1983,250:782–788.PubMedCrossRefGoogle Scholar
  4. (4).
    Heller SS, Frank KA, Kornfeld DS, Malm JR, Bowman Jr. FO: Psychological outcome following open-heart surgery.Archives of Internal Medicine. 1974,134:908–914.PubMedCrossRefGoogle Scholar
  5. (5).
    Bandura A: Self-efficacy: Toward a unifying theory of behavior change.Psychological Review. 1977,84:191–215.PubMedCrossRefGoogle Scholar
  6. (6).
    Bandura A: Self-efficacy mechanism in human agency.American Psychologist. 1982,37:122–147.CrossRefGoogle Scholar
  7. (7).
    Bandura A:Social Foundations of Thought and Action. Englewood Cliffs, NJ: Prentice-Hall, 1986.Google Scholar
  8. (8).
    O’Leary A: Self-efficacy and health.Behavior Research and Therapy. 1985,23:437–451.CrossRefGoogle Scholar
  9. (9).
    Stretcher VJ, DeVellis BM, Becker MH, Rosenstock IM: The role of self-efficacy in achieving health behavior change.Health Education Quarterly. 1986,13:73–92.Google Scholar
  10. (10).
    Bandura A, Adams NE, Hardy AB, Howells GH: Tests of the generality of self-efficacy theory.Cognitive Therapy and Research. 1980,4:39–66.CrossRefGoogle Scholar
  11. (11).
    Bandura A, Schunk DH: Cultivating competence, self-efficacy, and intrinsic interest through proximal self-motivation.Journal of Personality and Social Psychology. 1981,41:586–598.CrossRefGoogle Scholar
  12. (12).
    Betz NE, Hackett G: The relationship of career-related self-efficacy expectation to perceived career options in college men and women.Journal of Counseling Psychology. 1981,28:399–410.CrossRefGoogle Scholar
  13. (13).
    Davies FW, Yates BT: Self-efficacy expectancies versus outcome expectancies as determinants of performance deficits and depressive affect.Cognitive Therapy and Research. 1982,6:23–36.CrossRefGoogle Scholar
  14. (14).
    Barling J, Abel M: Self-efficacy beliefs and tennis performance.Cognitive Therapy and Research. 1983,53:406–414.Google Scholar
  15. (15).
    O’Leary A: Self-efficacy and health: Behavior and stress—Physiological mediation.Cognitive Therapy and Research. 1992,16: 229–245.CrossRefGoogle Scholar
  16. (16).
    McKusick L, Coates TJ, Morin SF, Pollack MA, Hoff C: Longitudinal predictors of unprotected anal intercourse among gay men in San Francisco: The AIDS behavioral research project.American Journal of Public Health. 1990,80:978–983.PubMedCrossRefGoogle Scholar
  17. (17).
    Ekstrand M, Coates TJ: Maintenance of safer sexual behaviors and predictors of risky sex: The San Francisco men’s health study.American Journal of Public Health. 1990,80:973–977.PubMedGoogle Scholar
  18. (18).
    Kelly JA, St Lawrence JS, Hood HV, Brasfield TL: Behavioral intervention to reduce AIDS risk activities.Journal of Consulting and Clinical Psychology. 1989,57:60–67.PubMedCrossRefGoogle Scholar
  19. (19).
    DiClemente CC, Prochaska JD, Gilbertini M: Self-efficacy and the stages of self-change of smoking.Cognitive Therapy and Research. 1985,9:181–200.CrossRefGoogle Scholar
  20. (20).
    Bandura A, Taylor CB, Williams SL, Mefford IN, Barchos JD: Catecholamine secretion as a function of perceived self-efficacy.Journal of Consulting and Clinical Psychology. 1985,53:406–414.PubMedCrossRefGoogle Scholar
  21. (21).
    DiClemente CC: Self-efficacy and smoking cessation maintenance: A preliminary report.Cognitive Therapy and Research. 1981,5: 175–187.CrossRefGoogle Scholar
  22. (22).
    Kaplan RM, Atkins CJ, Reinsch S: Specific efficacy expectations mediate exercise compliance in patients with COPD.Health Psychology. 1984,3:223–242.PubMedCrossRefGoogle Scholar
  23. (23).
    Taylor CB, Bandura A, Ewart CK, Miller NH, DeBusk RH: Exercise testing to enhance wives’ confidence in their husbands’ cardiac capability soon after clinically uncomplicated acute myocardial infarction.American Journal of Cardiology. 1985,55:635–638.PubMedCrossRefGoogle Scholar
  24. (24).
    Broadhead WE, Kaplan BH, Sherman AJ, et al: The epidemiologic evidence for a relationship between social support and health.American Journal of Epidemiology. 1983,777:521–537.Google Scholar
  25. (25).
    Cohen S, Syme SL: Issues in the study and application of social support. In Cohen S, Syme L (eds),Social Support and Health. New York: Academic Press, 1986, 3–22.Google Scholar
  26. (26).
    Turner RJ, Frankel BG, Levin DM: Social support: Conceptualization, measurement, and implications for mental health. In Greeley J (ed),Research in Community Mental Health. Greenwich, CT: JA Press, 1983, 67–111.Google Scholar
  27. (27).
    Heller K: The effects of social support: Prevention and treatment implications. In Goldstein AP, Kanfer FH (eds),Maximizing Treatment Gains: Transfer Enhancement in Psychotherapy. New York: Academic Press, 1979, 353–380.Google Scholar
  28. (28).
    Flor H, Kerns RD, Turk DC: The role of the spouse in the maintenance of chronic pain.Journal of Psychosomatic Research. 1987,31:251–259.PubMedCrossRefGoogle Scholar
  29. (29).
    Peters-Golden, H: Breast cancer: Varied perceptions of social support in the illness experience.Social Science and Medicine. 1982,76:483–491.Google Scholar
  30. (30).
    Lehman DR, Ellard JH, Wormian CB: Social support for the bereaved: Recipients’ and providers’ perspectives on what is helpful.Journal of Consulting and Clinical Psychology. 1986,54:438–446.CrossRefGoogle Scholar
  31. (31).
    Turner RJ, Frankel BG, Levin DM: Social support: Conceptualization, measurement, and implications for mental health. In Greeley J (ed),Research in Community Mental Health. Greenwich, CT: JA Press, 1983, 67–111.Google Scholar
  32. (32).
    Coyne JC, DeLongis A: Going beyond social support: The role of social relationships in adaptation.Journal of Consulting and Clinical Psychology. 1986,54:454–460.PubMedCrossRefGoogle Scholar
  33. (33).
    Levine M, Perkins DV: Social setting interventions and primary prevention: Comments on the report of the task panel on prevention to the President’s Commission on Mental Health.American Journal of Community Psychology. 1980,8:147–157.CrossRefGoogle Scholar
  34. (34).
    Levy RL: Social support and compliance: A selective review and critique of treatment integrity and outcome measurement.Social Science and Medicine. 1983,17:1329–1338.PubMedCrossRefGoogle Scholar
  35. (35).
    Thoits P: Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress.Journal of Health and Social Behavior. 1982,23:145–159.PubMedCrossRefGoogle Scholar
  36. (36).
    Fontana AF, Kerns RD, Rosenberg RL, Colonese KL: Support, stress, and recovery from coronary heart disease: A longitudinal causal model.Health Psychology. 1989,8:175–193.PubMedCrossRefGoogle Scholar
  37. (37).
    Kulik JA, Mahler HIM: Social support and recovery from surgery.Health Psychology. 1989,8:221–238.PubMedCrossRefGoogle Scholar
  38. (38).
    King KB, Reis HT, Porter CA, Norsen LH: Social support and long-term recovery from coronary artery surgery: Effects on patients and spouses.Health Psychology. 1993,12:56–63.PubMedCrossRefGoogle Scholar
  39. (39).
    Russell D, Cutrona CE: The provisions of social relationships and adaptation to stress. Annual Meeting of the American Psychological Association. Anaheim, CA: August 1984.Google Scholar
  40. (40).
    Cutrona C, Russell D, Rose J: Social support and adaptation to stress by the elderly.Journal of Psychology and Aging. 1986,1: 47–54.CrossRefGoogle Scholar
  41. (41).
    Weiss R: The provisions of social relationships. In Rubin Z (ed),Doing unto Others. Englewood Cliffs, NJ: Prentice Hall, 1974, 17–26.Google Scholar
  42. (42).
    Fontana AF, Kems RD, Rosenberg RL, Marcus JL, Colonese KL: Exercise training for cardiac patients: Adherence, fitness, and benefits.Journal of Cardiopulmonary Rehabilitation. 1986,6:4–15.CrossRefGoogle Scholar
  43. (43).
    Ley P: Psychological studies of doctor-patient communication. In Rachman S (ed),Contributions to Medical Psychology (Vol. I). Oxford, UK: Pergamon Press, 1977, 9–42.Google Scholar
  44. (44).
    Kerns RD, Turk DC, Rudy TE: The West Haven-Yale Multidimensional Pain Inventory (WHYMPI).Pain. 1985,23:345–356.PubMedCrossRefGoogle Scholar
  45. (45).
    National Institutes of Health: Integrated approach to the management of pain.Connecticut Medicine. 1986,50:677–682.Google Scholar
  46. (46).
    Sarason IG, Sarason BR: Experimentally provided social support.Journalof Personality and Social Psychology. 1985,50:1222–1225.CrossRefGoogle Scholar
  47. (47).
    Scheier MF, Carver CS: Optimism, coping, and health: Assessment and implications of generalized outcome expectancies.Health Psychology. 1985,4:219–247.PubMedCrossRefGoogle Scholar
  48. (48).
    Flor H, Kerns RD, Turk DC: The role of spouse reinforcement, perceived pain, and activity levels of chronic pain.Journal of Psychosomatic Research. 1987,31:251–259.PubMedCrossRefGoogle Scholar
  49. (49).
    Kems RD, Southwick S, Giller EL, et al: The relationship between reports of pain-related social interactions and expressions of pain and affective distress.Behavior Therapy. 1991,22:101–111.CrossRefGoogle Scholar
  50. (50).
    Mumford JS, Schlesinger JH, Glass GV: The effects of psychological intervention on recovery from surgery and heart attacks: An analysis of the literature.American Journal of Public Health. 1982,72:141–151.PubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 1995

Authors and Affiliations

  • Elsa C. Bastone
    • 1
  • Robert D. Kerns
    • 1
  1. 1.Department of PsychologyVA Connecticut Healthcare SystemsWest Haven

Personalised recommendations