title: Effects of Self-care Health Behaviors on Quality of Life Mediated by Cardiovascular Risk Factors Among Individuals with Coronary Artery Disease: A Structural Equation Modeling Approach.
abstract: OBJECTIVE
  The project was to test a structural equation model in which self-efficacy, self-care health behaviors, and modifiable risk factors predict the quality of life (QOL) of individuals with coronary artery disease.
  
  
  METHODS
  The data set from the intervention study with 130 patients with coronary artery disease before the intervention was included in the secondary analysis for this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument).
  
  
  RESULTS
  The mean age of the participants was 66.1 years. The following evaluation parameters indicated that the proposed model provided a good fit to the data: comparative fit index at .87, goodness of fit index at .91, adjusted goodness of fit index at .84, standardized root mean square residual at .06, root mean square error of estimation at .09, and confidence interval at 0.06-0.13. Self-efficacy, self-care health behaviors, and modifiable risk factors had significant effects on QOL and explained 64.0% of the variance, with modifiable risk factors mediating between self-care health behaviors and QOL.
  
  
  CONCLUSIONS
  The findings indicate that self-efficacy, self-care health behaviors, and modifiable risk factors play an important role in QOL in adults with coronary artery disease. Patients could be more confident in performing self-care health behaviors, leading to a better QOL, by more effectively managing their cardiovascular risk factors. Nursing strategies to improve QOL in this population should include motivating them to perform self-care health behaviors.
authors.affiliation: College of Nursing, Chungnam National University, Daejeon, South Korea.
authors.forename: Sukhee
authors.initials: S
authors.lastname: Ahn
authors.affiliation: College of Nursing, Chungnam National University, Daejeon, South Korea. Electronic address: songry@cnu.ac.kr.
authors.forename: Rhayun
authors.initials: R
authors.lastname: Song
authors.affiliation: College of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Si Wan
authors.initials: SW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D003324:Coronary Artery Disease / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care / Q000379:methods* / Q000523:psychology; D020377:Self Efficacy
keywords: coronary artery disease; health behavior; quality of life; risk; self efficacy