The purpose of this study was to determine the relationship between coping strategies, self-efficacy beliefs, and perceived social support and physical and psychological functioning during the first 6 weeks after cardiac surgery. A model of recovery was developed and tested with a convenience sample of 81 patients between the ages of 40 and 70 from 3 northern California community hospitals. The sample was 80% male, 83% Caucasian, 77% married, and 49% employed, with a mean age of 58.8 years. Data were obtained through preoperative interviews and questionnaires, telephone interviews at Weeks 2 and 6 postoperatively, and mailed questionnaires at Week 6.

Psychosocial variables and symptoms during recovery were assessed with the Brief Symptom Inventory (BSI), the Multidimensional Scale of Perceived Social Support, the Jenkins Self-Efficacy and Activity Scales, the Jalowiec Coping Scale, New York Heart Association (NYHA) symptom status, and an investigator developed Recovery Support Scale. An interview guide was used to assess recovery demands and coping resources.

In this sample of cardiac surgery patients, greater NYHA symptom status and recovery demands correlated with higher psychological distress and lower self-reported activity. No interactive effects among coping, social support, or self-efficacy were detected, although the interview data suggest such an effect.

Self-efficacy beliefs predicted self-reported walking, general activity, resumption of roles, and maintenance of health at Weeks 2 and 6 (p $<$.001). Return to work was best predicted by Week 2 work activity (p $<$.001) and perioperative complications (p $<$.05). Self-efficacy and activity for walking, general activity, work, and roles increased from 2 to 6 weeks (p $<$.01), as did health activity (p $<$.05).

Lower social support (p $<$.001), higher total coping (p $<$.001), and higher emotive coping strategies (p $<$.001) correlated with greater psychological distress (BSI) at Week 6. Confrontive coping was the most frequently reported coping strategy, but did not enter any statistical regression. Perceived social support decreased at Week 2 and increased at Week 6. Informational support at Week 2 correlated with self-efficacy beliefs and self-reported activities at Weeks 2 and 6. No buffering effects were detected for social support or coping.