Single-center cross-sectional network analysis links exercise self-efficacy with psychosocial factors after PCI

A cross-sectional study of 340 patients with coronary heart disease who had undergone percutaneous coronary intervention found that exercise self-efficacy was associated with several psychosocial factors in an interconnected network. The research, summarized in the study abstract, reported relatively strong observed connections between exercise self-efficacy and avoidance of exercise, avoidance, and friend support, while including exercise in a daily routine had the largest expected influence within the nine-item self-efficacy network. These results describe network associations rather than causal relationships or pathways that shape behavior.

The researchers recruited participants from a tertiary hospital in China and assessed exercise self-efficacy, kinesiophobia, heart-focused anxiety, and perceived social support using validated scales. They constructed two network models: an item-level model containing nine ordinal exercise self-efficacy items and a multidimensional model integrating 13 psychosocial dimensions. Gaussian graphical models with EBICglasso were used to estimate the networks. Expected influence identified components with greater estimated importance within the self-efficacy network, while targeted bridge expected influence quantified psychosocial factors whose estimated connections extended across the boundary between the self-efficacy and broader psychosocial communities.

Within the item-level analysis, the item “Include exercise in your daily routine” showed a relatively larger expected influence estimate than the other self-efficacy components. In the multidimensional analysis, “Avoidance of exercise,” “Avoidance,” and “Friend support” had relatively larger absolute targeted bridge expected influence estimates, indicating stronger observed associations with the exercise self-efficacy community. The investigators described exercise self-efficacy after percutaneous coronary intervention as an interconnected structure involving both its internal components and its relationships with related psychosocial factors, rather than an isolated construct.

Bootstrap and sensitivity analyses indicated acceptable accuracy for the estimated edge weights, good stability for the assessed centrality measures, and robustness of the principal findings after extreme observations were excluded. The study was nevertheless cross-sectional and limited to a sample from one tertiary hospital in China, so the network does not establish the direction or causality of the reported associations. The findings also should not be interpreted as evidence that changing any identified factor would improve exercise participation. The authors said their dual-network framework may support hypothesis-driven longitudinal research examining how exercise self-efficacy and related psychosocial factors are organized over time.

Subject of Research: Network associations between exercise self-efficacy and psychosocial factors in patients with coronary heart disease after percutaneous coronary intervention

Article Title: Network analysis of exercise self-efficacy and psychosocial factors in patients with coronary heart disease after percutaneous coronary intervention: a cross-sectional study

Article References: Nie, X., Gao, M., Cao, H., Chen, T., & Ou, J. (2026). Network analysis of exercise self-efficacy and psychosocial factors in patients with coronary heart disease after percutaneous coronary intervention: a cross-sectional study. BMC Psychology. https://doi.org/10.1186/s40359-026-05573-4

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05573-4

Keywords: exercise self-efficacy, coronary heart disease, percutaneous coronary intervention, psychosocial factors, network analysis, kinesiophobia, heart-focused anxiety, perceived social support, cross-sectional study, Network, analysis, exercise