Self-efficacy and its effect on step count in patients with intermittent claudication after endovascular interventions: A six-month quantitative study

Background: Endovascular intervention is often associated with improvements in physical function in patients with peripheral artery disease. Self-efficacy, the belief in one's ability to successfully carry out specific behaviors, is a well-established determinant of exercise engagement in diverse populations, including those with peripheral artery disease. However, the role of self-efficacy in maintaining basic and instrumental activities of daily living following endovascular intervention is unclear. Aim: To investigate the relationship between self-efficacy and functioning, walking capacity, and emotional well-being in patients with peripheral artery disease before and after endovascular interventions. Methods: Twenty-eight individuals with peripheral artery disease presenting with either intermittent claudication or critical limb-threatening ischemia—who underwent endovascular interventions participated in this study. Standardized questionnaires were used to assess self-efficacy, anxiety, and depression. Daily-steps were calculated by a smartwatch. Independence in performing daily living activities was assessed using the modified Barthel Activities of Daily-Living Index and the independence in instrumental activities of daily-living questionnaire. Data was collected before the intervention (T1), at three months (T2), and at six months post-intervention (T3); this design enabled a comprehensive analysis of changes over time. Results: Initially, higher self-efficacy correlated with better functioning of daily activities (r = 0.437, p < 0.01) and instrumental activities (r = 0.475, p < 0.01). At six months, higher self-efficacy correlated positively with all domains, including increased step count (r = 0.555, p < 0.01). Self-efficacy had a significant negative correlation with reported anxiety (r = -0.574, p < 0.01) and depression levels (r = -0.622, p < 0.01) post-treatment. A positive association was observed between female sex and self-efficacy in those with initially high self-efficacy levels. Conclusions: Self-efficacy influences outcomes such as functional abilities, physical activity, and mental wellness in patients with peripheral artery disease following endovascular interventions.