Health Behaviors and Influencing Factors Among Middle-Aged and Young Patients With Coronary Heart Disease During Home-Based Cardiac Rehabilitation: A Cross-Sectional Study

Abstract

Objective: To assess the current status of cardiovascular health behaviors and examine the influencing psychological and cognitive factors based on intertemporal decision-making and motivation theories among young and middle-aged patients with coronary heart disease (CHD) during home-based cardiac rehabilitation (HBCR). Methods: A cross-sectional study was conducted from November 2025 to January 2026. A total of 210 young and middle-aged CHD patients undergoing HBCR were surveyed using a set of instruments, including the Cardiovascular Health Behaviors Questionnaire, the Delay Discounting Questionnaire, the Brief Self-Control Scale, the Anticipated Emotion Questionnaire, the Time Focus Scale, and the Behavioral Inhibition/Activation Systems Scale. A multiple linear regression analysis was performed to identify independent influencing factors. Results: The overall cardiovascular health behavior score was 49.43 ± 6.09, indicating a moderate-to-low level. Regression analysis revealed that behavioral activation system sensitivity ( β = 0.181), self-control ( β = 0.195), future time focus ( β = 0.175), negative anticipated emotions ( β = 0.148), and positive anticipated emotions ( β = 0.111) were positive predictors of health behaviors. In contrast, behavioral inhibition system sensitivity ( β = -0.206) and delay discounting ( β = -0.143) were negative predictors. These factors collectively explained 85.20% of the total variance in health behavior scores. Conclusion: The health behavior level among young and middle-aged CHD patients during HBCR requires improvement and is predominantly influenced by modifiable psychological and cognitive factors. Future interventions should aim to enhance approach motivation, self-regulatory capacity, and future orientation through targeted psychological and behavioral strategies to optimize HBCR outcomes.

Keywords

Home-based cardiac rehabilitation / Coronary heart disease / Health behaviors / Psychological factors / Cognitive factors

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