Associations Between Fatigue, Knowledge, Self-Management, and Self-Efficacy Among Community-Dwelling Patients with Stable Coronary Heart Disease in Pingdingshan, China: A Cross-Sectional Study.

BACKGROUND: Fatigue is a common but underrecognized symptom in community-dwelling Chinese adults with coronary heart disease (CHD), adversely affecting self-care and quality of life. While prior studies have separately examined fatigue, knowledge, and self-management in CHD populations, few have investigated their interrelationships in community-based settings in China. This study aimed to examine the associations among CHD-related fatigue (measured by the Fatigue Scale-14, which assesses both physical and mental dimensions), disease-related knowledge, self-management behaviors, and self-efficacy in community-dwelling patients with stable CHD, and to explore whether knowledge, self-management, and self-efficacy are correlated with fatigue severity. METHODS: A cross-sectional survey was carried out in two urban communities of a single district in Pingdingshan, China, between March and April of 2024. 136 eligible adults with stable CHD were selected via consecutive sampling. Validated scales were used to measure fatigue, knowledge, self-management behaviors, and self-efficacy. To investigate relationships between these variables, Spearman correlation analyses were carried out. RESULTS: 92.65% of participants reported feeling fatigued, with a mean score of 8.73 ± 2.15. Only 7.35% of patients had high fatigue-related knowledge, and 6.62% had a high self-management score. Overall, patients showed limited knowledge and low engagement in self-management behaviors. Additionally, self-efficacy was low (mean 32.35 ± 12.18). Fatigue knowledge showed a weak, statistically significant correlation with fatigue (rs = -0.164, p = 0.056), while self-management (rs = -0.181, p < 0.05) and self-efficacy (rs = -0.320, p < 0.001) demonstrated weak and weak-to-moderate negative correlations with fatigue, respectively. Knowledge, self-management, and self-efficacy were found to have strong positive correlations with each other (rs = 0.832-0.912). CONCLUSION: Community-dwelling CHD patients frequently experience fatigue alongside low disease knowledge, poor self-management, and limited self-efficacy. These findings support the potential value of targeted community-based patient education programs and integrated disease management strategies targeting knowledge, self-management, and self-efficacy. Future intervention studies are needed to evaluate whether such approaches can reduce fatigue burden in community-dwelling CHD patients.