Self-efficacy expectations were measured in 149 recovering cardiac surgery patients to determine whether in-patient education and telephone monitoring during convalescence enhanced perceptions of cardiac efficacy and reported activity. Significant differences were found for experimental patients in self-efficacy expectations for walking between 4 and 8 weeks (P = 0.02) and between 8 and 24 weeks (P = 0.05) following surgery. Experimental patients also reported higher levels of general activity at 4 weeks (P = 0.05) and 8 weeks (P = 0.02) as well as more walking and lifting at 8 weeks (P = 0.01 and P = 0.0008, respectively). By 12 weeks, treatment differences were no longer significant except for continued higher general activity levels (P = 0.03) for experimental patients. Self-efficacy expectations, summed for all physical activities, at at 8 weeks were found to be a significant predictor of self-reported activity at 12 weeks, contributing 14.8% of the 34.8% explained variance (R2 change = 0.1479; F = 26.58; P less than 0.0001). Self-efficacy expectations summed for all physical activity at 8 weeks were also significant predictors of self-reported activities at 24 weeks, contributing 8.5% of the variance (R2 change = 0.0847; F = 14.48; P = 0.0002). A New York Heart Association functional class at 4 and 8 weeks was an independent predictor of self-reported activity at 12 weeks, as was 8 week functional class for self-reported activity at 24 weeks. Mood state did not contribute to explained variance in the regression models.(ABSTRACT TRUNCATED AT 250 WORDS)