OBJECTIVE:We examine prospectively the role of specific forms of self-efficacy in the physical and role function for patients with coronary heart disease after controlling for the effects of anxiety and depression. METHODS:A 6-month prospective cohort study was conducted after cardiac catheterization of 198 HMO members, demonstrating clinically significant coronary disease. Coronary disease severity was assessed through cardiac catheterization; physical function, role function, anxiety, depression, and self-efficacy were assessed through questionnaires. RESULTS:The Cardiac Self-Efficacy Scale had two factors (maintain function and control symptoms) with high internal consistency and good convergent and discriminant validity. In multiple regression models, the self-efficacy scales significantly predicted physical function, social function, and family function after controlling for baseline function, baseline anxiety, and other significant correlates. CONCLUSIONS:Self-efficacy to maintain function and to control symptoms helps predict the physical function and role function, after accounting for coronary disease severity, anxiety, and depression in patients with clinically significant coronary disease. Interventions to improve self-efficacy may have a broader applicability in the heart disease population than previously appreciated.