Abstract Body (Do not enter title and authors here): Background: Expectations for recovery following cardiac intensive care unit (CICU) hospitalization may shape how patients engage in care and cope with challenges after discharge. Evidence suggests that higher expectations and stronger coping self-efficacy support better recovery, but few studies have explored how these factors develop or interact over time.

Research Question and Hypotheses: This study examined the longitudinal relationship between expectations for recovery and coping self-efficacy over the first 3 months post-discharge among CICU survivors. We hypothesized that higher expectations for recovery would be positively associated with greater coping self-efficacy at corresponding timepoints.

Methods: This longitudinal analysis was nested within the Wellness and Needs of Men and Women after a Cardiac Intensive Care Unit Stay (WellNOW) Study, a cohort of CICU survivors. Participants were adults (N = 132) who completed surveys at baseline and 3 months after CICU discharge. Coping self-efficacy was the outcome (range, 0-130). The primary predictor was expectations for recovery measured on a 0-100 visual analog scale. Mixed-effects linear regression was used to evaluate the association between expectations and coping self-efficacy over time, adjusting for age, sex, income, comorbidity burden, depressive symptoms, social support, ICU length of stay, Sequential Organ Failure Assessment score, and clinical context (surgical vs medical). Missing data were handled using multiple imputation by chained equations, with results pooled across 20 imputed datasets.

Results: Participants had a mean age of 62.2 years (SD = 13.1); 52% were female and 61% identified as White. Over half reported financial strain, and 45% had an annual income <$49,000. In the multivariable model, higher expectations for recovery were significantly associated with greater coping self-efficacy (β = 0.30; 95% CI, 0.15-0.46). There was no significant interaction with time (P = .45), indicating a consistent association across both timepoints. A sensitivity analysis using complete cases (n = 116), excluding participants with any missing covariate or outcome data, yielded similar results.

Conclusion: Expectations for recovery are positively associated with coping self-efficacy among CICU survivors and remain stable over the early recovery period. Interventions that foster positive and realistic expectations may promote self-efficacy and enhance patient-centered recovery after critical illness.