Objective To explore the mediating effect of coping styles (confrontation, avoidance and submission) between interoception and self-efficacy in patients with unstable angina (UA).

Methods A total of 260 patients with UA were selected and a cross-sectional survey was conducted using the general information questionnaire, medical coping styles questionnaire (MCMQ), Chinese version of the multidimensional assessment of interoceptive awareness-2 (MAIA2) and heart health self-efficacy and self-management (HH-SESM) scale.

Results The scores of the dimensions of confrontation, avoidance and submission of MCMQ in UA patients were (18.82 ± 6.72), (16.45 ± 5.63), and (12.72 ± 4.56) points, respectively. The score of MAIA2 was (21.16 ± 3.39) points, and the score of HH-SESM was (48.26 ± 6.72) points. The results of correlation analysis showed that the interoception and confrontation coping style were positively correlated with self-efficacy (r = 0.374, 0.325, P ＜ 0.01), while the avoidance coping style was negatively correlated with self-efficacy (r = –0.381, P ＜ 0.01), and the interoception was positively correlated with confrontation coping style (r = 0.359, P ＜ 0.01). It was negatively correlated with the avoidance coping style (r = –0.406, P ＜ 0.01). The interoception was positively correlated with the confrontation coping style (r = 0.359, P ＜ 0.01), and negatively correlated with the avoidance coping style (r = –0.406, P ＜ 0.01). The mediating effect analysis indicated that the confrontation coping style and avoidant coping style played a partial mediating role between interoception and self-efficacy, with indirect effect values of 0.065 (95%CI: 0.028–0.118) and 0.085 (95%CI: 0.041–0.142), respectively (P ＜ 0.01), the mediating effect accounted for 48.39% of the total effect, and the mediating effect of the submission coping style was not statistically significant (P ＞ 0.05).

Conclusions The self-efficacy of patients with unstable angina is at a medium to low level. Interoception is positively correlated with self-efficacy, and coping styles have a partial mediating effect in this relationship. The confrontation may play a positive role in the positive correlation between interoception and self-efficacy. It is recommended to formulate intervention strategies centered on coping styles to encourage patients to adopt confrontation coping and improve self-management efficacy.