The pathway analysis of relationship between illness uncertainty, perceived stress, coping strategies, and quality of life in patients with coronary artery disease.

BACKGROUND: Previous studies suggests that illness uncertainty is associated with quality of life in chronic illness, yet the underlying mechanisms remain unclear, particularly in coronary artery disease (CAD). This study aims to explore the relationship between uncertainty in illness, perceived stress, coping strategies, and quality of life in patients with coronary artery disease. METHODS: This cross-sectional study was conducted in 150 patients with CAD recruited at a specialized heart clinic affiliated with Tabriz University of Medical Sciences, Tabriz (Iran) in 2024. Uncertainty in illness, perceived stress, coping strategies, and QoL were evaluated through self-reported questionnaires. The multiple mediation model was analyzed using SPSS and Amos software, with a P-value of less than 0.05 considered significant. RESULTS: The mean (SD) scores of uncertainty in illness, perceived stress, coping strategies, physical, and psychological quality of life were 66.77 (11.97) (in a range of 23-115), 29.57 (4.96), 59.91 (10.32), 11.95 (2.90), and 16.48 (1.69), respectively. The Pearson correlation indicated a significant positive correlation between uncertainty in illness and perceived stress (r = 0.50, P < 0.001). Additionally, uncertainty in illness was negatively and significantly correlated with coping strategies (r = -0.41, P < 0.001) and physical QoL (r = -0.32, P < 0.001). There was also a significant negative correlation between perceived stress and coping strategies (r = -0.29, P < 0.001) as well as between perceived stress and physical QoL (r = -0.37, P < 0.001). Furthermore, a significant positive correlation was found between psychological QoL and physical QoL (r = 0.39, P < 0.001). CONCLUSIONS: Uncertainty in illness and perceived stress are important factors that affect QoL in patients with coronary artery disease. It is recommended to implement well-structured interventions aimed at decreasing illness uncertainty and perceived stress while improving physical quality of life in patients with coronary artery disease.