Uncertainty in illness and perceived stress are important factors that affect quality of life in patients with coronary artery disease, with perceived stress and coping strategies serving as mediators in this relationship.
Illness uncertainty was significantly and positively correlated with perceived stress in CAD patients.
Illness uncertainty was negatively and significantly correlated with coping strategies in CAD patients.
Illness uncertainty was negatively and significantly correlated with physical quality of life in CAD patients.
Perceived stress was negatively and significantly correlated with coping strategies in CAD patients.
Perceived stress was negatively and significantly correlated with physical quality of life in CAD patients.
Physical quality of life and psychological quality of life were significantly and positively correlated in CAD patients.
A multiple mediation model was used to analyze whether perceived stress and coping strategies mediated the relationship between illness uncertainty and quality of life.
This research suggests that in patients with coronary artery disease (CAD), not knowing what to expect from their illness — called 'illness uncertainty' — plays an important role in their overall well-being. Specifically, the study found that when patients feel more uncertain about their illness, they also tend to feel more stressed, use fewer effective coping strategies, and report a lower physical quality of life. The study was conducted with 150 CAD patients in Iran and used questionnaires to measure all of these factors. The researchers also found that perceived stress and coping strategies appear to act as links — or mediators — between illness uncertainty and quality of life. In other words, illness uncertainty may partly harm quality of life by increasing stress and reducing patients' ability to cope effectively with their condition. Additionally, patients who had better physical quality of life also tended to have better psychological quality of life, highlighting the interconnected nature of physical and mental well-being in this population. This research suggests that healthcare providers working with CAD patients should consider addressing not just the physical aspects of the disease but also patients' psychological experiences, particularly their feelings of uncertainty and stress. Structured interventions that reduce illness uncertainty and perceived stress — such as patient education programs, counseling, or stress management strategies — could potentially improve quality of life for people living with coronary artery disease.
Allahbakhshian A, Sajjadi S, Sarbakhsh P, Tabrizi H. (2026). The pathway analysis of relationship between illness uncertainty, perceived stress, coping strategies, and quality of life in patients with coronary artery disease.. PloS one. https://doi.org/10.1371/journal.pone.0357910