Mediating effect of coping strategy and psychological status between illness perception and quality of life among patients with atrial fibrillation: a cross-sectional study

Background This study investigated the mediating effects of coping strategies and psychological status on the relationship between illness perception and health-related quality of life (HRQoL) among patients with atrial fibrillation (AF). Methods This cross-sectional study enrolled 178 patients with AF who were admitted to a tertiary hospital in Beijing City in mainland from March 2020 and June 2022. Assessments were made for HRQoL using the Short Form Health Survey depressive symptoms using the Patient Health Questionnaire-9, anxiety using the Generalized Anxiety Disorder-7 (GAD-7), illness perception using the Brief Illness Perception Questionnaire (BIPQ), AF symptoms using the Atrial Fibrillation Severity Scale (AFSS), and coping strategies using the Brief-COPE Scale. Results Significant correlations were observed between illness perception, emotional variables, coping strategies, and HRQoL scores. The regression analysis found that BIPQ, GAD, Maladaptive coping and Problem-focused coping are significant predictors of PCS (F = 20.906, R-2 = 0.326, p < 0.01) and MCS (F = 31.24, R-2 = 0.419, p < 0.01). Bootstrap samples were used to conduct mediation analysis. The indirect effects of GAD-7 and Problem-focused coping (PC) on the impact of BIPQ on QoL were significant. GAD accounted for 13.2-19.3% of the variance in the total effect across different models, while PC accounted for 22.1-25.8%. The results also indicated a significant chain effect in the illness percepitong-anxiety-coping style-QoL model, which can explain 4.3-10.2% of the total effect, respectively. Conclusions The perception of illness significantly influenced HRQoL in patients with AF, as mediated by emotional symptoms and coping strategies. This highlights the importance of anxiety and problem-focused coping mechanisms. These findings underscore the need for a holistic, patient-centered approach to AF management that incorporates emotional well-being and coping strategies. Trial registration Retrospectively registered with ClinicalTrials.gov (NCT05974098). The date of registration: 1 August 2023.