Factors Influencing Health-Related Quality of Life in Patients With Atrial Fibrillation: A Path Analytic Model

BACKGROUND: Atrial fibrillation (AF) is a chronic disease that negatively affects patients' health-related quality of life (HRQoL). Understanding the various influencing factors is crucial. OBJECTIVE: The objective of this study was to develop and validate a model that predicts HRQoL in patients with AF, based on the model of Ferrans et al and the literature. METHODS: We recruited 266 patients (mean age, 68.14 years; 61.7% male) from a cardiology outpatient clinic using convenience sampling. Data were collected on individual characteristics, social support (Multidimensional Scale of Perceived Social Support), unpleasant symptoms (Symptom Checklist Version III), depression (Center for Epidemiologic Studies Depression Scale), anxiety (State Anxiety Inventory), self-management behaviors, perceived health status, and HRQoL (36-Item Short-Form Health Survey). Descriptive statistics, correlations, and path analysis were used for data analysis. RESULTS: The final model, after including additional pathways based on the modification index, demonstrated good fit indices. It explained 63.3% of the variance in the physical component summary, directly influenced by perceived health status, age, unpleasant symptoms, and depression. It explained 69.6% of the variance in the mental component summary, directly influenced by perceived health status, depression, anxiety, unpleasant symptoms, and age. Social support had an indirect effect on HRQoL. CONCLUSIONS: To improve HRQoL in patients with AF, interventions are required to reduce unpleasant symptoms, depression, and anxiety, enhance perceived health status, and address age-related factors. In addition, social support should be systematically monitored and strengthened.