Directional Model of Health-Related Quality of Life After Percutaneous Coronary Intervention: A Structural Equation Model Analysis

Background: Although percutaneous coronary intervention (PCI) improves survival and clinical outcomes in patients with acute coronary syndrome (ACS), many patients continue to experience impaired health-related quality of life (HRQoL). However, the direct determinants and mediating pathways influencing HRQoL among patients with ACS following PCI remain incompletely understood.Purpose: This study aimed to test the relationships among determinants of HRQoL based on the revised Wilson and Cleary model in patients with ACS following PCI.Methods: This cross-sectional study involved 240 patients. Data were collected using the Cardiac Self-Efficacy Scale, Fatigue Assessment Scale, Seattle Angina Questionnaire-7, Depression Anxiety Stress Scale-21, Social Functioning Questionnaire, and MacNew Quality of Life Questionnaire. Structural equation modeling was performed using SmartPLS version 3.2.7.Results: Self-efficacy, fatigue, anxiety, and social functioning demonstrated significant direct effects on HRQoL (β = 0.276, β = −0.151, β = −0.152, and β = 0.307, respectively; p < .05). Social functioning had the greatest direct effect on HRQoL (β = 0.307), while self-efficacy had the strongest association with its observed variables (β = 0.789).Conclusion: Self-efficacy, fatigue, anxiety, and social functioning were significant determinants of HRQoL in patients with ACS following PCI. These findings may inform comprehensive patient assessment and the development of targeted, patient-centered nursing care strategies to improve HRQoL.