Social Support and Quality of Life in Patients with Persistent Atrial Fibrillation: The Mediating Role of Illness Perception

Background: Persistent atrial fibrillation is associated with impaired quality of life and adverse health outcomes. Psychosocial factors, particularly social support and illness perception, may influence patients’ adaptation to the disease. However, the mediating role of illness perception in the relationship between social support and quality of life has not been adequately investigated. Objective: To examine the association between perceived social support and quality of life and whether this association operates indirectly through illness perception in patients with persistent atrial fibrillation. Methods: In this cross-sectional study, 150 patients with persistent atrial fibrillation were recruited from hospitals affiliated with Tehran University of Medical Sciences in 2025. Data were collected using the Multidimensional Scale of Perceived Social Support, Brief Illness Perception Questionnaire, and Atrial Fibrillation Effect on Quality of Life questionnaire. Mediation analysis was performed using PROCESS Macro Model 4. Results: Social support was positively associated with illness perception and quality of life (P< 0.001), with higher illness perception scores indicating a more threatening perception of illness. Illness perception was also positively associated with quality of life (P< 0.001) and partially accounted for the association between social support and quality of life (indirect effect = 0.091, 95% CI: 0.036– 0.144). The model explained 57.5% of the variance in quality of life. Conclusions: Social support and illness perception were significantly associated with quality of life in patients with persistent atrial fibrillation. These findings highlight the importance of considering patients’ perceived illness and social support when providing patient-centered care to support quality of life. Plain Language Summary: What’s New?