Psychosocial Pathways to Quality of Life in Cardiovascular Disease: The Roles of Stress, Anxiety, Sleep, Coping, and Social Support

Abstract Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide and is frequently accompanied by significant psychological distress that can affect patients’ quality of life. Individuals living with CVD frequently experience elevated anxiety, perceived stress, and sleep disturbance, all of which may negatively affect overall quality of life. Coping strategies and social support represent key psychosocial resources that may buffer the effects of stress and anxiety in this population. Despite increasing recognition of these factors, research examining psychosocial outcomes in CVD often investigates individual constructs in isolation rather than within an integrated framework. This paper proposes a conceptual model that integrates perceived stress, anxiety, sleep quality, coping, and social support as interconnected factors influencing quality of life among individuals living with CVD. Drawing on Stress and Coping Theory and related psychosocial perspectives, the model proposes that perceived stress contributes to anxiety, which subsequently influences sleep quality and quality of life. Coping strategies and social support are conceptualized as moderating resources that may buffer the effects of psychological distress. By synthesizing these constructs within a unified framework, the proposed model provides a theoretical foundation for future empirical research and offers implications for nursing practice aimed at improving psychosocial outcomes among individuals living with CVD.