The Role of Illness Perception, Hope, and Perceived Social Support in the Prediction of Loneliness in Patients With Acute Coronary Syndrome: A Cross‐Sectional Study

ABSTRACT Background and Aims Loneliness is a well‐known factor associated with increased mortality risk in cardiovascular patients, and hospitalization in Coronary Care Units (CCU) can exacerbate feelings of loneliness. This study aimed to examine the predictive role of illness perception, hope, and perceived social support on loneliness among patients with Acute Coronary Syndrome (ACS). Methods In this descriptive cross‐sectional study, 213 ACS patients admitted to CCUs of university hospitals in southern Iran were enrolled through convenience sampling from October 2021 to March 2022. Data were collected using a demographic characteristics form, illness perception scale, Snyder's Hope Scale, perceived social support questionnaire, and loneliness Scale. Data analysis involved Pearson correlation coefficients and hierarchical linear regression. Results Loneliness was most strongly associated with perceived social support (r = − 0.717, p < 0.001, r² = 0.52), followed by illness perception (r = 0.591, p < 0.001, r² = 0.35) and hope (r = − 0.546, p < 0.001, r² = 0.30). Hierarchical regression analysis indicated that illness perception (Step 2: ΔR² = 0.332, β = 0.58, p < 0.001, f² = 0.50) and hope (Step 3: β = − 0.32, p < 0.001, f² = 0.13) were significant predictors; in the final model, perceived social support emerged as the strongest predictor (β = − 0.52, p < 0.001), with the model explaining 56.5% of the variance in loneliness (R² = 0.565). Conclusion This study underscores the pivotal role of illness perception and perceived social support in shaping loneliness among ACS patients. Targeted interventions to improve illness perception and enhance social support systems may effectively alleviate loneliness, potentially improving clinical outcomes in this vulnerable population.