The effect of self-disclosure on loneliness among patients with coronary heart disease: The chain mediating effect of social support and sense of coherence

Background: Loneliness is prevalent in patients with coronary heart disease (CHD). It has a serious impact on the physical and mental health and the quality of life of patients with CHD. However, what factors contribute to loneliness and the mechanism of action still need to be explored.Objectives: To explore the chain mediating effect among self-disclosure, social support, sense of coherence and loneliness in patients with CHD through a chain mediating model.Methods: This cross-sectional study included 248 patients with CHD from three tertiary hospitals in Shiyan, Hubei Province, China. Self-reported scales were used to assess feelings of loneliness, self-disclosure, social support and sense of coherence. The Amos 26.0 software was used to construct the chain mediating effect.Results: Self-disclosure cannot directly affect patients' loneliness (beta = -0.60, P>0.05). Social support and sense of coherence play a significant complete mediating role between self-disclosure and loneliness, with an overall mediating effect value of -0.479. Conclusion: Self-disclosure in CHD patients indirectly affect loneliness through social support and sense of coherence (beta = -0.479, P = 0.001). Improving patient self-disclosure and modulation of social support and sense of coherence help reduce in loneliness.