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Article

Between Pain and Hope: How Social Support Improves the Experience and Quality of Life of Chronic Disease Patients in Upper Egypt

by
Saudi Mohamed Hassan
,
Ahmed Thabet Helal Ibrahiem
*,
Wafa Said Al-Maamari
,
Emad Farouk Saleh
,
Magdy Mohammed Mustafa
and
Hosni Ibrahim Abdelghani
Sociology & Social Work Department, The College of Arts and Social Sciences, Sultan Qaboos University, Muscat 123, Oman
*
Author to whom correspondence should be addressed.
Soc. Sci. 2025, 14(10), 606; https://doi.org/10.3390/socsci14100606 (registering DOI)
Submission received: 24 July 2025 / Revised: 1 October 2025 / Accepted: 2 October 2025 / Published: 13 October 2025
(This article belongs to the Section Community and Urban Sociology)
Versions Notes

Abstract

Chronic diseases, with their long-term pain and suffering, are the main cause of disability and death. In this case, social support is related to better health outcomes for patients with such diseases. This study aims to investigate the relationship between social support and health quality of life for patients with chronic diseases. It is conducted on 100 patients diagnosed with chronic diseases at Assiut University Hospital in Upper-Egypt through hospital records from January 2025 to April 2025. Data are collected using the Social Support and Health Quality of Life Questionnaire and analyzed using SPSS version 17. Participants state that the most common type of social support is emotional support, with an average of (2.32), followed by material support, with an average of (2.31), and finally informational support, with an average of (2.29). The results of this study show a statistically significant relationship between social support and quality of life among patients with chronic diseases. Thus, patients who receive greater social support experienced improved health-related quality of life through increased adherence to treatment, the adoption of health-promoting behaviors, and the adoption of healthy lifestyles that positively influence their quality of life.

1. Introduction

Chronic diseases are not only a clinical problem but a public health problem as well (Fineberg 2012). Chronic diseases, with their long-term pain and suffering, mainly cause disability and death (Stephen 2010). Living with a chronic disease causes many changes in the patient’s life, quality of life, and the psychological and social well-being (De Ridder et al. 2008). Hence, social support and social networks are very important factors regarding the effective management of chronic health conditions (Poon et al. 2003). Social support has been associated with better health outcomes in a number of chronic diseases (Aylaz and Kılınç 2017). Therefore, the social support system is an effective mechanism that helps patients adapt to chronic diseases and enhance their quality of life (Roy 2011).
Regarding chronic diseases, social support is described as the material, emotional, and behavioral assistance and support provided by family, friends, or others from the social network to the patient, which has a positive impact on the patient’s behavior in managing himself/herself and his/her health (Lin et al. 2025). Health-related quality of life is a main indicator of the overall health among patients with chronic diseases, describing high levels of health knowledge, health-promoting physical behavior, adherence to a specific diet, and a low number of comorbidities (Lee and Oh 2020).
Social relationship patterns and various sources of social support, such as those provided by healthcare providers, family, and friends, have a significant impact on multiple dimensions of patients’ quality of life, including behavioral, emotional, physical, functional, and social aspects. (Luszczynska et al. 2013).
In this study, health-related quality of life (HRQoL) is conceptualized as a multidimensional construct including physical, psychological, and social well-being (Ferrans et al. 2005). Within this framework, treatment adherence and dietary compliance are considered important behavioral components contributing to better outcomes.
Building on this conceptualization, recent scholarship has emphasized that HRQoL is not limited to clinical outcomes but also encompasses behavioral and psychosocial indicators that shape patients’ overall well-being.
Health-related quality of life is closely linked to several key indicators, including higher levels of health literacy, engagement in health-promoting physical behaviors, perceived emotional and informational support, reduced comorbidity burden, improved health culture, enhanced self-efficacy, and the empowerment to adopt behaviors that support physical well-being (Lee and Oh 2020).
Recent studies have consistently highlighted the pivotal role of social support in improving the quality of life among patients with chronic and long-term health conditions. For instance, Moisoglou et al. (2024) demonstrated that resilience and social support significantly reduced anxiety and depression and enhanced quality of life among patients with post-COVID-19 syndrome. Similarly, Xu et al. (2023) found that social support mediated the relationship between self-care ability and life quality in cured leprosy patients, underscoring its protective role in vulnerable populations. Regarding patients on hemodialysis, Sułkowski et al. (2024) reported that social support, particularly emotional and informational support, was crucial in mitigating the psychological and physical challenges of dialysis, while Babovic et al. (2024) confirmed that perceived social support positively influenced health-related quality of life even when biochemical and immunonutritional parameters were considered.
Despite the growing body of evidence linking social support to improved health outcomes, most existing studies have focused on specific patient groups such as cancer survivors, hemodialysis patients, or those recovering from COVID-19. However, there is still limited empirical research that examines the multifaceted forms of social support and their direct influence on treatment adherence, adoption of health-promoting behaviors, and dietary practices among patients with chronic diseases in the context of Upper Egypt. This gap highlights the need for a more context-specific investigation that considers cultural, social, and healthcare dynamics unique to this setting. Addressing this gap will not only broaden the existing knowledge but also provide practical implications for healthcare providers, policymakers, and families in supporting patients to achieve better quality of life outcomes.

2. Literature of Review

Social support has long been recognized as an important psychosocial factor that enhances self-care behaviors and improves health outcomes, particularly among individuals with chronic diseases (Mohebi et al. 2018; Thoits 2011). It refers to the emotional, informational, and instrumental assistance provided by social networks, which can significantly influence patients’ ability to cope with illness and maintain well-being. Several studies have consistently shown that social support is positively associated with improved health-related quality of life (HRQoL). For instance, Chollou et al. (2022) reported that patients with greater social support enjoy a higher quality of life than their peers with limited support. Similarly, Remor (2002) confirmed the critical role of social support in understanding the quality of life of people living with HIV. Other studies have explored specific sources of support: Luszczynska et al. (2013) examined support from healthcare teams, families, and friends, while Årestedt et al. (2013) demonstrated that older patients with heart failure who received adequate social support were more adherent to treatment. In the same line, Maghsoodi and Salehinejad (2020) highlighted the predictive role of practical, service, financial, and emotional support in coping strategies, and Hajek et al. (2022) found that social support contributes to reducing complications of chronic diseases in the elderly. More recently, Goggin et al. (2024) provided further evidence of the positive link between social support, quality of life, and survival outcomes among cancer patients.
A large body of literature also links social support with improved treatment adherence. García-Cadena et al. (2012) demonstrated that patients receiving social support from partners adhered more effectively to treatment regimens. Likewise, Chisholm-Burns et al. (2010) showed that social, emotional, and family support were critical for adherence to immunosuppressive therapy in kidney transplant patients, while Gu et al. (2017) confirmed its strong effect on diabetes management. Warth et al. (2019) examined psychosocial interventions in palliative care, reporting positive impacts on patient outcomes. Riani and Putri (2023) reinforced these findings by showing that patients with family support were more committed to medical instructions. Collectively, these studies converge on the notion that social support is a critical factor in improving medication adherence across different chronic conditions.
In addition to treatment adherence, adopting health-promoting behaviors is another pathway through which social support enhances HRQoL. Safren et al. (2007) emphasized the necessity of positive behaviors for the long-term effectiveness of interventions. Kushner and Sorensen (2013) demonstrated that a healthy lifestyle positively impacts chronic disease management, while Martos-Méndez (2015) noted that insufficient support often results in poor compliance with medical recommendations. Ricardo et al. (2015) further confirmed that lifestyle behaviors such as physical activity, diet, and abstinence from smoking improve disease management. Oh (2019) highlighted the role of social support from healthcare professionals in promoting healthy habits among elderly women, and Zhang et al. (2024) concluded that higher levels of social support are associated with healthier lifestyles.
Dietary adherence also emerges as a crucial mediator of health outcomes. Cardol et al. (2022) and Yang et al. (2021) reported that social support facilitated adherence to diet among patients with chronic illnesses such as type 2 diabetes. Chair et al. (2015) and Ahrari et al. (2014) found that patients with greater support were more consistent in following dietary recommendations, while Pieroth et al. (2017) confirmed that elderly patients with higher levels of support followed better diets. Zhang et al. (2025) also emphasized the mediating role of social support in self-management, linking it to improved nutritional habits and reduced malnutrition risks.
Taken together, these studies demonstrate that social support is a central determinant of health outcomes across chronic conditions, improving treatment adherence, promoting healthier behaviors, and enhancing dietary compliance. Despite differences in disease type, population, and setting, the convergence of evidence highlights the vital role of social and family support in improving both physical and psychological well-being.
This study is therefore grounded in Social Support Theory, which emphasizes the role of emotional, informational, and instrumental support in helping individuals cope with stressors and maintain well-being (Thoits 2011). It also draws on the Health-Related Quality of Life (HRQoL) framework, which conceptualizes quality of life as a multidimensional construct shaped not only by clinical symptoms but also by psychosocial resources such as family, community, and healthcare systems (Ferrans et al. 2005). Together, these frameworks provide the conceptual lens for understanding how social support contributes to improved outcomes and higher quality of life among patients with chronic diseases.

3. Study Objectives

  • To identify the main forms of social support available to patients with chronic diseases at Assiut University Hospital in Upper Egypt.
  • To assess the level of health-related quality of life among patients with chronic diseases in the study setting.
  • To examine the association between social support and improvements in health-related quality of life, with a particular focus on treatment adherence, adoption of healthy behaviors, and compliance with dietary regimens.
  • To analyze the relationship between selected patient characteristics (monthly income, years since diagnosis, number of medications, and disease severity) and their overall health-related quality of life.

4. Research Questions

  • What are the main forms of social support available to patients with chronic diseases?
  • What is the level of health-related quality of life among patients with chronic diseases?
  • How is social support associated with improvements in health-related quality of life, specifically in terms of treatment adherence, healthy behaviors, and compliance with dietary regimens?
  • What is the relationship between selected patient characteristics (monthly income, years since diagnosis, number of medications, and disease severity) and their overall health-related quality of life

5. Materials and Methods

5.1. Study Design and Setting

This study adopted a descriptive correlational research design to explore the relationship between social support provided to patients with chronic diseases and their health-related quality of life. The research was conducted at Assiut University Hospital, Egypt.

5.2. Sample and Sampling Technique

A total of 100 patients were recruited using a purposive sampling technique. Eligibility was determined based on a comprehensive review of hospital records, considering patients’ age group, type of chronic disease, and years since diagnosis. Participants were selected from patients admitted to the internal medicine, cardiology, hepatology, and oncology departments.

5.3. Inclusion and Exclusion Criteria

Inclusion criteria required patients to (a) have a confirmed diagnosis of a chronic disease, (b) be registered in the hospital database between January and April 2025, (c) have been diagnosed for more than one year, (d) be able to complete the study questionnaire, and (e) provide voluntary informed consent to participate. Exclusion criteria included patients in childhood or adolescence during the data collection period, as well as those in critical conditions that could compromise their comprehension of the questionnaire items.

5.4. Data Collection Procedures

Data were collected between January and April 2025 through structured, face-to-face interviews conducted during patients’ scheduled visits to the outpatient clinics (internal medicine, cardiology, hepatology, and oncology) at Assiut University Hospital. After eligibility screening from hospital records, participants were approached in the waiting areas, informed about the study, and invited to participate. Upon obtaining written consent, the questionnaire was administered by trained research assistants in a standardized manner to ensure accuracy and minimize interviewer bias. All responses were recorded immediately, and confidentiality was strictly maintained throughout the process.

6. Questionnaire

To examine the relationship between social support and health-related quality of life (HRQoL) among patients with chronic diseases, a structured questionnaire consisting of 41 items was developed. Of these, 21 items measured the dimensions of social support, namely, emotional, informational, and material support, while 20 items assessed the dimensions of health-related quality of life, including (treatment adherence, adopting a healthy diet, and practicing health-promoting behaviors.). The questionnaire was designed based on several well-established scales, such as the World Health Organization’s Health-Related Quality of Life Scale, the McGill Quality of Life Questionnaire (MQOL) and its subcomponents—physical and psychological symptoms, and life outlook (Cohen et al. 1995)—as well as the questionnaire developed by (Luszczynska et al. 2013) about social support facets and sources (received and perceived support from healthcare professionals, family, and friends) and QOL aspects (emotional, physical symptoms, functional, and social). The full questionnaire is available from the authors upon reasonable request.
A structured questionnaire is used to collect data from the study participants at Assiut University Hospital, departments of internal medicine, hepatology, cardiology, and oncology. The questionnaire includes a group of demographic variables such as gender, age, educational level, number of family members, and monthly income. It also includes health information including the presence of health insurance, type of disease, severity of the condition, and number of years since diagnosis. It mainly contains two main variables. The first is forms of social support, The other one is health-related quality of life, which is
Social support and quality of life are measured using a three-point Likert scale (yes = 3, somewhat = 2, no = 1). To prove the validity and reliability of the tool, content validity assessment is adopted, and Cronbach’s alpha coefficient is calculated, which reaches (0.935), indicating a high level of internal consistency. Also, the split-half Spearman–Brown method was used to ensure the reliability of the study instrument (Table 1).
The objectives and procedures of the study were presented to the hospital administration, and official approvals were obtained, including from the Ethics Committee of the Faculty of Medicine, Assiut University, Number (04-2025-300665) for the year 2025. Detailed information describing this study was distributed to all potential participants, who provided their informed consent. Participation was voluntary, and consent could be withdrawn at any time. The questionnaire was administered during sessions supervised by physicians and nursing staff in collaboration with the research team members.

7. Results

7.1. Sociodemographic Characteristics

The statistical analyses in this study are performed using the Statistical Package for the Social Sciences (SPSS) version 17. They include describing demographic and clinical variables using frequencies and percentages. They also analyze the scores of forms of social support and health-related quality of life using arithmetic means, standard deviations, and internal consistency coefficients using Cronbach’s alpha to determine the reliability of the study tool. To define the connection between social support and health-related quality of life among patients with chronic diseases, the Pearson correlation coefficient is used. The chi-square test is applied to analyze the relationship between some demographic and clinical variables in addition to the overall health-related quality of life.
The questionnaire was administered to patients attending the internal medicine, hepatology, cardiology, and oncology departments at Assiut University Hospital in Egypt. Out of e th111 patients approached, 100 provided valid responses, resulting in a response rate of 90.09%. Eleven questionnaires were excluded due to incomplete or duplicate answers.
As shown in Table 2, most patients in the study were male and middle-aged, with nearly two-thirds holding a university or postgraduate degree. The majority of participants reported a monthly income below 9000 EGP, and about half lived in medium-sized households of three to six members. In terms of health status, cardiovascular diseases (heart disease and hypertension) were the most common conditions, followed by cancer and diabetes. Nearly half of the patients had been diagnosed for three to less than six years, and most reported their disease severity as moderate or severe. Furthermore, half of the participants were taking six or more medications daily, reflecting the considerable physical and economic burden associated with managing chronic disease.

7.2. Results Related to Forms of Social Support

Table 3 indicates the responses of the study participants regarding the forms of social support provided to them and their role in enhancing their quality of life. The participants indicate that the overall level of social support is Moderate, with an overall mean of (2.31). These results confirm that social support contributes positively to improving the quality of life for patients with chronic diseases. In addition, patients who receive effective social and family support achieve higher levels of quality of life compared to their peers who do not receive that kind of support.
Based on the previous results, emotional support is the most common social support provided to patients with chronic diseases, with an arithmetic mean of (2.32) and a standard deviation of (0.39). This type of support is greatly associated with treatment adherence, which participants express as a key factor in achieving their healthy quality of life and enhancing health outcomes.
The results show the great importance of family support as the most significant source of emotional support provided to the patients. Participants indicate the great role of family support as a crucial step to achieving their quality of life. Family support has many positive long-term results. It also encourages adherence to treatment doses and contributes to supporting self-care behaviors in dealing with chronic diseases.
According to Rosland et al. (2018), family support plays a pivotal role in enhancing the engagement of adults with diabetes in the healthcare process and improving their adherence to treatment plans, which positively contributes to reducing the likelihood of health complications. Similarly, Martire and Schulz (2007) highlighted the family’s crucial role in supporting self-management among patients with chronic diseases, positively influencing patients’ health behaviors and improving their daily lifestyle. In the same vein, De Maria et al. (2020) emphasized that the family support received by patients with chronic illnesses directly contributes to enhancing their health-related quality of life, particularly their psychological well-being.
On the other hand, the support provided by healthcare team is a necessary element in improving the quality of life for patients with chronic diseases, through the positive impact of the interactive relationship between the patient and the medical team. Their effective and reliable communication contributes to enhancing medication adherence, clarifying their benefits and side effects, and encouraging adherence to the treatment regimen.
Financial support comes second as the most common type of support reported by the study participants, with a mean of (2.31) and a standard deviation of (0.42), which is moderate. Many chronic diseases require long-term care, which requires ongoing medical expenses. The study participants indicate the impact of the disease on the family budget and well-being, and their difficulty completing treatment due to its high costs.
The study highlighted the importance of considering the impact of challenging economic conditions as predictors of poor treatment adherence and decreased health-related quality of life among patients. Simsek et al. (2014) examined the relationship between socioeconomic status and health-related behaviors, including unhealthy dietary patterns, and their negative impact on patients’ overall health. Furthermore, Tang et al. (2021) demonstrated the positive effect of economic support on the health status and self-management capacity of patients with chronic illnesses.
These findings regarding low monthly income among patients underscore that the financial support provided to individuals with chronic diseases remains insufficient. Many patients face difficult family economic circumstances that adversely affect their health. They reported not receiving adequate financial assistance during their illness, emphasizing.
Informational support as a form of social support comes at a moderate level, with an arithmetic mean of (2.29) with a standard deviation of (0.51). It is represented in providing patients with information related to the nature of the disease, instructions related to treatment regimens and its side effects, and the health risks resulting from not taking it.
Understanding the relationship between informational support and treatment adherence is of paramount importance, as poor adherence is strongly associated with a lack of information and knowledge provided to patients. The more patients understand their illness and gain health literacy regarding its nature and management strategies, the higher their level of adherence to the treatment plan. Conversely, insufficient awareness and knowledge about medications and their side effects, along with negative beliefs about the disease and treatment, contribute to lower medication adherence rates.
Several studies have demonstrated the effectiveness of informational support as a form of social support directed toward improving medical regimen adherence among patients with chronic diseases. Song et al. (2020) reported that informational support provided by patient communities significantly increased patients’ opportunities to achieve their health goals. Similarly, Fauzia and Mandaty (2023) confirmed that patients’ level of knowledge has a significant impact on medication adherence.
Regarding the information provided by the healthcare professionals, the study participants indicate that they discuss their health condition and treatment plans with their healthcare providers. They also receive a variety of information and advice related to adherence to regular medication dosages, the nature of their chronic illness, potential complications, and appropriate healthy eating practices. Quality of life as a whole as determined by patients with chronic diseases.
Table 4 shows that the level of health quality of life, in general, among the study participants is at a Moderate level, as the arithmetic mean is (2.29) and the standard deviation (0.38). The results of this study also reveal a group of topics related to health quality of life among patients with chronic diseases, and this is evident in the following variables:
First, a well-balanced diet: It has an arithmetic mean of (2.32) and a standard deviation of (0.46), indicating that it is an important variable in assessing the quality of healthy life. It highlights the relationship between diet and the risk of chronic diseases.
In this context, supporting health-promoting behaviors represents a key variable in the management of long-term medical conditions and in improving the quality of care for chronic diseases. Most chronic illnesses require the adoption of positive health behaviors to ensure the long-term effectiveness of therapeutic interventions. Such behaviors include patients’ engagement in self-care, addressing risky behaviors, adhering to medical recommendations, engaging in regular physical activity, refraining from smoking, maintaining a healthy weight, and actively participating as partners in the management of their health. These behaviors enhance patients’ ability to make sustainable health decisions, thereby contributing to improved health-related quality of life
Second, adherence to medical specifications: It has an arithmetic mean of (2.31) and a standard deviation of (0.45), and compliance with medical specifications by the patients. The results show that the quality of health life of patients with chronic diseases may be negatively affected by poor treatment management, such as non-adherence to the medical prescription, ignoring diets, and failure to modify health behavior, especially in long-term treatments, as some patients tend to stop treatment when they feel better.
Involving families and caregivers enhances patients’ quality of life, alleviates the burden on caregivers, encourages treatment adherence, and strengthens patients’ ability to cope with their illness. It also provides greater support for patient self-management through changes in practice systems (Goldberg and Rickler 2011). Participants in the study expressed feelings of discomfort regarding their illness, even in cases of relative improvement in their health condition. This highlights the importance of interventions aimed at improving disease management to achieve positive outcomes, including enhanced monitoring of the condition, symptom reduction, and improvements in both physical and psychosocial functioning.
Third, adopting a healthy lifestyle: It is the most important variable in the health-related quality of life for patients with chronic diseases, with an arithmetic mean of (2.24) and a standard deviation of (0.44). It promotes a healthy lifestyle by supporting health-promoting behaviors as a key variable in managing long-term conditions and improving the quality of healthcare for chronic diseases. Most chronic diseases require adopting positive behaviors to ensure the effectiveness of therapeutic intervention in the long-term. These behaviors include self-care for patients, addressing risky behaviors, and complying with medical recommendations. Regular physical activity, abstaining from smoking, maintaining a healthy weight, and making patients active partners in managing their health increases their ability to make sustainable health decisions that contribute to improving their health-related quality of life.

7.3. The Relationship Between Overall Social Support and Health-Based Quality of Life

Table 5 shows a relationship between social support as a whole and health quality of life. The relationship between social support and the study participants’ quality of life using Pearson’s correlation coefficient, where the value of Pearson’s correlation coefficient is (0.619), which proves a strong direct relationship at the significance level of (0.01). Correlation analyses are also used to determine the relationship between various variables related to the study participants’ quality of life, which could function as supporting variables. Social support and its dimensions (informational, emotional, and tangible material support) are factors that can better achieve quality of life in chronic diseases due to the fact that the quality of life is higher among patients who receive support from their spouses, family members, and friends. In addition, social support is one of the most important psychological and social factors that enhance an individual’s sense of security and comfort. When the patients feel surrounded by people who provide them with emotional, material, and moral support, this is positively reflected in their psychological state and their ability to adapt to illness or stress, which improves their assessment of their quality of life.

7.4. Determining the Relationships Between Demographic and Clinical Variables of Patients Associated with Health-Related Quality of Life

Table 6 shows a statistically significant direct relationship between monthly income and the overall health quality of life, as the value of Chi-square (χ2) is up to (106.18 *) which is statistically significant at a significance level less than (0.05). These results can be due to the fact that the monthly income and the severity of illness reflect a direct and realistic impact on the individual’s life, whether through the ability to meet health needs or through the impact of disease symptoms on the person’s daily activities. People with high income often have greater potential to obtain better healthcare, good nutrition, psychological support, and a healthy lifestyle, which is positively reflected in their quality of life.
The health-related quality of life rates among patients with chronic diseases increase are related to the individual’s economic status. Through a multivariate analysis, Siboni et al. (2019) demonstrate that economic status is one of the most important factors predicting the quality of life of those patients. Their study emphasizes the need to prioritize financial support programs to improve the patients’ quality of life.
Monthly income also plays a major role in influencing treatment adherence and the patients’ quality of life. Rising healthcare costs affect the patients’ ability to comply with treatment. Several studies have shown a relationship between the high cost of medications and the patients’ difficulty obtaining them on time. Ghimire et al. (2015) report that economic factors related to medications and their high cost increase the financial burden on patients. McPherson et al. (2007) also demonstrates that the high cost of medications may make patients feel like a burden to others. In addition, Konstantinou et al. (2020) indicate that economic barriers, such as the high cost of medications and low income, represent obstacles to patients’ access to different healthcare services.
There is a statistically significant relationship between the severity of the disease and the overall quality of health life, as the value of Chi-square (χ2) is (85.40 **), which is statistically significant at a level less than (0.05). These results indicate that the quality-of-life rates decrease among patients with chronic diseases with periods of disease severity and development. As the disease becomes more severe, it can lead to more health problems and make it harder to reach treatment goals, which may lower the overall quality of life for the patients.
The study results are consistent with some studies, such as Liu et al. (2020) which shows the negative impact of the number and severity of chronic diseases on the quality of life of the elderly with infectious diseases. Brettschneider et al. (2013) also reports a decrease in the level of overall health quality of life among patients with multiple diseases with an increase in the number and severity of cases.
On the other hand, the results above indicate the absence of a statistically significant relationship between some demographic variables, i.e., years of diagnosis, number of medications, and the overall health-related quality of life among patients, with the significance level being greater than 0.05 due to the patients’ psychological and social adaptation to the disease. Over time, patients become accustomed to living with their chronic condition and learn how to manage it, which reduces the impact of the length of the diagnosis period on their quality of life. Moreover, the number of medications or the complexity of the dosage regimen does not necessarily reflect the severity or the negative impact of the condition. Support from healthcare providers and family, along with suitable treatment plans, can help balance challenges like taking many medications or dealing with a long-term illness, helping patients keep a stable quality of life.

8. Discussion

This study presents a review and analysis of the relationship between social support and health-related quality of life for patients with chronic diseases. The results demonstrate a relationship between social support and health-related quality of life for patients with chronic diseases. This is what many previous studies have indicated, such as Thomson et al. (2011), which shows the reciprocal influence of social support on the physical and psychological quality of life of coronary artery disease patients. Bennett et al. (2001) also indicates that social support has a strong influence on changes in health-related quality of life. Conversely, Hajek et al. (2022) identifies a correlation between low social support and an increased likelihood of developing health problems in patients with chronic diseases. Zhang et al. (2025) confirms a positive relationship between social support, self-management, and overall health-related quality of life.
The results highlight the importance of social support as a factor influencing chronic disease patients’ adherence to medical recommendations and adoption of healthy behaviors, including a healthy diet. The study participants state that higher levels of social support are associated with improved health outcomes due to a significant improvement in their quality of life.
Family support is widely recognized as one of the most important sources of help for patients with chronic diseases. Many patients say that having supportive family members makes a big difference; it helps them comply with their treatment plans, follow medical advice, and make healthier lifestyle choices. When patients feel supported at home, they are more likely to live in ways that improve their health and well-being. For example, Rosland et al. (2018) finds that family support helps adults with diabetes follow their treatment plans better. Martire and Schulz (2007) also highlight how families can encourage good habits and self-care. Similarly, De Maria et al. (2020) indicate that this kind of support strengthens the patient’s overall quality of life.
Many patients have reported that the supportive behaviors of those around them are a main element of their emotional support. These behaviors include accompanying the patient to medical appointments, conducting tests and examinations, maintaining a proper diet, assisting with treatment plans and daily tasks, and showing concern and affection throughout the various stages of the disease. These practices directly enhance the quality of life for those patients.
The role of healthcare providers and the information they provide to patients are of great importance when regarding the effects of medications, their uses, and their side effects. The study participants emphasize the importance of their role in providing accurate information about their health condition, disease complications, the risks of medication refusal, and the importance of following healthy regimen and preventive health behaviors. Polinski et al. (2014) highlights the importance of a trusting relationship between patients and healthcare providers in health decision-making, medication adherence, and side effects. Meanwhile, Nirmal et al. (2022) indicates that social support behaviors provided by the healthcare team are among the factors driving treatment adherence and improving quality of life for patients with chronic diseases.
This study also demonstrates the strong impact of social support in adopting healthy behaviors and lifestyle, particularly when regarding chronic diseases. As a chronic illness progresses, patients are often encouraged to adjust their routines and adopt healthier lifestyle habits to better manage their conditions. These factors are important in forming a healthy quality of life. They also play a crucial role in maintaining overall health, supporting disease prevention, and reducing the risk of developing many chronic conditions (Kushner and Sorensen 2013; Martos-Méndez 2015; Garett 2016; Oh 2019).
On the other hand, the study results show the important role played by social support in following an organized diet and developing self-eating behaviors as important variables in achieving a healthy quality of life for chronic diseases patients. Accordingly, the shift towards healthy eating patterns is a necessary factor in reducing the high rates of chronic diseases, as many studies have emphasized the strong link between diet and the risk of developing chronic conditions (Ahrari et al. 2014; Pieroth et al. 2017; Yang et al. 2021; Cardol et al. 2022).
The study results also confirm the vital role of informational support in improving the quality of life for patients with chronic diseases. Knowledge is a key factor in the effectiveness of healthcare systems and promoting positive behavior toward treatment adherence. Poor treatment adherence is often related to a lack of information and knowledge introduced to patients. The more patients understand their condition and how to manage it, the more they are to comply with their treatment plans (Song et al. 2020).
Although emotional support is the most common and influential form of social support in this study, material support represents the most realistic and direct form of support, as many of the study participants express their suffering from multiple economic pressures in managing chronic diseases. Jeon et al. (2009) show that the costs of managing chronic diseases exceed living expenses. Abegunde and Stanciole (2008) confirm a strong relationship between chronic diseases and high health and non-healthcare costs for patients. Simsek et al. (2014) confirm the relationship between economic status and health behaviors, including unhealthy diets.
In addition, that study also highlights the importance of investigating the impact of difficult economic conditions on patients’ adherence to treatment. Regarding the low monthly incomes of those patients, the results also confirm that the economic support provided is insufficient, as those patients suffer from difficult family economic conditions which negatively impact their health. The patients express receiving insufficient financial assistance during their illness, emphasizing the impact of healthcare costs on the family budget and well-being.
This study obtains an interaction between economic characteristics and health-related quality of life among patients with chronic diseases. It confirms a strong relationship between a patient’s economic status and improved health-related quality of life. Patients with chronic diseases, especially those with limited incomes, face significant difficulties in completing treatment due to high financial costs. Siboni et al. (2019) indicate that economic status and disease type are among the main variables affecting the quality of life among patients with chronic diseases.
In addition, disease severity can lead to a decline in the quality of life as the disease progresses and becomes more severe. Patients may experience feelings of frustration and despair, especially when treatment is prolonged without obvious improvement. These feelings are becoming worse by previous unsuccessful treatment experiences or accompanying complications. All of these obstacles burden the patients’ psychological state and negatively affect their adherence to treatment, resulting in a limited achievement of clinical goals and a reduced quality of life.
Regarding the type of disease, heart disease and high blood pressure are the most common diseases, followed by cancer. The significance of these diseases lies in the fact that they reflect clear indicators of changing lifestyles, as the type of these diseases represents an increasing global health challenge. Among the most prominent causes of death are their direct link to unhealthy dietary patterns, lack of physical activity, smoking, and stress. Hence, the need for in-depth studies to guide health policies, enhance prevention programs, and develop intervention strategies to promote a healthy quality of life.
Patients’ medical history or years of diagnosis may also influence their condition. The longer the illness, the greater the likelihood of developing chronic complications. Furthermore, motivation to adhere to treatment may decline with a sense of routine and repetition. Thus, in-depth studies are needed to investigate the relationship between medical history and patients’ health-related quality of life.
The multiplicity and frequent use of medications also have undesirable consequences as one of the main reasons for non-compliance with treatment and poor quality of life for patients with chronic diseases, especially with regard to concerns related to the use of medications, their side effects, increased dosages, and increased physical, psychological, and economic burden on the patients.

9. Conclusions

The findings of this study highlight a clear and significant relationship between social support and health-related quality of life among patients with chronic diseases. Patients who reported higher levels of emotional, informational, and financial support demonstrated better adherence to treatment, engagement in health-promoting behaviors, and adoption of healthier lifestyles, which, in turn, positively influenced their quality of life. These results emphasize the importance of strengthening family, community, and healthcare-based support systems as essential components in managing chronic illness and improving overall patient well-being. In particular, enhancing patient–family communication and ensuring accessible psychosocial resources can serve as practical strategies to improve quality of life outcomes.

9.1. Limitations

This study has several limitations that should be acknowledged. First, the sample was restricted to 100 patients from Assiut University Hospital, which may not fully represent the diversity of adults living with chronic diseases across Egypt. Patients from private hospitals, rural health centers, or other governorates were not included, limiting the generalizability of the findings to the national population. Second, the study did not include pediatric patients, relapse cases, or individuals in the terminal stages of illness, all of whom may experience social support and quality of life differently. Third, reliance on self-reported data may introduce reporting bias. Despite these limitations, the study provides important insights into the role of social support in improving quality of life and underscores the need for broader, multi-center research to validate and extend these findings in different Egyptian contexts.

9.2. Ethical Considerations

Ethical approval for this study was obtained from the Institutional Review Board of the Faculty of Medicine, Assiut University (Approval No. 04-2025-300665). Prior to participation, each patient was verbally informed during the interview about the purpose of the study, the procedures involved, the potential benefits, and their rights as participants. Verbal consent was then obtained before administering the questionnaire. To ensure confidentiality, questionnaires did not include names or identifying details, and each response was recorded anonymously. Completed printed questionnaires were securely stored in a locked location accessible only to the research team. The importance of confidentiality and the voluntary nature of participation were explained to the patients, and the interviewers made sure that each participant understood their rights and agreed willingly to take part in the study.

Author Contributions

Conceptualization, S.M.H.; Methodology, A.T.H.I.; Software, H.I.A.; Formal analysis, E.F.S.; Investigation, S.M.H.; Resources, W.S.A.-M. and H.I.A.; Data curation, E.F.S.; Writing—original draft, S.M.H.; Writing—review & editing, A.T.H.I. and M.M.M. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Institutional Review Board of Assiut University Hospitals, Egypt (Approval No. 04-2025-300665).

Informed Consent Statement

The objectives, procedures, and ethical aspects of the study were thoroughly explained to all participants before data collection. Participation was entirely voluntary, and informed consent was obtained from all individuals involved in the study. Ethical approval was granted by the Institutional Review Board of Assiut University Hospitals, Egypt, prior to the commencement of data collection.

Data Availability Statement

The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author.

Conflicts of Interest

The authors declare no conflict of interest.

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Table 1. Spearman–Brown method of study instrument (n =15).
Table 1. Spearman–Brown method of study instrument (n =15).
No.DimensionsNumber of ItemsSplit-Half
(Spearman–Brown)
1Emotional support70.951
2Informational support70.777
3Financial support70.878
Total210.928
1Adherence to medical specifications70.908
2Following a structured diet70.765
3Adopting a healthy lifestyle60.888
Total200.922
The reliability of the questionnaire as a whole.410.968
Table 2. Sociodemographic and Clinical Characteristics of the Study Sample (n = 100).
Table 2. Sociodemographic and Clinical Characteristics of the Study Sample (n = 100).
CharacteristicsCategoriesN (%)
GenderMale62 (62.0)
Female38 (38.0)
Age (years)<4032 (32.0)
40–<6045 (45.0)
≥6023 (23.0)
Education levelLess than secondary24 (24.0)
Secondary17 (17.0)
University40 (40.0)
Postgraduate19 (19.0)
Family members<323 (23.0)
3–<655 (55.0)
≥622 (22.0)
Monthly salary (EGP)<300020 (20.0)
3000–<600025 (25.0)
6000–<900028 (28.0)
≥900027 (27.0)
Health insurancePublic29 (29.0)
Private49 (49.0)
None22 (22.0)
Disease typeDiabetes14 (14.0)
Cancer22 (22.0)
Hypertension23 (23.0)
Heart diseases23 (23.0)
Kidney disorders12 (12.0)
Other chronic diseases6 (6.0)
Years since diagnosis<3 years21 (21.0)
3–<6 years48 (48.0)
≥6 years31 (31.0)
Disease severityMild17 (17.0)
Moderate54 (54.0)
Severe29 (29.0)
Number of medications<315 (15.0)
3–<635 (35.0)
≥650 (50.0)
Table 3. Shows the forms of social support provided to the patients (n = 100).
Table 3. Shows the forms of social support provided to the patients (n = 100).
No.DimensionsArithmetic MeanStandard DeviationLevelRank
1Emotional support2.32 0.39 Moderate 1
2Informational support2.29 0.51 Moderate 3
3Financial support 2.31 0.42 Moderate 2
Total 2.31 0.33 The overall level is Moderate
Table 4. Presents the levels of the dimensions of health-related quality of life among the patients (n = 100).
Table 4. Presents the levels of the dimensions of health-related quality of life among the patients (n = 100).
No.DimensionsArithmetic MeanStandard DeviationLevelRank
1Adherence to medical specifications2.310.45Moderate2
2Following a structured diet2.320.46Moderate1
3Adopting a healthy lifestyle2.240.44Moderate3
health quality of life2.290.38The overall level is Moderate
Table 5. Shows the Pearson correlation coefficient (R) to determine the correlation between overall social support and overall health quality of life (n = 100).
Table 5. Shows the Pearson correlation coefficient (R) to determine the correlation between overall social support and overall health quality of life (n = 100).
Health Quality of LifeSocial Support
0.619 ** 1 Pearson correlation coefficient
0.000 Significance level
100 100 Sample sizeSocial Support
** p < 0.01.
Table 6. Shows the relationship between demographic and clinical variables among the study participants and their definition of health-related quality of life as a whole (n = 100).
Table 6. Shows the relationship between demographic and clinical variables among the study participants and their definition of health-related quality of life as a whole (n = 100).
No.Demographic and Clinical VariablesOverall Health-Related Quality of Life
The CoefficientCoefficient Value(α)Significance
1Monthly incomeChi-square (χ2)106.08 * 0.03 Significant
2Years since diagnosisChi-square (χ2) 57.94 0.33 Not Significant
3Number of medicationsChi-square (χ2) 66.94 0.11 Not Significant
4Disease severityChi-square (χ2)85.40 ** 0.00 Significant
** p < 0.01; * p < 0.05.
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Hassan, S.M.; Ibrahiem, A.T.H.; Al-Maamari, W.S.; Saleh, E.F.; Mustafa, M.M.; Abdelghani, H.I. Between Pain and Hope: How Social Support Improves the Experience and Quality of Life of Chronic Disease Patients in Upper Egypt. Soc. Sci. 2025, 14, 606. https://doi.org/10.3390/socsci14100606

AMA Style

Hassan SM, Ibrahiem ATH, Al-Maamari WS, Saleh EF, Mustafa MM, Abdelghani HI. Between Pain and Hope: How Social Support Improves the Experience and Quality of Life of Chronic Disease Patients in Upper Egypt. Social Sciences. 2025; 14(10):606. https://doi.org/10.3390/socsci14100606

Chicago/Turabian Style

Hassan, Saudi Mohamed, Ahmed Thabet Helal Ibrahiem, Wafa Said Al-Maamari, Emad Farouk Saleh, Magdy Mohammed Mustafa, and Hosni Ibrahim Abdelghani. 2025. "Between Pain and Hope: How Social Support Improves the Experience and Quality of Life of Chronic Disease Patients in Upper Egypt" Social Sciences 14, no. 10: 606. https://doi.org/10.3390/socsci14100606

APA Style

Hassan, S. M., Ibrahiem, A. T. H., Al-Maamari, W. S., Saleh, E. F., Mustafa, M. M., & Abdelghani, H. I. (2025). Between Pain and Hope: How Social Support Improves the Experience and Quality of Life of Chronic Disease Patients in Upper Egypt. Social Sciences, 14(10), 606. https://doi.org/10.3390/socsci14100606

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