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BackgroundMoyamoya disease is a cerebrovascular disorder and a significant chronic health concern requiring regular monitoring to control the disease and its related complications.ObjectiveTo develop a structural model based on the salutogenesis theory, and to identify how social support, sense of coherence, and stress contribute to health behaviors, subjective health status, and quality of life in adolescents with moyamoya disease.MethodsWe examined a hypothetical model by integrating the concepts of a structural health-related quality-of-life model based on the salutogenesis theory among 239 adolescents with moyamoya disease in Korea. Data on health-related quality of life of adolescents with moyamoya disease were collected using the following scales: social support rating scale, sense of coherence scale, stress scale, health behavior scale, subjective health status scale, and quality-of-life scale. A structural equation model was used to analyze the data.ResultsThe final model demonstrated goodness-of-fit. A sense of coherence directly influenced quality of life (β = 0.504, p < 0.01) and indirectly influenced quality of life (β = 0.299, p < 0.05) through health behavior. Stress (β = -0.414, p < 0.001) and health behavior (β = -0.085, p < 0.01) directly influenced quality of life. Social support directly influenced health behavior (β = 0.321, p < 0.01) and subjective health status (β = 0.112, p < 0.01).DiscussionSince moyamoya disease, a chronic disease, is progressive, it is very important to identify factors for health promotion.This study found that sense of coherence and social support were significant factors contributing to lower stress, improved health, and quality of life in adolescents with moyamoya disease. This paper is intended to help health experts to develop an intervention strategy based on theory as an approach for chronic disease management.