Abstract
Spiritual well-being (SWB) is increasingly recognized as a determinant of quality of life (QoL) in cancer care, yet little is known about this relationship in breast cancer patients particularly newly diagnosed. This study aimed to assess the association between SWB and QoL among newly diagnosed women with breast cancer. A cross-sectional study conducted about 12 months after treatment included 144 women newly diagnosed with breast cancer who completed the Arabic versions of the FACIT-Sp-12 and EORTC QLQ-BR23 at governmental hospitals in the southern West Bank. Descriptive statistics and Spearman correlations examined associations between spiritual well-being and quality-of-life domains were used. Stepwise multiple linear regression was performed, adjusting for sociodemographic, clinical, and support variables. Overall spiritual well-being (SWB) was moderate (M = 29.70 ± 8.21), with higher scores in Faith (11.26 ± 3.43) and Meaning (11.04 ± 2.90), and the lowest in Peace (7.40 ± 3.46). QoL showed moderate concerns for body image (43.17 ± 30.67), low sexual functioning (34.49 ± 24.43) and enjoyment (34.72 ± 28.39), and the lowest scores for future perspective (23.38 ± 29.52). SWB correlated positively with body image (r = .493, p < .01) and sexual functioning (Meaning: r = .297, p < .01), and negatively with systemic therapy side effects (Meaning: r = -.306, p < .01), breast symptoms (Meaning: r = -.337, p < .01), arm symptoms (Meaning: r = -.296, p < .01), and hair loss distress (Peace: r = -.215, p < .01). In multivariable models, Peace (B = 5.434, p < .001) and Faith (B = 5.194, p < .001) predicted better body image; Meaning predicted higher sexual functioning (B = 1.837, p = .001), sexual enjoyment (B = 2.224, p = .001), and fewer systemic (B = - 5.393, p < .001) and breast symptoms (B = - 5.030, p < .001). Peace predicted lower distress from hair loss (B = - 2.117, p = .001). SWB plays a vital role in enhancing QoL in Palestinian women with breast cancer. Interventions should integrate culturally sensitive spiritual and psychosocial support that strengthens purpose and inner peace alongside routine oncology follow-up.