Structural Model of Quality of Life in Patients with Breast Cancer: The Role of Psychological Hardiness, Religious Orientation, Perceived Social Protection and Self-Efficacy with Mediation of Resilience and Death Anxiety

The quality of life in cancer patients has become increasingly important. The purpose of this study was to examine the predictive model of quality of life in patients with breast cancer based on psychological hardiness, religious orientation, perceived social support, and self-efficacy with mediation of resiliency and death anxiety.

The research method was analytical and structural equation modeling. The statistical population in this study included all patients with breast cancer referring to Cancer Institute of Imam Khomeini and Milad hospitals in Tehran, Iran in 2018. Purposeful sampling method was used to select the sample. 300 patients with breast cancer were selected based on the criteria for entering and leaving criteria. The research tool was a general self-efficacy questionnaire of Sherer et al., multi-dimensional perceived social support questionnaire Zamet et al., Allport Religious Orientation Questionnaire, Kobasa Psychological Hardiness Questionnaire, Templar Death Anxiety Scale, The Conor-Davidson Resilience Questionnaire, and the World Health Organization Quality of Life Scale.

The results of the model analysis showed that the factor structure of the research scales was acceptable. The results of the conceptual model test showed that the fitting indices of the research model are in a favorable condition. Religious orientation and psychological hardiness on quality of life in patients with breast cancer have significant direct and indirect effects on resiliency and death anxiety. In addition, perceived social support and self-efficacy exhibits a significant indirect effect on death anxiety of patients. Furthermore, resiliency and death anxiety have a significant direct effect on the quality of life of patients with breast cancer.

Our results indicate the importance of the antidote to psychological hardiness, religious orientation, and perceived social support in improvement of the quality of life of patients with breast cancer.