{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:24:09Z","timestamp":1777983849614,"version":"3.51.4"},"reference-count":64,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-33745-6","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:42:25Z","timestamp":1769510545000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spiritual well-being and quality of life among newly diagnosed Palestinian women with breast cancer: a prospective study"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8879-8991","authenticated-orcid":false,"given":"Ibtisam","family":"Titi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6410-4720","authenticated-orcid":false,"given":"Nuha","family":"El Sharif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"33745_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-025-93883-9","volume":"15","author":"Y Cai","year":"2025","unstructured":"Cai, Y., Dai, F., Ye, Y. & Qian, J. The global burden of breast cancer among women of reproductive age: a comprehensive analysis. Sci. Rep. 15, 1\u201320. https:\/\/doi.org\/10.1038\/s41598-025-93883-9 (2025).","journal-title":"Sci. Rep."},{"key":"33745_CR2","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.jncc.2025.02.002","volume":"5","author":"Y Zhang","year":"2025","unstructured":"Zhang, Y. et al. Global burden of female breast cancer: new estimates in 2022, temporal trend and future projections up to 2050 based on the latest release from GLOBOCAN. J. Natl. Cancer Cent. 5, 287\u2013296. https:\/\/doi.org\/10.1016\/j.jncc.2025.02.002 (2025).","journal-title":"J. Natl. Cancer Cent."},{"key":"33745_CR3","unstructured":"MOH. Annual Health Report,2023 Palestinian Ministry of Heath, Health Information Unit, Health Policy & Planning Unit (2024)."},{"key":"33745_CR4","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.cnre.2017.03.006","volume":"4","author":"Z-P Ai","year":"2017","unstructured":"Ai, Z-P., Gao, X-L., Li, J-F., Zhou, J-R. & Wu, Y-F. Changing trends and influencing factors of the quality of life of chemotherapy patients with breast cancer. Chin. Nurs. Res. 4, 18\u201323. https:\/\/doi.org\/10.1016\/j.cnre.2017.03.006 (2017).","journal-title":"Chin. Nurs. Res."},{"key":"33745_CR5","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s41669-024-00543-1","volume":"9","author":"FS Mennini","year":"2025","unstructured":"Mennini, F. S. et al. Burden of disease of breast cancer in italy: a real-world data analysis. PharmacoEconomics - Open. 9, 283\u2013290. https:\/\/doi.org\/10.1007\/s41669-024-00543-1 (2025).","journal-title":"PharmacoEconomics - Open."},{"key":"33745_CR6","doi-asserted-by":"publisher","unstructured":"Jetan, M. et al. The impact of spiritual well-being on the quality of life of cancer patients: a cross-sectional study. Integr. Cancer Ther. 2023, 22. https:\/\/doi.org\/10.1177\/15347354231210841 (2023).","DOI":"10.1177\/15347354231210841"},{"key":"33745_CR7","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1007\/s00520-012-1650-1","volume":"21","author":"N Jafari","year":"2013","unstructured":"Jafari, N. et al. Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy. Support Care Cancer. 21, 1219\u20131225. https:\/\/doi.org\/10.1007\/s00520-012-1650-1 (2013).","journal-title":"Support Care Cancer"},{"key":"33745_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12904-020-0534-2","volume":"19","author":"E Rabitti","year":"2020","unstructured":"Rabitti, E. et al. The assessment of spiritual well-being in cancer patients with advanced disease: which are its meaningful dimensions? BMC Palliat. Care. 19, 1\u20138. https:\/\/doi.org\/10.1186\/s12904-020-0534-2 (2020).","journal-title":"BMC Palliat. Care"},{"key":"33745_CR9","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/S0885-3924(02)00440-2","volume":"24","author":"C Sep\u00falveda","year":"2002","unstructured":"Sep\u00falveda, C., Marlin, A., Yoshida, T. & Ullrich, A. Palliative care: the world health organization\u2019s global perspective. J. Pain Symptom Manage. 24, 91\u201396. https:\/\/doi.org\/10.1016\/S0885-3924(02)00440-2 (2002).","journal-title":"J. Pain Symptom Manage."},{"key":"33745_CR10","doi-asserted-by":"publisher","first-page":"3663","DOI":"10.21037\/apm-22-692","volume":"11","author":"N Ahmad","year":"2022","unstructured":"Ahmad, N. et al. The FACIT-Sp spiritual wellbeing scale: a factor analysis in patients with severe and\/or life-limiting medical illnesses. Ann. Palliat. Med. 11, 3663\u20133673. https:\/\/doi.org\/10.21037\/apm-22-692 (2022).","journal-title":"Ann. Palliat. Med."},{"key":"33745_CR11","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/ACM.0000000000000083","volume":"89","author":"CM Puchalski","year":"2014","unstructured":"Puchalski, C. M., Blatt, B., Kogan, M. & Butler, A. Spirituality and health: the development of a field. Acad. Med. 89, 10\u201316. https:\/\/doi.org\/10.1097\/ACM.0000000000000083 (2014).","journal-title":"Acad. Med."},{"key":"33745_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/ecc.12677","volume":"26","author":"AA Martoni","year":"2017","unstructured":"Martoni, A. A. et al. Spiritual well-being of Italian advanced cancer patients in the home palliative care setting. Eur. J. Cancer Care (Engl). 26, 1\u20139. https:\/\/doi.org\/10.1111\/ecc.12677 (2017).","journal-title":"Eur. J. Cancer Care (Engl)"},{"key":"33745_CR13","doi-asserted-by":"publisher","first-page":"229","DOI":"10.5455\/msm.2016.28.229-234","volume":"28","author":"E Fradelos","year":"2016","unstructured":"Fradelos, E. et al. The translation, validation and cultural adaptation of functional assessment of chronic illness therapy - spiritual well-being 12 (facit-sp12) scale in Greek Language. Mater. Socio Med. 28, 229. https:\/\/doi.org\/10.5455\/msm.2016.28.229-234 (2016).","journal-title":"Mater. Socio Med."},{"key":"33745_CR14","doi-asserted-by":"publisher","first-page":"437","DOI":"10.4103\/IJPC.IJPC_53_17","volume":"23","author":"MA Forouzi","year":"2017","unstructured":"Forouzi, M. A., Tirgari, B., Safarizadeh, M. H. & Jahani, Y. Spiritual needs and quality of life of patients with cancer. Indian J. Palliat. Care. 23, 437\u2013444. https:\/\/doi.org\/10.4103\/IJPC.IJPC_53_17 (2017).","journal-title":"Indian J. Palliat. Care"},{"key":"33745_CR15","doi-asserted-by":"publisher","first-page":"491","DOI":"10.5935\/abc.20160076","volume":"106","author":"JS Alvarez","year":"2016","unstructured":"Alvarez, J. S. et al. Association between spirituality and adherence to management in outpatients with heart failure. Arq. Bras. Cardiol. 106, 491\u2013501. https:\/\/doi.org\/10.5935\/abc.20160076 (2016).","journal-title":"Arq. Bras. Cardiol."},{"key":"33745_CR16","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1177\/0898010118761401","volume":"37","author":"CC Clark","year":"2019","unstructured":"Clark, C. C. & Hunter, J. Spirituality, spiritual well-being, and spiritual coping in advanced heart failure: review of the literature. J. Holist. Nurs. 37, 56\u201373. https:\/\/doi.org\/10.1177\/0898010118761401 (2019).","journal-title":"J. Holist. Nurs."},{"key":"33745_CR17","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1111\/ppc.12249","volume":"54","author":"MF Alradaydeh","year":"2018","unstructured":"Alradaydeh, M. F. & Khalil, A. A. The association of spiritual well-being and depression among patients receiving Hemodialysis. Perspect. Psychiatr Care. 54, 341\u2013347. https:\/\/doi.org\/10.1111\/ppc.12249 (2018).","journal-title":"Perspect. Psychiatr Care"},{"key":"33745_CR18","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1002\/cncr.29286","volume":"121","author":"AR Munoz","year":"2015","unstructured":"Munoz, A. R., Salsman, J. M., Stein, K. D. & Cella, D. Reference values of the functional assessment of chronic illness therapy-spiritual well-being: a report from the American cancer society\u2019s studies of cancer survivors. Cancer 121, 1838\u20131844. https:\/\/doi.org\/10.1002\/cncr.29286 (2015).","journal-title":"Cancer"},{"key":"33745_CR19","doi-asserted-by":"publisher","first-page":"2581","DOI":"10.1007\/s00520-018-4089-1","volume":"26","author":"E Abou Chaar","year":"2018","unstructured":"Abou Chaar, E. et al. Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Support Care Cancer. 26, 2581\u20132590. https:\/\/doi.org\/10.1007\/s00520-018-4089-1 (2018).","journal-title":"Support Care Cancer"},{"key":"33745_CR20","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1017\/S1478951519000464","volume":"18","author":"M Yilmaz","year":"2020","unstructured":"Yilmaz, M. & Cengiz, H. \u00d6. The relationship between spiritual well-being and quality of life in cancer survivors. Palliat. Support Care. 18, 55\u201362. https:\/\/doi.org\/10.1017\/S1478951519000464 (2020).","journal-title":"Palliat. Support Care"},{"key":"33745_CR21","doi-asserted-by":"publisher","unstructured":"Muzdalifah, F., Ariyani, M., Gazadinda, R. & Tsalitsaturrajbiyah Spiritual well-being as a predictor of quality of life among breast cancer patients in Indonesia. In Proc 3rd Borobudur int symp humanit Soc sci 2021 (BIS-HSS 2021) 258\u2013268 (2023). https:\/\/doi.org\/10.2991\/978-2-494069-49-7_44.","DOI":"10.2991\/978-2-494069-49-7_44"},{"key":"33745_CR22","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1089\/jpm.2014.0189","volume":"18","author":"M Bai","year":"2015","unstructured":"Bai, M. & Lazenby, M. A systematic review of associations between spiritual well-being and quality of life at the scale and factor levels in studies among patients with cancer. J. Palliat. Med. 18, 286\u2013298. https:\/\/doi.org\/10.1089\/jpm.2014.0189 (2015).","journal-title":"J. Palliat. Med."},{"key":"33745_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/1980-220X-REEUSP-2020-0476","volume":"55","author":"ML Brand\u00e3o","year":"2021","unstructured":"Brand\u00e3o, M. L., Fritsch, T. Z., Toebe, T. R. P. & Rabin, E. G. Association between spirituality and quality of life of women with breast cancer undergoing radiotherapy. Rev. Da Esc Enferm. 55, 1\u20136. https:\/\/doi.org\/10.1590\/1980-220X-REEUSP-2020-0476 (2021).","journal-title":"Rev. Da Esc Enferm"},{"key":"33745_CR24","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1017\/S1478951514000820","volume":"13","author":"M Bai","year":"2015","unstructured":"Bai, M., Lazenby, M., Jeon, S., Dixon, J. & McCorkle, R. Exploring the relationship between spiritual well-being and quality of life among patients newly diagnosed with advanced cancer. Palliat. Support Care. 13, 927\u2013935. https:\/\/doi.org\/10.1017\/S1478951514000820 (2015).","journal-title":"Palliat. Support Care"},{"key":"33745_CR25","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12905-025-03571-z","volume":"25","author":"SM Abdelrahman","year":"2025","unstructured":"Abdelrahman, S. M., Ibraheem, M. H., Allam, H. & Sewram, V. Factors affecting quality of life in women post mastectomy for breast cancer in Baheya foundation (Egypt): a retrospective cohort study. BMC Womens Health. 25, 43. https:\/\/doi.org\/10.1186\/s12905-025-03571-z (2025).","journal-title":"BMC Womens Health"},{"key":"33745_CR26","doi-asserted-by":"publisher","first-page":"E54","DOI":"10.1097\/NCC.0000000000000689","volume":"43","author":"PJ Oh","year":"2020","unstructured":"Oh, P. J. & Cho, J. R. Changes in fatigue, psychological distress, and quality of life after chemotherapy in women with breast cancer: a prospective study. Cancer Nurs. 43, E54\u201360. https:\/\/doi.org\/10.1097\/NCC.0000000000000689 (2020).","journal-title":"Cancer Nurs."},{"key":"33745_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5339\/qmj.2022.43","volume":"2022","author":"C El Jabari","year":"2022","unstructured":"El Jabari, C., Nawajah, I. & Jabareen, H. FACT-G assessment of the quality of life for Palestinian patients with cancer. Qatar Med. J. 2022, 1\u20139. https:\/\/doi.org\/10.5339\/qmj.2022.43 (2022).","journal-title":"Qatar Med. J."},{"key":"33745_CR28","doi-asserted-by":"crossref","unstructured":"Titi, I. & Sharif, N. E. Factors associated with supportive care needs among Palestinian women with breast cancer in the West bank: a cross-sectional study. Cancers 2024, 1\u201321 (2024).","DOI":"10.3390\/cancers16213663"},{"key":"33745_CR29","doi-asserted-by":"publisher","first-page":"2756","DOI":"10.1200\/JCO.1996.14.10.2756","volume":"14","author":"M Sprangers","year":"1996","unstructured":"Sprangers, M. et al. The EORTC breast cancer-specific quality-of-lifequestionnaire module: first results from a three-country field study. J. Clin. Oncol. 14, 2756\u20132768 (1996).","journal-title":"J. Clin. Oncol."},{"key":"33745_CR30","doi-asserted-by":"publisher","first-page":"908","DOI":"10.2298\/VSP180629155K","volume":"77","author":"S Kostic","year":"2020","unstructured":"Kostic, S. et al. Assessment of age-related influences on the quality of life of breast cancer patients before and after surgical treatment. Vojnosanit Pregl. 77, 908\u2013916. https:\/\/doi.org\/10.2298\/VSP180629155K (2020).","journal-title":"Vojnosanit Pregl"},{"key":"33745_CR31","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3390\/rel2010077","volume":"2","author":"JM Bredle","year":"2011","unstructured":"Bredle, J. M., Salsman, J. M., Debb, S. M., Arnold, B. J. & Cella, D. Spiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy-Spiritual Well-Being scale (FACIT-Sp). Religions 2, 77\u201394. https:\/\/doi.org\/10.3390\/rel2010077 (2011).","journal-title":"Religions"},{"key":"33745_CR32","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1002\/pon.2062","volume":"22","author":"M Lazenby","year":"2013","unstructured":"Lazenby, M., Khatib, J., Al-Khair, F. & Neamat, M. Psychometric properties of the functional assessment of chronic illness Therapy - Spiritual Well-being (FACIT-Sp) in an Arabic-speaking, predominantly Muslim population. Psychooncology 22, 220\u2013227. https:\/\/doi.org\/10.1002\/pon.2062 (2013).","journal-title":"Psychooncology"},{"key":"33745_CR33","first-page":"404","volume":"29","author":"Y Yu","year":"2023","unstructured":"Yu, Y. et al. Spiritual well-being and quality of life for patients undergoing chemotherapy for pancreatic cancer: correlates and influencing factors. Altern. Ther. Health Med. 29, 404\u2013411 (2023).","journal-title":"Altern. Ther. Health Med."},{"key":"33745_CR34","doi-asserted-by":"publisher","unstructured":"Abu-Odah, H., Molassiotis, A. & Yat Wa Liu, J. Analysis of the unmet needs of Palestinian advanced cancer patients and their relationship to emotional distress: results from a cross-sectional study. BMC Palliat. Care 2022,  21. https:\/\/doi.org\/10.1186\/s12904-022-00959-8 (2022).","DOI":"10.1186\/s12904-022-00959-8"},{"key":"33745_CR35","doi-asserted-by":"publisher","first-page":"6767","DOI":"10.1007\/s00520-022-07104-4","volume":"30","author":"RM Albusoul","year":"2022","unstructured":"Albusoul, R. M., Hasanien, A. A., Abdalrahim, M. S., Zeilani, R. S. & Al-Maharma, D. Y. The effect of spiritual well-being on symptom experience in patients with cancer. Support Care Cancer  30, 6767\u20136774. https:\/\/doi.org\/10.1007\/s00520-022-07104-4 (2022).","journal-title":"Support Care Cancer"},{"key":"33745_CR36","doi-asserted-by":"publisher","first-page":"2096","DOI":"10.1007\/s10943-017-0370-8","volume":"56","author":"A Al-Natour","year":"2017","unstructured":"Al-Natour, A., Al Momani, S. M. & Qandil, A. M. A. The relationship between spirituality and quality of life of Jordanian women diagnosed with breast cancer. J. Relig. Health. 56, 2096\u20132108. https:\/\/doi.org\/10.1007\/s10943-017-0370-8 (2017).","journal-title":"J. Relig. Health"},{"key":"33745_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12659\/MSM.941769","volume":"29","author":"M Machul","year":"2023","unstructured":"Machul, M., Bredle, J., Jurek, K. & Dobrowolska, B. Psychometric properties of the Polish version of the FACIT-Sp-12: assessing spiritual well-being among patients with chronic diseases. Med. Sci. Monit. 29, 1\u201313. https:\/\/doi.org\/10.12659\/MSM.941769 (2023).","journal-title":"Med. Sci. Monit."},{"key":"33745_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/jjns.12276","volume":"17","author":"Y Kamijo","year":"2020","unstructured":"Kamijo, Y. & Miyamura, T. Spirituality and associated factors among cancer patients undergoing chemotherapy. Japan J. Nurs. Sci. 17, 1\u201312. https:\/\/doi.org\/10.1111\/jjns.12276 (2020).","journal-title":"Japan J. Nurs. Sci."},{"key":"33745_CR39","doi-asserted-by":"publisher","first-page":"E43","DOI":"10.1097\/NCC.0000000000000298","volume":"39","author":"YC Wang","year":"2016","unstructured":"Wang, Y. C. & Lin, C. C. Spiritual well-being May reduce the negative impacts of cancer symptoms on the quality of life and the desire for hastened death in terminally ill cancer patients. Cancer Nurs. 39, E43\u201350. https:\/\/doi.org\/10.1097\/NCC.0000000000000298 (2016).","journal-title":"Cancer Nurs."},{"key":"33745_CR40","doi-asserted-by":"publisher","first-page":"871","DOI":"10.12740\/pp\/onlinefirst\/63787","volume":"51","author":"A S\u0142owik","year":"2017","unstructured":"S\u0142owik, A., Jab\u0142o\u0144ski, M., Micha\u0142owska-Kaczmarczyk, A. & Jach, R. Evaluation of quality of life in women with breast cancer, with particular emphasis on sexual satisfaction, future perspectives and body image, depending on the method of surgery. Psychiatr Pol. 51, 871\u2013888. https:\/\/doi.org\/10.12740\/pp\/onlinefirst\/63787 (2017).","journal-title":"Psychiatr Pol."},{"key":"33745_CR41","doi-asserted-by":"publisher","unstructured":"Papadopoulos, T., Abrahim, A., Sergelidis, D. & Bitchava, K. Original Article \u0395\u03c1\u03b5\u03c5\u03bd\u03b7\u03c4\u03b9\u03ba\u03ae 2, 119\u2013123. https:\/\/doi.org\/10.4314\/ajcem.v12i3. (2011).","DOI":"10.4314\/ajcem.v12i3"},{"key":"33745_CR42","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1186\/s12905-024-03402-7","volume":"24","author":"B Omari","year":"2024","unstructured":"Omari, B. et al. Assessing the factors associated with body image perception and quality of life of Palestinian women undergoing breast cancer treatment: a cross-sectional study. BMC Womens Health. 24, 565. https:\/\/doi.org\/10.1186\/s12905-024-03402-7 (2024).","journal-title":"BMC Womens Health"},{"key":"33745_CR43","doi-asserted-by":"publisher","first-page":"2389","DOI":"10.2147\/NDT.S135624","volume":"13","author":"JA Su","year":"2017","unstructured":"Su, J. A. et al. Depression and family support in breast cancer patients. Neuropsychiatr Dis. Treat. 13, 2389\u20132396. https:\/\/doi.org\/10.2147\/NDT.S135624 (2017).","journal-title":"Neuropsychiatr Dis. Treat."},{"key":"33745_CR44","doi-asserted-by":"publisher","first-page":"162","DOI":"10.5737\/23688076322162171","volume":"32","author":"JGB da Silva","year":"2022","unstructured":"da Silva, J. G. B., Costa, D. T., Lima Cavalcanti, I. D., Nogueira, M. C. & de BL, D. A. Quality of life in women with breast cancer under radiotherapy. Can. Oncol. Nurs. J. 32, 162\u2013171. https:\/\/doi.org\/10.5737\/23688076322162171 (2022).","journal-title":"Can. Oncol. Nurs. J."},{"key":"33745_CR45","doi-asserted-by":"publisher","first-page":"185","DOI":"10.31557\/APJCP.2020.21.1.185","volume":"21","author":"M Konieczny","year":"2020","unstructured":"Konieczny, M., Cipora, E., Sygit, K. & Fal, A. Quality of life of women with breast cancer and socio-demographic factors. Asian Pac. J. Cancer Prev. 21, 185\u2013193. https:\/\/doi.org\/10.31557\/APJCP.2020.21.1.185 (2020).","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"33745_CR46","doi-asserted-by":"publisher","first-page":"5377","DOI":"10.7314\/APJCP.2014.15.13.5377","volume":"15","author":"H Acil","year":"2014","unstructured":"Acil, H. & Cavdar, I. Comparison of quality of life of Turkish breast cancer patients receiving breast conserving surgery or modified radical mastectomy. Asian Pac. J. Cancer Prev. 15, 5377\u20135381. https:\/\/doi.org\/10.7314\/APJCP.2014.15.13.5377 (2014).","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"33745_CR47","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s11136-018-2017-y","volume":"28","author":"AI Cobo-Cuenca","year":"2019","unstructured":"Cobo-Cuenca, A. I., Mart\u00edn-Espinosa, N. M., Rodr\u00edguez-Borrego, M. A. & Carmona-Torres, J. M. Determinants of satisfaction with life and self-esteem in women with breast cancer. Qual. Life Res. 28, 379\u2013387. https:\/\/doi.org\/10.1007\/s11136-018-2017-y (2019).","journal-title":"Qual. Life Res."},{"key":"33745_CR48","doi-asserted-by":"publisher","unstructured":"\u015etef\u01cenu\u0163, A. M., Vintil\u01ce, M. & Tudorel, O. I. The relationship of dyadic coping with emotional functioning and quality of the relationship in couples facing cancer\u2014a meta-analysis. Front. Psychol. 2021, 11. https:\/\/doi.org\/10.3389\/fpsyg.2020.594015 (2021).","DOI":"10.3389\/fpsyg.2020.594015"},{"key":"33745_CR49","doi-asserted-by":"publisher","unstructured":"Valente, M., Chirico, I., Ottoboni, G. & Chattat, R. Relationship dynamics among couples dealing with breast cancer: a systematic review. Int. J. Environ. Res. Public. Health 2021, 18. https:\/\/doi.org\/10.3390\/ijerph18147288 (2021).","DOI":"10.3390\/ijerph18147288"},{"key":"33745_CR50","doi-asserted-by":"publisher","unstructured":"Santos, L. N., de Aguiar, S. S., Rodrigues, G. M., Thuler, L. C. S. & Bergmann, A. dos,Influence of age on health-related quality of life of women diagnosed with breast cancer. Rev. Bras. Cancerol.  69, 1\u20138. https:\/\/doi.org\/10.32635\/2176-9745.rbc.2023v69n2.3826 (2023).","DOI":"10.32635\/2176-9745.rbc.2023v69n2.3826"},{"key":"33745_CR51","unstructured":"Saleh, E. M. & Narjes, A. H. Health-related quality of life in women with breast cancer attending Basrah oncology centre. Basrah J. Surg. 2021, 59\u201362 (2021)."},{"key":"33745_CR52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5812\/semj-136337","volume":"25","author":"A Tahmasebi-Ghorrabi","year":"2024","unstructured":"Tahmasebi-Ghorrabi, A., Mosavi, M. & Torabipour, A. Health-related quality of life associated factors in breast cancer patients in 2017\u20132018. Shiraz E Med. J. 25, 1\u201310. https:\/\/doi.org\/10.5812\/semj-136337 (2024).","journal-title":"Shiraz E Med. J."},{"key":"33745_CR53","doi-asserted-by":"publisher","first-page":"121","DOI":"10.4274\/ejbh.galenos.2023.2022-9-1","volume":"19","author":"M Konieczny","year":"2023","unstructured":"Konieczny, M. & Fal, A. The influence of the surgical treatment method on the quality of life of women with breast cancer. Eur. J. Breast Heal. 19, 121\u2013133. https:\/\/doi.org\/10.4274\/ejbh.galenos.2023.2022-9-1 (2023).","journal-title":"Eur. J. Breast Heal"},{"key":"33745_CR54","doi-asserted-by":"publisher","unstructured":"Abeer, A. R. & Rawaa, A. M. H. Assessing the quality of life in breast cancer women: a cross sectional descriptive study. Asian Pac. J. Cancer Prev. 23, 2299\u20132307. https:\/\/doi.org\/10.31557\/APJCP.2022.23.7.2299 (2022).","DOI":"10.31557\/APJCP.2022.23.7.2299"},{"key":"33745_CR55","doi-asserted-by":"publisher","first-page":"238","DOI":"10.9734\/jammr\/2020\/v32i2430773","volume":"32","author":"M Malik","year":"2020","unstructured":"Malik, M., Inam, N. & Hussain, A. Assessment of health related quality of life using EORTC QLQ BR-23 among breast cancer patients in Pakistan. J. Adv. Med. Med. Res. 32, 238\u2013245. https:\/\/doi.org\/10.9734\/jammr\/2020\/v32i2430773 (2020).","journal-title":"J. Adv. Med. Med. Res."},{"key":"33745_CR56","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1590\/1806-93042017000200010","volume":"17","author":"PA Barbosa","year":"2017","unstructured":"Barbosa, P. A., Cesca, R. G., Pac\u00edfico, T. E. D. & Leite, I. C. G. Quality of life in women with breast cancer, after surgical intervention, in a City in the Zona Da Mata region in Minas Gerais, Brazil. Rev. Bras. Saude Matern Infant. 17, 385\u2013399. https:\/\/doi.org\/10.1590\/1806-93042017000200010 (2017).","journal-title":"Rev. Bras. Saude Matern Infant"},{"key":"33745_CR57","unstructured":"Busari, M., & Henry, G. (2025). Impact of hospital environment on patient satisfaction: studying facility design, cleanliness, noise reduction, and comfort measures. Unpublished manuscript, available on ResearchGate."},{"key":"33745_CR58","doi-asserted-by":"publisher","unstructured":"Johnsson, A., Fugl-Meyer, K., Bordas, P., \u00c5hman, J. & Von Wachenfeldt, A. Side effects and its management in adjuvant endocrine therapy for breast cancer: a matter of communication and counseling. Breast Cancer Basic. Clin. Res. 2023,  17. https:\/\/doi.org\/10.1177\/11782234221145440 (2023).","DOI":"10.1177\/11782234221145440"},{"key":"33745_CR59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/cnr2.1242","volume":"3","author":"M Ikeda","year":"2020","unstructured":"Ikeda, M. et al. Effects of the appearance care program for breast cancer patients receiving chemotherapy: a mixed method study. Cancer Rep. 3, 1\u20139. https:\/\/doi.org\/10.1002\/cnr2.1242 (2020).","journal-title":"Cancer Rep."},{"key":"33745_CR60","doi-asserted-by":"publisher","first-page":"35","DOI":"10.15406\/ncoaj.2019.06.00180","volume":"6","author":"MG Alvarado","year":"2019","unstructured":"Alvarado, M. G. et al. Spiritual well-being and quality of life in advanced age women post-mastectomy for breast cancer operated. Nurs. Care Open. Access. J. 6, 35\u201340. https:\/\/doi.org\/10.15406\/ncoaj.2019.06.00180 (2019).","journal-title":"Nurs. Care Open. Access. J."},{"key":"33745_CR61","doi-asserted-by":"publisher","unstructured":"Sharifi, M., Koenig, H. G., Dadfar, M., Turan, Y. & Ghorbani, A. The effectiveness of spirituality-centered cognitive therapy on body image, sexual function, illness perception and intrusive thoughts in Iranian women after mastectomy. Religions 2024, 15. https:\/\/doi.org\/10.3390\/rel15050578 (2024).","DOI":"10.3390\/rel15050578"},{"key":"33745_CR62","doi-asserted-by":"publisher","unstructured":"Akrawi, D., Bartrop, R., Potter, U. & Touyz, S. Religiosity, spirituality in relation to disordered eating and body image concerns: a systematic review. J. Eat. Disord. 3, 256.  https:\/\/doi.org\/10.1186\/s40337-015-0064-0 (2015).","DOI":"10.1186\/s40337-015-0064-0"},{"key":"33745_CR63","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.bodyim.2019.01.004","volume":"28","author":"M Tiggemann","year":"2019","unstructured":"Tiggemann, M. & Hage, K. Religion and spirituality: pathways to positive body image. Body Image. 28, 135\u2013141. https:\/\/doi.org\/10.1016\/j.bodyim.2019.01.004 (2019).","journal-title":"Body Image"},{"key":"33745_CR64","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.17140\/pmhcoj-se-1-102","volume":"SE","author":"RA Seir","year":"2017","unstructured":"Seir, R. A. & Kharroubi, A. Implementation of palliative care in palestine: cultural and religious perspectives. Palliat. Med. Hosp. Care - Open. J. SE, S4\u20139. https:\/\/doi.org\/10.17140\/pmhcoj-se-1-102 (2017).","journal-title":"Palliat. Med. Hosp. Care - Open. J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33745-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33745-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33745-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:42:29Z","timestamp":1769510549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-33745-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":64,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["33745"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-33745-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7649759\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,27]]},"assertion":[{"value":"18 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki, and approved by the Research Ethics Committee of Al-Quds University (reference number: REF. 10\/24, dated February 2024).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all participants involved in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"3644"}}