Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment.

This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia. A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined. Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001). The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context.