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Frontiers in public health · 2026

Unveiling age-differentiated pathways: spiritual well-being links to quality of life in breast cancer survivors through network analysis.

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Yang Cheng, Zeng Qin, Li Jiawei

Аннотация

BACKGROUND: Enhancing the quality of life (QoL) of breast cancer survivors is a key public health priority. Spiritual well-being (SpWB) is recognized as a correlate, but its systemic role in connecting different life domains and how this varies by age remain unclear, hindering the generation of hypotheses for tailored support programs.

METHODS: We conducted a cross-sectional study of 302 breast cancer patients (stages I-III) in active treatment. Using psychometric network analysis, we mapped the interconnections between QoL (FACT-B scale) and SpWB (FACIT-Sp-12). Centrality and bridge metrics identified key nodes, and comparisons were made between younger (≤50) and older (>50) patients.

RESULTS: SpWB was the strongest connector among physical, emotional, social, and functional QoL domains. The most central concerns were fear of disease progression and difficulty accepting the disease. Age-based differences appeared in network connectivity strength. Younger patients showed tighter links among identity, emotional distress, and other domains, suggesting greater vulnerability to interacting difficulties. Older patients relied more on separate social support nodes.

CONCLUSION: This study provides a systemic, person-centered map of resilience in a cohort of Chinese breast cancer patients. SpWB is not merely a personal resource but a central hub associated with broad aspects of well-being in this sample. The marked age differences call for age-stratified support strategies: younger survivors may benefit from integrated psycho-spiritual interventions targeting identity and fear, while older survivors may profit from strengthened social support networks. These preliminary findings suggest that integrating spiritual health assessment into survivorship care may be worth considering, pending validation in diverse populations.

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