The Role of Attachment Styles and Physical Activity in Predicting Quality of Life in Women with Breast Cancer: The Mediating Role of Resilience
Keywords:
Attachment Styles, Physical Activity, Resilience, Quality of Life, Breast Cancer, Structural Equation ModelingAbstract
The present study aimed to examine the role of attachment styles and physical activity in predicting quality of life in women with breast cancer, with a particular focus on the mediating role of resilience. This applied study employed a descriptive-correlational design. The statistical population included all women with breast cancer who had active medical records at Imam Ali Hospital in Karaj, from which 85 participants were selected using convenience sampling. Inclusion criteria included confirmed diagnosis, age range of 20–50 years, and willingness to participate. Data were collected using the WHOQOL-BREF, Van Oudenhoven Attachment Styles Questionnaire, Connor–Davidson Resilience Scale (CD-RISC), and an international physical activity questionnaire. Data analysis was conducted using descriptive statistics, Pearson correlation, regression analysis, and structural equation modeling. The normality of the data was assessed using the Kolmogorov–Smirnov test, and analyses were performed using SPSS version 22 and AMOS software. The results of structural equation modeling indicated that attachment styles had a significant direct effect on quality of life (β = 0.62, p < 0.001) and an indirect effect through resilience. Physical activity also showed a significant direct effect on quality of life (β = 0.58, p < 0.001) as well as an indirect effect via resilience (β = 0.55, p < 0.001). Resilience had a significant positive effect on quality of life (β = 0.64, p < 0.001). Model fit indices confirmed an acceptable fit (χ²/df = 2.11, RMSEA = 0.03, GFI = 0.98). Overall, all hypothesized paths were statistically significant (p < 0.001). The findings suggest that attachment styles and physical activity are significant predictors of quality of life in women with breast cancer, both directly and indirectly through resilience. Enhancing resilience may strengthen the positive effects of adaptive attachment patterns and physical activity, thereby improving overall well-being.
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Copyright (c) 2026 Fatemeh Rasouli (Author); Parisa Peyvandi; Parvaneh Ghodsi (Author)
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