Association of Religiosity and Spirituality With Psychological Well-Being Among Breast Cancer Survivors: A Systematic Review and Meta-analysis Protocol

Background Breast cancer is the most prevalent malignancy in women worldwide. Apart from its physical consequences, the diagnosis and treatment of breast cancer may substantially affect mental and emotional health. Religiosity and spirituality have been increasingly recognized as relevant coping resources, possibly contributing to resilience, quality of life, and subjective well-being in breast cancer survivors. Objective This systematic review protocol aims to ensure methodological transparency and rigor by describing the planned methods for investigating the association between religiosity, spirituality, and psychological health among women who have survived breast cancer through a systematic review of observational studies. Methods A comprehensive search will be performed across ten electronic databases. Grey literature will be identified through Google Scholar, ProQuest Dissertations & Theses Global, and OpenGrey. The reference lists of all included studies will be screened, and experts in the field will be consulted to identify additional pertinent studies. Eligible studies will include adult women diagnosed with breast carcinoma, regardless of histological subtype or disease stage. The exposed group will comprise women who report religiosity and/or spirituality, whereas the comparison group will include women who receive usual care or who report no religiosity and/or spirituality. The primary outcome will be psychological well-being, while secondary outcomes will include therapy adherence and overall survival. Study selection and risk-of-bias assessment using the ROBINS-E tool will be independently performed by two reviewers. When appropriate, random-effects meta-analysis will be conducted, with effect estimates expressed as odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs). Registration This protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251148635.