Relationship between Quality of Life and Suicide Risk in Iranian Cancer Patients: The Mediating Role of Religious Coping

Objective: Cancer patients often experience significant declines in quality of life (QoL), which can elevate suicide risk. In culturally religious societies like Iran, religious coping may serve as a critical buffer against such adverse outcomes. This study examined the relationship between QoL and suicide risk among Iranian cancer patients, with a focus on the mediating role of religious coping. Method: A purposive sample of 350 cancer patients from Tehran was analyzed using validated measures of QoL (EORTC QLQ-C30), suicide risk (Beck Scale for Suicide Ideation), and religious coping (Brief RCOPE-14). Data were analyzed using SPSS v26 and the PROCESS macro v4.0. Results: Bivariate correlations revealed that lower QoL was strongly associated with higher suicide risk (r = -0.62, p < 0.001), while positive religious coping correlated with better QoL (r = 0.48, p < 0.001) and reduced suicide risk (r = -0.41, p < 0.001). Mediation analyses demonstrated that positive religious coping significantly attenuated the QoL-suicide risk relationship (indirect β = -0.09, 95% CI [-0.15, -0.04]), accounting for 17% of the total effect. Negative religious coping, though less prevalent, also mediated this relationship but to a lesser extent (indirect β = -0.03, 95% CI [-0.05, -0.01]). Subgroup analyses indicated that the protective effect of positive religious coping was stronger in advancedstage patients. Conclusion: These findings underscore the importance of integrating spiritual care into oncology settings in Iran, leveraging faith-based resources to enhance resilience and reduce suicide risk. Future research should explore longitudinal and culturally tailored interventions to further elucidate the role of religious coping in cancer survivorship.