Quality of Life Breast Cancer Survivors: Compassion and Cognitive Flexibility Mediated by Mental Distress

Background: Breast cancer is the most common cancer among women and the second leading cause of death after lung cancer.Although the number of recovered patients has increased, the treatment's side effects still affect them.This study aimed to investigate the mediating role of mental distress in the relationship between self-compassion, cognitive flexibility, and quality of life (QoL). Methods:The descriptive method used correlation and structural equations.The population consisted of women referred to Iranmehr Hospital in Birjand City, Iran, between 2016 and March 2022, diagnosed with breast cancer.Of these, 202 participants were selected through convenience sampling.The patients were administered quality-of-life questionnaires, the psychological impact of cancer scale for measuring mental distress, the cognitive flexibility questionnaire, and the self-compassion questionnaire.SPSS software, version 25, LISREL software, version 8.8, Pearson correlation methods, and structural equation modeling analysis were used.Results: All goodness-of-fit indices for the model fell within an acceptable range, indicating that the hypothesized model was a good fit for the sample.The significance level for the Sobel test was considered to be