Effect of Group-Based Dhikr Therapy on Health-Related Quality of Life (HRQoL) in Women with Breast Cancer: A Single-Center Randomized Controlled Trial

Abstract

Background: Breast cancer and its treatments significantly impair patients’ health-related quality of life (HRQoL). Spiritually oriented interventions, such as Dhikr therapy — the rhythmic recitation of Islamic holy words and phrases — aim to promote physiological and psychological relaxation. Although such approaches have shown promise in improving quality of life, evidence on structured, group-based Dhikr programs in oncology populations remains limited. This study aimed to evaluate the effectiveness of a six-session group-based Dhikr therapy program on HRQoL in women with breast cancer.

Materials and Methods: This two-arm, parallel-group randomized controlled trial included 60 women aged 25–55 years with confirmed breast cancer. Participants were randomly allocated (1:1) to either the intervention group (n=30), which received a structured 6-week group-based Dhikr therapy, or the control group (n=30), which received standard oncology care. The intervention consisted of weekly 90-minute sessions incorporating Quranic reflection, gratitude practice, guided visualization, and facilitated group sharing. The primary outcome was HRQoL, assessed using the EORTC QLQ-C30 and QLQ-BR23 questionnaires at baseline and within one week after intervention completion. The trial was registered with the institutional ethics committee (IR.SBMU.CRC.REC.1403.005). Statistical analysis was performed using SPSS v.31. Continuous data are presented as mean ± SD and categorical data as frequencies (%). Group differences were assessed with independent t-test, Mann–Whitney U, and chi-square tests as appropriate. Intervention effects on HRQoL were analyzed by two-way repeated-measures ANOVA. Significance was set at P ≤ 0.05.

Results: Compared with the control group, women in the Dhikr therapy group showed statistically significant improvements in all domains of the QLQ-C30: Symptom subscale (mean change: −17.40 vs. +9.38; P < 0.001), Function subscale (+9.58 vs. −20.08; P < 0.001), Single Items subscale (a global symptom index; −14.26 vs. +9.08; P < 0.001), and total score (intervention: 53.89 ± 32.51 to 75.83 ± 19.25; control: 70.28 ± 22.07 to 52.22 ± 16.07; P < 0.001). Similarly, the intervention group demonstrated significant improvements in the QLQ-BR23: Symptom subscale (−10.97 vs. +5.14; P = 0.001) and Function subscale (+15.41 vs. −32.91; P = 0.001), while the control group showed deterioration in both subscales.

Conclusion: A structured, group-based Dhikr therapy program improved both general and breast cancer-specific HRQoL among women with breast cancer. These findings support the integration of culturally appropriate spiritual interventions into standard supportive oncology care.