<![CDATA[Background: Mastectomy resolves a surgical problem but leaves a psychospiritual one, and the cancer survivor organisations supporting women after that surgery in Banjarmasin, South Kalimantan have no local evidence on which resource to strengthen first. Objective: To quantify the association of spiritual well-being and perceived social support with coping among women after mastectomy, to test whether coping differs by cancer stage or by time since surgery, and to identify which factor shows the stronger independent association once the other is held constant. Methods: This community-based analytical cross-sectional study assessed members of Yayasan Kanker Indonesia Banjarmasin and the Cancer Information and Support Center South Kalimantan (total sampling; n = 101, 81.5% of 124 enumerated members) at home with the FACIT-Sp-12, Brief COPE and MSPSS. Analysis used Spearman correlation with Bonett-Wright intervals, exact contingency tests, rank-based effect sizes and binary logistic regression with E-value sensitivity analysis. Results: Adaptive coping was present in 69.3% (95% CI 59.7-77.5). Coping correlated with spiritual well-being (ρ = 0.478, 95% CI 0.302-0.623) and with perceived social support (ρ = 0.569, 95% CI 0.408-0.696), both p < 0.001. Coping did not differ by cancer stage (p = 0.057, r = 0.189) or time since mastectomy (p = 0.101, ε² = 0.046). Adjusted, perceived social support was independently associated with adaptive coping (aOR = 4.63, 95% CI 1.67-12.80, p = 0.003) whereas spiritual well-being was not (aOR = 1.92, 95% CI 0.88-4.19, p = 0.099); the difference BETWEEN the coefficients was itself not significant (ratio of odds ratios 2.41, 95% CI 0.67-8.66, p = 0.179), so social support is independently associated with coping but is not established as the stronger resource. Conclusion: Strengthening perceived support through a survivor peer-educator cadre and family-inclusive counselling is the priority these data support for evaluation; spiritual care should not be displaced.]]>
