ORIGINAL ARTICLE Exploring the relationship between sexual function, sense of coherence, and well-being in a sample of Iranian breast cancer survivors Fatemeh Lashani 1 & Camelia Rohani 2,3 & Fatemeh Estebsari 2 & Malihe Nasiri 4 Received: 30 May 2020 /Accepted: 13 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020 Abstract Purpose This study was aimed at exploring the type and role of relationships between sexual function, sense of coherence (SOC), and well-being in a sample of Iranian breast cancer survivors. Methods In this cross-sectional study with correlational design, data were collected from 181 survivors by consecutive sampling. They answered demographic and clinical information sheet, the SOC scale, the Female Sexual Function Index (FSFI), and the Health Index (HI). The data were analyzed using SPSS version 20. Results The mean age of survivors was 47.04 ± 9.05 years. Most survivors were menopausal (51.9%) and underwent mastecto- my (69.1%), and 12 months or more had passed since their treatment ended (71.2%). Sexual function was positively correlated with the level of SOC (r = 0.20) and the HI (r = 0.33). Also, there was a positive correlation between the level of SOC and the HI (r = 0.51). The results of logistic regression analyses showed the protective role of the SOC (OR: 0.95; 95% CI: 0.92–0.97) and the HI (OR: 0.87; 95% CI: 0.79–0.96) for women’s sexual function. According to these results, the mediating role of the SOC was assessed between the variables of the HI and the FSFI. The SOC revealed a complete mediating effect in this relationship. Conclusions The mediator role of the SOC between survivors’ well-being and their sexual function helps nurses and clinicians to understand how the SOC can be used as a screening test to detect survivors who are at risk of sexual problems and to plan for salutogenic interventions. Keywords Sense of coherence . Sexual function . Well-being . Breast cancer . Survivor . Mediator Introduction Breast cancer is a major health problem worldwide in the developed and less developed countries [1]. According to GLOBOCAN 2018, breast cancer is the most common can- cer among Iranian women with around 27% of all cancers. The age-specific standardized incidence rate in the popula- tion of Iranian women is 31 per 100,000 [2]. Increasing * Camelia Rohani cameliarohani@yahoo.com; camelia.rohani@sbmu.ac.ir; camelia.rohani@esh.se Fatemeh Lashani flashani97@gmail.com Fatemeh Estebsari fa_estebsari@yahoo.com Malihe Nasiri malihenasiri@gmail.com 1 Community Health Nursing, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Neiaiesh Highway, Opposite to Rajaee Heart Hospital, Tehran 1996835119, Iran 3 Department of Health Care Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Box 11189, Campus Ersta, Stigbergsgatan 30, SE-100 61 Stockholm, Sweden 4 Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Supportive Care in Cancer https://doi.org/10.1007/s00520-020-05831-0