The Power of Spiritual Well-Being: Its Relationship with Pain Intensity, Pain Management, and Pain Catastrophizing in Individuals with Chronic Pain

Do We Ask What the Deities Can Do for Us? The Roles of Dao Religion and Resilience in Suicidality in Chronic Pain

Objectives: Resilience to pain is a protective factor against aversive pain outcomes, such as suicide. Religiosity as a cornerstone of resilience has been found to be associated with reduced risk of suicidality in chronic pain. However, affiliations to different religions have displayed differences in suicide risk. This study focuses on the roles of pain resilience and Dao religion in mitigating suicidal experience in individuals with chronic pain. Methods: This study adopted a mixed-method approach. A preliminary investigation was conducted regarding the internal consistency and construct validity of the translated version of the pain resilience scale (PRS). Qualitative data were collected through interviews with individuals experiencing chronic pain. Levels of PRS and gender were included in the logistic regression on the probability of suicide attempts. The role of Dao practice was qualitatively analyzed through narrative analysis. Results: Among the 24 participants, 14 were affiliated with the Dao religion; therefore, the transcripts of these 14 interviews were analyzed. Individuals with moderate scores on the PRS were 11.60 times less likely to have attempted suicide than those with low PRS scores. The likelihood further decreased by 38.7 times in those with high PRS scores. Four themes emerged from the qualitative interviews. The participants experienced a burden from pain, made efforts to please the deities in exchange for better pain control, continuously adjusted to pain, and ultimately developed a new perspective on the relationship between their religion and pain. Many individuals have engaged in Dao rituals to try to alleviate their physical and psychological pain. Most participants tended to offer a religious interpretation of enlightening moments after surviving a suicide attempt. Discussion: This study illustrates how pain resilience and Dao religious practices mitigate suicidality in chronic pain. Trial Registration: ClinicalTrials.gov identifier: NCT05148364.

The Relationship Between Pain Catastrophizing and Spiritual Well-Being in Adult Cancer Patients: A Cross-Sectional Observational Study

CONTEXT

Chronic cancer-related pain adversely affects patients' physical and psychological well-being. Pain catastrophizing intensifies pain perception and emotional distress, whereas spiritual well-being may provide essential coping mechanisms. The interplay between spiritual well-being and pain catastrophizing in cancer patients is not thoroughly studied.

OBJECTIVES

To investigate the relationship between spiritual well-being and pain catastrophizing in cancer patients experiencing chronic pain.

METHODS

A cross-sectional observational study was conducted from June 2023 to June 2024 at cancer center enrolling patients with cancer and pain intensity ≥4/10. Participants completed the Pain Catastrophizing Scale and the FACIT-Spiritual Well-being Scale (FACIT-Sp-12) including the domains Meaning, Peace, Faith. Demographic data, symptom burden, and Karnofsky performance status were also collected. A Generalized Additive Model was employed to assess associations between scores of Pain Catastrophizing Scale and spiritual well-being domains, controlling for symptom burden and demographic variables.

RESULTS

Ninety-seven patients, mostly male, with gastrointestinal cancer, a mean age of 62.9 years and mean Karnofsky score 44.4 (SD 7.7) completed the study. Higher levels of Peace (β = -1.96, p = 0.004) and Faith (β = -0.99, P = 0.031) were significantly associated with lower pain catastrophizing, while meaning was not significantly associated (β = 0.87, P = 0.237). Increased symptom burden was positively correlated with higher pain catastrophizing (β = 0.16, P = 0.005). The model explained 38.9% of the variance in pain catastrophizing scores (Adjusted R² = 0.389).

CONCLUSION

Spiritual well-being, specifically the Peace and Faith domains, is inversely related to pain catastrophizing in cancer patients. Integrating spiritual care into pain management strategies may enhance coping mechanisms and reduce emotional distress, thereby improving patients' quality of life.

Pain Intensity and Pain Catastrophizing Among Patients with Chronic Pain: The Mediating Effect of Self-Efficacy

Aim

This study aimed to explore the mediating role of sense of self-efficacy in the relationship between pain intensity and pain catastrophizing among chronic pain patients.

Methods

A questionnaire survey was administered to patients with chronic pain at the pain intervention departments of three tertiary hospitals in Shaanxi Province between July 2023 and July 2024. The visual analogue scale, chronic pain self-efficacy scale, and pain catastrophizing scale were used to assess the patients' pain intensity, self-efficacy, and pain catastrophizing degree, respectively. SPSS 27.0 and Mplus 8.3 software were used for statistical analysis.

Results

This study included a total of 430 patients with chronic pain. The average score for catastrophizing pain among participants was 22.76 (score range 0-52), which is considered moderate. Pain intensity and pain catastrophizing were significantly and positively correlated, and the findings found that chronic pain self-efficacy mediated the correlation between pain intensity and pain catastrophizing after controlling for sociodemographic and disease-related variables. In addition, chronic pain self-efficacy was found to be an important mediator, accounting for 32.5% of the total effect.

Conclusion

Among patients with chronic pain, chronic pain self-efficacy explains the relationship of pain intensity and pain catastrophizing. These findings imply that interventions that decrease pain intensity and increase patients' sense of self-efficacy are beneficial for improving pain catastrophizing in this population.

Comparison of the Predictive Role of Spiritual Well-Being and Pain Intensity on Pain Catastrophizing in Acute and Chronic Pain

AIM

This study was conducted to compare the predictive effect of spiritual well-being and pain intensity on pain catastrophizing of individuals with acute and chronic pain.

DESIGN

This research is a cross-sectional and comparative study.

METHODS

The study included 116 individuals with chronic pain and 111 individuals with acute pain. The study data were collected using the Descriptive Characteristics Questionnaire, Pain Catastrophizing Scale, Three-Factor Spiritual Well-Being Scale, Turkish Graded Chronic Pain Scale-Revised (TurGCPS-R) and Numerical Rating Scale.

RESULTS

The pain catastrophizing levels of individuals with chronic pain were significantly higher than individuals with acute pain. There was a statistically significant negative correlation between spiritual well-being and pain catastrophizing levels in both groups. The strength of this relationship was stronger in individuals with chronic pain. Spiritual well-being and pain intensity explained 53% of the total variance in pain catastrophizing in the chronic pain group, while they explained 34% in the acute pain group.

CONCLUSIONS

As a result of the study, it was determined that as the level of spiritual well-being increased, the pain catastrophizing and pain intensity decreased in acute and chronic pain patients. In addition, spiritual well-being was an important predictor of pain catastrophizing in both acute and chronic pain patients.

CLINICAL IMPLICATIONS

Because pain has a multidimensional structure, evaluating all dimensions of pain and providing holistic care for all dimensions will increase the effectiveness of optimal treatment. If nurses understand all dimensions of pain, they can create a pain management plan specific to the patient's needs. In this way, more effective, personalized and comprehensive care is provided and significant contributions are made to the patient and the healthcare system. In addition, the patient's autonomy whose spiritual practices are allowed will be supported.

Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications

Pain is a crucial factor in rheumatic disorders, and reducing it is a primary goal of successful treatment. Adaptive pain-coping strategies can enhance this improvement, but maladaptive approaches such as pain catastrophizing may worsen overall patient well-being. This narrative review aims to provide a concise overview of the existing knowledge on pain catastrophizing in the most prevalent specific rheumatic disorders. The objective of this study was to improve understanding of this phenomenon and its implications, as well as to pinpoint potential directions for future research. We conducted searches in the MEDLINE/PubMed, SCOPUS, and DOAJ bibliography databases to identify articles related to pain catastrophizing in rheumatoid arthritis, psoriatic arthritis, axial spondylarthritis, systemic sclerosis, systemic lupus erythematosus, Sjögren's syndrome, juvenile idiopathic arthritis, and osteoarthritis (non-surgical treatment). Data extraction was performed on November 1, 2023. The investigators screened the identified articles to determine their relevance and whether they met the inclusion criteria. Following a bibliography search, which was further expanded by screening of citations and references, we included 156 records in the current review. The full-text analysis centred on pain catastrophizing, encompassing its prevalence, pathogenesis, and impact. The review established the role of catastrophizing in amplifying pain and diminishing various aspects of general well-being. Also, potential treatment approaches were discussed and summarised across the examined disorders. Pain catastrophizing is as a significant factor in rheumatic disorders. Its impact warrants further exploration through prospective controlled trials to enhance global patient outcomes.