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. 2024 Feb 20;32(3):169.
doi: 10.1007/s00520-024-08378-6.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study

Megan Miller  1 , Stephanie Speicher  2 , Katie Hardie  2 , Roger Brown  2 , William E Rosa  3
Affiliations

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study

Megan Miller et al. Support Care Cancer. .

Abstract

Purpose: Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing.

Methods: This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences.

Results: Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan.

Conclusions: This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Keywords: Cancer; Mixed methods; Oncology; Pain; Spirituality.

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Conflict of interest statement

Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Adapted version of the Theory of Unpleasant Symptoms
Fig. 2
Fig. 2
Study flow diagram
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