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Observational Study
. 2025 Apr 17:2025:3056383.
doi: 10.1155/prm/3056383. eCollection 2025.

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

Ling-Jun Liu  1   2 , Hsiu-Ling Peng  3 , Edward Meng-Hua Lin  2 , Wan-Ping Liang  4
Affiliations
Observational Study

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

Ling-Jun Liu et al. Pain Res Manag. .

Abstract

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.

Keywords: chronic pain; mixed-method study; religiosity; resilience; suicide.

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Conflict of interest statement

Peng and Lin declare no conflicts of interest. Liu and Liang are employees of Changhua Christian Hospital, but the funding party plays no part in the conduction, analysis, and the reporting of the study. The results reflect only the opinions of the authors.

Figures

Figure 1
Figure 1
Final theme map derived from the interviews.
Figure 2
Figure 2
Frequency of references to suicide attempts by participant characteristics PRS group indicates the grouping according to scores rated on the pain resilience scale. Suicide = 0 indicates no suicide attempt; Suicide = 1 indicates with suicide attempt. Opioid = 0 indicates no use of opioid for pain control; and Opioid = 1 indicates the use of prescription opioid as a method of pain control.
See this image and copyright information in PMC

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