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

Abstract

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.