Miller Megan, Speicher Stephanie, Hardie Katie, Brown Roger, Rosa William E
School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI, 53705, USA.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 Third Avenue, 4th floor, New York, NY, 10017, USA.
Support Care Cancer. 2024 Feb 20;32(3):169. doi: 10.1007/s00520-024-08378-6.
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.
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 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.
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.
基础研究表明，精神性可能会影响癌症患者体验疼痛的方式。一种潜在途径是通过思想和信念的改变，比如与疼痛相关的灾难化思维。本研究的目的是了解精神性是否通过与疼痛相关的灾难化思维影响疼痛体验。
本解释性序列混合方法研究以一种改编后的不愉快症状理论为依据。数据通过在线调查（N = 79）和后续定性访谈（N = 25）收集。第一阶段采用经验贝叶斯分析。第二阶段使用演绎性内容分析。第三阶段涉及创建一个混合方法联合展示，以整合研究结果并得出元推论。
结果表明，总体精神幸福感与与疼痛相关的灾难化思维直接呈负相关，与疼痛干扰、疼痛严重程度和与疼痛相关的痛苦等结果间接呈负相关。定性类别突出了精神性在面对疼痛时的支持作用，同时也揭示了在某些疼痛（即严重、神经性和/或慢性疼痛）情况下精神性的局限性。混合方法研究结果揭示了精神性对一些人在面对癌症和癌症相关疼痛时的重要性，以及将精神性纳入更大规模疼痛管理计划的必要性。
本研究通过探索精神性在疼痛体验中的复杂作用推进了支持性癌症护理。研究结果将为进一步探索精神性在支持癌症背景下的整体症状管理中的作用提供信息，以及为开发和测试增强精神性并解决与症状相关痛苦的干预措施提供信息。
