Multimodal Psychobehavioral Interventions for Lung Cancer-Related Pain: A Protocol Development and Validation Study Examining the Mediating Role of Self-Efficacy in the Relationship Between Pain Perception and Adaptive Coping Strategies.

OBJECTIVE

To evaluate the effects of a comprehensive intervention program on cancer pain and self-efficacy in patients with lung cancer.

METHODS

A total of 120 lung cancer patients with cancer pain who received treatment from January 2021 to December 2023 at The First People's Hospital of Zunyi were enrolled in this study. A within-subject design was used, comparing patients' pain and self-efficacy scores before and after a comprehensive intervention. The intervention included pharmacologic therapy, psychological counseling, health education, mindfulness training, social support, and personalized rehabilitation. Pain was assessed using the Numerical Rating Scale (NRS), and self-efficacy was measured with the Chronic Disease Self-Efficacy Scale (CDSE). Subgroup and regression analyses were performed to explore related factors.

RESULTS

After intervention, the average NRS pain score decreased significantly from 7.2 ± 1.5 to 3.8 ± 1.2 (↓47.22%, t=15.6, p<0.001). Patients participating in mindfulness training reported a greater reduction in pain than non-participants (p=0.013). The total CDSE score increased from 52.3 ± 8.7 to 72.4 ± 9.5 (t=12.4, p<0.001), with significant improvements across all subscales (self-management, general efficacy, goal achievement, and problem-solving; all p<0.001). Subgroup analyses revealed that the improvements were consistent across gender, age groups, and education levels (p>0.05). Logistic regression identified pain relief (NRS score) as a significant predictor of enhanced self-efficacy (OR=1.403, 95% CI: 1.125-1.885, p=0.002), whereas age and education were not significant.

CONCLUSION

A comprehensive, multimodal intervention significantly improved both pain control and self-efficacy in patients with lung cancer-related pain. The effects were robust across demographic subgroups, with pain relief being a key factor influencing self-efficacy. These findings support the integration of psychological and behavioral strategies in pain management for cancer patients.