Coping strategies of patients with lung cancer-related pain

Previous findings in patients with nonmalignant pain indicate a relationship between pain coping strategies and psychological factors. Although coping strategies have been explored in patients with cancer pain, relationships with such factors have not been reported. We wished to examine relationships between selected pain and psychological variables and the use of pain coping strategies. Forty-five patients with pain related to lung cancer indicated how they expressed their pain to others and completed the McGill-Melzack Pain Questionnaire (MPQ), State-Trait Anxiety Inventory, Visual Analogue Scale of pain intensity, and the Coping Strategies Questionnaire (CSQ). Forty-two percent of the patients reported that they tried not to let others know they had pain, and 40% indicated they told others when they had pain. Preferences for not telling others was associated with more frequent pain coping attempts for all CSQ subscales but those of catastrophizing and reinterpreting pain sensation. State anxiety demonstrated positive correlation with catastrophizing coping strategies (r = 0.48) and negative correlation with ability to control (r = -0.50) and decrease (r = -0.50) pain. The number of pain sites was correlated with coping self-statements (r = 0.34). Pain intensity and state anxiety demonstrated similar relationships. Pain quality as measured with the MPQ demonstrated moderately strong correlation with diverting attention, praying and hoping, catastrophizing, and increased activity. Interventions aimed at reinforcing or expanding a patient's pain coping repertoire should be developed with consideration given to the patient's anxiety level, pain intensity, pain quality, and pain expression preference.