Acceptance of pain: a study in patients with advanced cancer

Pain, among the most common symptoms of cancer, impacts on multiple domains of wellbeing. Significant numbers of patients continue to experience pain despite pharmacological interventions. Although there is evidence to suggest that acceptance of pain is related to better wellbeing among patients with chronic nonmalignant pain, little is known about acceptance of cancer pain. The purpose of this cross-sectional study was to determine the correlates of pain acceptance in 81 patients with advanced cancer and pain. Demographic, disease, and treatment-related information was collected, and patients completed measures of pain, physical, psychological, and social/relational wellbeing and pain acceptance. Multivariate regression models, using backward elimination, determined the correlates of each subscale of the Chronic Pain Acceptance Questionnaire separately. Activity Engagement was negatively associated with depressive symptoms. Pain Willingness was negatively associated with pain catastrophizing. Parents living with children had lower Pain Willingness scores than non-parents. These relationships were independent of pain severity and physical functioning. These preliminary results suggest that acceptance of cancer pain is related to better psychological wellbeing and that there may be a relational element, with parents at risk of experiencing difficulty in adapting to ongoing cancer pain. These data lay the groundwork for future research and interventions designed to enhance quality of life for patients with advanced cancer and pain.