Pain Acceptance as a Protective Factor Against Parental Stress in Parents with Chronic Pain Conditions

Chronic pain can challenge effective parenting by limiting functional capacity and increasing vulnerability to stress. Within a process-based framework, pain acceptance-an element of psychological flexibility-may shape how parents manage pain-related demands during caregiving. This study examined associations between pain acceptance, pain intensity, pain interference in parenting, and parental stress in parents with chronic pain. A cross-sectional design was employed with 200 parents diagnosed with chronic pain. Participants completed the Chronic Pain Acceptance Questionnaire (CPAQ), the Parenting Tasks Interference Scale (PTI), and the Parental Stress Scale (PSS). Structural equation modeling (SEM) was conducted with robust estimation, and a serial mediation model (PROCESS Model 6) was used to estimate indirect effects using 5000 bootstrap resamples. Higher pain acceptance was associated with lower pain intensity and reduced interference in parenting. Pain interference, in turn, was related to higher parental stress, whereas pain intensity showed no direct association with stress. Serial mediation analyses showed a significant indirect association between pain acceptance and parental stress through pain interference, as well as a significant sequential indirect association involving pain intensity and pain interference. The indirect association through pain intensity alone was not significant. Model fit was excellent (CFI = 0.998; RMSEA = 0.021). The findings suggest that parental stress is more closely associated with pain acceptance and engagement in valued caregiving than with pain intensity. Process-based interventions targeting acceptance may be relevant for supporting family well-being.