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Acceptance of pain: A study in patients with advanced cancer

Gauthier, Lynn R.a,b; Rodin, Garyb,c,d; Zimmermann, Camillac,d; Warr, Davidd,e; Moore, Malcolmd,e; Shepherd, Francesd,e; Gagliese, Luciaa,b,c,d,*

doi: 10.1016/j.pain.2009.02.009
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ABSTRACT 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.

aSchool of Kinesiology and Health Science, York University, Toronto, Canada

bBehavioural Sciences and Health Research Division, Toronto General Research Institute, University Health Network, 200 Elizabeth St., Toronto, Ont., Canada, M5G 2C4

cDepartment of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, & Psychosocial Oncology and Palliative Care Research Division, Ontario Cancer Institute, University Health Network, Toronto, Canada

dFaculty of Medicine, University of Toronto, Toronto, Canada

eDepartment of Medical Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada

*Corresponding author. Address: Behavioural Sciences and Health Research Division, Toronto General Research Institute, University Health Network, 200 Elizabeth St., Toronto, Ont., Canada, M5G 2C4. Tel.: +1 416 340 4296; fax: +1 416 340 4739.

E-mail address:lucia.gagliese@uhn.on.ca

ARTICLE INFO

Article history:

Received September 23, 2008

Received in revised form January 23, 2009

Accepted February 17, 2009.

Presented, in part, at the 27th Annual Scientific Meeting of the American Pain Society and the Canadian Association of Psychosocial Oncology Conference, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.
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