The Role of Pain-Related Beliefs in Adjustment to Cancer Pain

Although evidence from chronic non-cancer pain population supports the role of pain-related beliefs in patients’ adjustment to chronic pain, little has been known about the impact of pain-related beliefs in the adjustment to cancer pain. This study examined the factor structure, reliability and validity of the Pain Beliefs and Perception Inventory among a sample of 232 cancer patients undergoing treatment for cancer at the Institute of Cancer in Tehran. A factor analysis supported 4 factors. Factor one, Pain Permanence, consists of 4 items addresses the beliefs that pain will not change in the future. Factor two, Self-Blame consists of 3 items and reflects the patients’ beliefs that they are the appropriate target for blame for their pain experience. Factor three, Pain Stability, consists of 4 items and taps into the belief that pain is quite stable and present all the time and factor four, Mysteriousness, consists of 4 items and addresses the belief that pain is an aversive event that is poorly understood. These factors had satisfactory reliability (internal consistency); the Chronbach’s alphas for the subscales ranged from 0.70 to 0.77. These factors were then correlated with averages of pain intensity and pain interference with daily activities as well as with some measures of general health indices. Higher scores on each belief were positively and significantly associated with more severe pain and higher levels of pain interference. Also, higher scores on Pain Constancy, Pain Permanence and Mysteriousness were significantly associated with some, but not all general health indexes. Multiple hierarchical regression analyses revealed that stronger belief on Pain Stability was an independent and significant predictor of the severity of pain and pain interference after controlling for the possible confounding effects of age of the patients. Also, stronger belief in Pain Stability was an independent and significant predictor of Bodily pain, General Health and Vitality; stronger belief in Pain Permanence was an independent and significant predictor of General Health and stronger belief on pain as a mystery was an independent and significant and predictor of weaker General and Mental Health conditions. These findings are particularly significant because the relationships were controlled for the possible effects of patients’ pain severity. The clinical implications of these findings are discussed.