[The Relationship Between Pain and Demoralization in Cancer Patients].

ABSTRACT

BACKGROUND: While patients with cancer commonly experience bodily pain, their perceptions of this pain may differ. Continually experiencing pain elicits a sense of helplessness and pessimism in these patients and exacerbates their perception of interpersonal alienation, which may cause the demoralization syndrome. In Taiwan, the rate of demoralization among patients with cancer is substantially higher than that in other countries. PURPOSE: The meaning of cancer pain is used as the mediating variable to investigate the relationship between the pain that is experienced by patients with cancer and their demoralization. METHODS: Sixty cancer patients were surveyed using convenience sampling. Data were collected using the Taiwanese version of the Brief Pain Inventory, the Mandarin version of the Demoralization Scale, and the Perceived Meanings of Cancer Pain Inventory. The primary statistical analysis method used was path analysis. RESULTS: (1) The extent to which pain disrupted the daily life of the participants directly affected their demoralization and perceived meanings of pain. (2) For the patient group that experienced the least pain, the extent to which pain disrupted daily life increased their demoralization scores, with this increase mediated by their perceived meaning of pain as "being threatened." (3) For the patient group that experienced the most pain, the extent to which pain disrupted daily life and to which they perceived the meaning of pain as "a challenge" indirectly affected their demoralization scores. CONCLUSIONS / IMPLICATIONS FOR PRACTICE Cancer care should not only alleviate patient pain but also emphasize the effect of pain on disrupting the daily life of patients and eliciting their sense of demoralization. This enables the early diagnosis of the demoralization syndrome. Care may be provided in accordance with the various meanings of pain that are perceived by cancer patients. When patients perceive pain as a challenge, they are unlikely to be demoralized. However, when patients perceive pain as a threat, attention should be paid to their sense of demoralization.