The contribution of psychological flexibility to functioning in patients with cancer-related pain

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Background: Studies of individuals with non-cancer-related chronic pain, find that higher levels of psychological flexibility (PF) are associated with less distress, better functioning, and a better response to treatment. People diagnosed with cancer are at significantly increased risk of developing chronic cancer-related pain, the presence of which is associated with poorer health outcomes. Little is known about whether PF is applicable to cancer pain. The current study investigates the relationship between chronic cancer-related pain, distress and functioning, and three theoretical processes proposed by the PF model: pain acceptance, present-moment focus, and committed action. Methods: Adults (n = 246) with a cancer diagnosis (current or previous), and living in Sweden, completed an online survey involving standardized measures of cancer related
pain (intensity and impairment), depression, fatigue, PF and social stigma. Results: Moderate to strong correlations were found between PF and all variables. In regression analyses, PF, and particularly pain acceptance, accounted for a large and significant proportion of the observed variance in depression, pain-related and overall functioning, after controlling for cancer status, pain intensity and social stigma.
Conclusion: Consistent with studies of non-cancer-related pain, higher levels of PF were strongly associated with lower levels of distress and better functioning in individuals with cancer-related pain. Further studies are needed to further explore these relationships and to determine whether psychosocial treatments targeting PF may be of benefit to people with chronic cancer-related pain.
Original languageEnglish
Pages (from-to)413-423
JournalEuropean Journal of Pain
Issue number3
Early online date2022 Dec 23
Publication statusPublished - 2023

Subject classification (UKÄ)

  • Cancer and Oncology
  • Applied Psychology

Free keywords

  • Chronic Pain
  • Cancer
  • Cancer related pain
  • Psychological Flexibility
  • Overall functioning


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