Modeling psychological well-being among abdominal and pelvic cancer patients: The roles of total pain, meaning in life, and coping.

Objective: Relationships between pain and well-being are mediated by a variety of factors. This study examines a serial mediating role of meaning in life and coping in the relationship of total pain with psychological well-being in abdominal and pelvic cancer (APC) patients. Total pain is understood in terms of physical, psychological, social, and spiritual components interacting upon one another.

Methods: Adult patients diagnosed with the APC (N = 333) who were undergoing radiotherapy/chemotherapy treatment in two inpatient units of university hospitals completed questionnaires measuring total pain, psychological well-being, meaning in life, and coping. SEM analysis was used to examine serial mediation effects.

Results: All the dimensions of total pain were negatively associated with presence of meaning, coping strategies, and psychological well-being. In contrast, the pain dimensions were positively associated with search for meaning. Presence of meaning, search for meaning, emotion- and meaning-focused coping were serial mediators in the relationship between total pain and psychological well-being.

Conclusions: Our results strongly suggests that a holistic examination of pain among patients with cancer is important for several reasons. They also indicate that psychological well-being is significantly influenced by the serial interplay of personal meaning structures and coping abilities.