Fear of Pain in Patients With Advanced Cancer or in Patients With Chronic Noncancer Pain

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Abstract

Objectives

Pain is one of the most prevalent symptoms in patients with advanced cancer and, according to anecdotal reports, perhaps the most feared. Surprisingly, fear of pain has been the subject of little research within cancer care. The literature on chronic noncancer pain, however, suggests that fear of pain contributes to limitations in function in populations with diverse chronic illness. Little is known about the extent to which such findings might generalize from patients with chronic noncancer pain to those with chronic cancer pain. Therefore, this research examined the extent to which fear of pain is associated with limitations in function in patients with advanced cancer and also compared patients with chronic cancer and noncancer pain.

Methods

We recruited 117 patients with advanced cancer who received a referral for pain management and 118 patients with a primary complaint of chronic noncancer pain. Participants completed self-report questionnaires.

Results

Findings revealed similarities between the groups for fear of pain and limitations in function, but they differed on level of depression and pain severity (patients with noncancer pain were more depressed and reported higher pain severity). Fear of pain independently predicted limitations in function in both groups controlling for demographic variables and pain severity. When depression and physical symptoms were controlled, fear of pain predicted limitations in function only in patients with advanced cancer.

Discussion

The findings emphasize the importance of psychological dimensions of pain in patients with advanced cancer, as well as the similarities and differences between the 2 groups of patients suffering from chronic pain.

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