Living under the dominance of pain across the present and future: A qualitative study of pain catastrophizing in cancer survivors with chemotherapy-induced peripheral neuropathy

초록

Purpose: This study aimed to explore the lived experiences of pain catastrophizing among adult cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN) who reported high levels of pain catastrophizing. Methods: In this qualitative study, adult cancer survivors with persistent CIPN who scored 30 or higher on the Pain Catastrophizing Scale participated in semi-structured interviews. Data from 19 participants were analyzed according to Giorgi's phenomenological procedures to identify the essential meaning and structure of pain catastrophizing experiences. Results: Five constituents reflecting the lived experience of pain catastrophizing among cancer survivors with CIPN were identified through the analysis. The participants described living under the dominance of pain, with daily life centered on persistent symptoms. They constantly anticipated worsening pain, which heightened their anxiety and sensitivity to bodily sensations. Pain was projected onto the future, shaping negative expectations and disrupting life plans, roles, and sense of identity. Ongoing pain also led to gradual emotional exhaustion, marked by emotional fatigue and ambivalence toward treatment. Simultaneously, participants described actively attempting to regulate their minds through acceptance, cognitive reframing, emotional regulation, and intentional strategies. Taken together, these findings illustrate the psychological processes underlying pain catastrophizing. Conclusions: This study provides an in-depth understanding of pain catastrophizing among cancer survivors with persistent CIPN as a complex lived experience that extends beyond maladaptive thinking. The findings highlight the need for interventions that address physical symptoms as well as the emotional and existential dimensions of pain, supporting the development of targeted psychological interventions to reduce catastrophizing in this population.

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