Identifying and Ranking Psychological Determinants of Pain Tolerance in Patients with Chronic Disorders

Abstract

This study aimed to identify and rank the psychological determinants influencing pain tolerance among patients with chronic disorders using a sequential exploratory mixed-methods approach. The research employed a mixed-methods sequential design (qualitative–quantitative). In the qualitative phase, data were obtained through a systematic literature review and inductive content analysis using NVivo version 14 to extract key psychological components. In the quantitative phase, a researcher-developed questionnaire based on qualitative findings was administered to 180 chronic pain patients in Tehran. Data were analyzed using SPSS version 26 and the Friedman test to rank the significance of psychological factors affecting pain tolerance. The Friedman test indicated significant differences among the examined psychological factors (χ²=96.215, Sig=0.000). Psychological resilience obtained the highest mean rank (6.87), followed by emotion regulation (6.54) and self-efficacy/internal control (6.21), whereas cognitive attitudes toward pain had the lowest mean rank (3.79). The findings confirmed that resilience, self-efficacy, and emotion regulation are the most influential determinants of pain tolerance in chronic pain patients. Pain tolerance is a multidimensional phenomenon shaped by psychological, emotional, and social interactions. Enhancing resilience, improving emotional regulation skills, and fostering self-efficacy can significantly strengthen patients’ pain endurance and quality of life.