From a psychological perspective, pain is not merely a somatic phenomenon but an experience that is cognitively interpreted and emotionally processed. The question “Does pain ennoble?” refers to the multidimensional nature of suffering, which, in the context of cancer, takes the form of total pain, encompassing physical, psychological, social, and spiritual components. A growing body of empirical evidence indicates that patients experiencing pain employ a variety of cognitive and behavioral strategies to regulate and reduce it, including religious and spiritual resources such as prayer, religious practices, and seeking spiritual support (Cascio et al., 2025; Korkut et al., 2024). Spirituality may play an important role in modulating the experience of pain through cognitive and emotional processes.
The present paper reports findings from a study conducted among cancer patients, which examined the serial mediating effects of meaning in life and pain coping strategies in the relationship between spirituality and total pain, encompassing physical, psychological, social, and spiritual struggles among post-treatment oncology patients. The results revealed complex associations between dimensions of spirituality and total pain. The main findings indicated significant indirect effects, whereby the relationship between spirituality and total pain was mediated by the presence of meaning in life, the search for meaning, and three pain coping strategies: diverting attention, catastrophizing, and ignoring sensations. These findings support a serial mediation model in which the relationship between spirituality and total pain is mediated by two types of mediators: meaning in life and pain coping strategies.