The Experience of Social Alienation in Patients with Chronic Cancer-Related Pain: A Qualitative Study.

PURPOSE: This study aims to explore the lived experience of social alienation in patients with chronic cancer-related pain (CCRP), identify its underlying drivers, delineate their unmet multidimensional needs, and establish an evidence base for precise psychosocial intervention strategies. PATIENTS AND METHODS: Between February and March 2026, 22 patients with CCRP were selected using purposive sampling from a tertiary hospital in Xuzhou, Jiangsu Province, China, to participate in semi-structured, in-depth interviews. Data were analyzed using Colaizzi 7-step method. RESULTS: Five main themes emerged as the underlying drivers of social alienation: Pain-Induced Confinement, Cognitive-Affective Overload, Relational Misalignment and Absence, Pain Concealment, and Attentional Competition. These drivers interact dynamically to form a vicious cycle of social alienation and pain amplification, with attentional competition functioning as the underlying mechanism. Furthermore, corresponding unmet multidimensional needs were mapped to each driver, highlighting critical gaps such as dignified mobility assistance, destigmatization support, and caregiver empathy training. CONCLUSION: Social alienation in patients with CCRP is a complex, dynamic process driven by factors including pain-induced confinement, cognitive-affective overload, and relational misalignment and absence. Effective pain management must transcend the biomedical paradigm to incorporate holistic psychosocial reconstruction, family empowerment, and the restoration of social connectivity to overcome underlying pain management barriers.