A Mixed-Methods Analysis of Pain Catastrophizing and Coping Mechanisms Among Nursing Students: An Explanatory Perspective

Abstract

Purpose: This study aimed to examine nursing students’ pain experiences, the cognitive-emotional process of pain catastrophizing, and their coping strategies. Methods: An explanatory, sequential, mixed-method study design was employed. The study was conducted with nursing students at a university between August 2024 and March 2025. A total of 422 students completed quantitative questionnaires, and 21 students participated in qualitative interviews. Quantitative data were collected using a Descriptive Information Form, the Pain Coping Inventory, and the Pain Catastrophizing Scale. Qualitative data were collected through semistructured interviews. Results: The mean scores on the Pain Catastrophizing Scale were 22.47 ± 10.12, while the mean scores on the Active Coping Inventory subscale were 15.59 ± 4.59 and on the Passive Coping Inventory subscale were 34.3 ± 6.59. A significant and positive relationship was found between the Passive Coping Inventory subscale and the Pain Catastrophizing Scale (r = 0.602, p < 0.05), whereas no significant relationship was found with the Active Coping Inventory subscale (p > 0.05). Four main themes were identified in the qualitative analysis: “prevalence and locations of pain experiences,” “factors causing pain,” “reflections of pain,” and “pain coping strategies.” Students described their pain through metaphors of helplessness, reporting that it led to “mental breakdown,” “social isolation,” and decreased academic performance. Conclusion: Findings indicate that a reliance on passive coping styles was significantly associated with a higher tendency to catastrophize pain. The results highlight a critical gap in nursing education; students struggle to manage their own pain due to stress and clinical demands, which may impact their future professional resilience. Integrating psychological coping skills into the nursing curriculum is essential.