Learning Objective #1: Explore the use of the SEM statistic technique in developing a model for cancer pain experience

Learning Objective #2: Discuss the problem and issue of using the SEM statistic technique in developing a theoretical model

---

The purpose of this study is to gain a better understanding of the use of a statistic technique, structural equation modelling in developing a theoretical model of Belief and Cancer Pain Experience Model in Thai cancer patients. The proposed Beliefs and Cancer Pain Experience Model included 12 proposed variables, 5 demographic variable pain beliefs, spiritual beliefs, primary and secondary appraisal, pain coping, and pain related outcomes: pain intensity and pain interference and one proposed moderator, pain treatment effectiveness. In the initial study, the exploratory descriptive design is being used to describe the cancer pain experience and to examine a Thai cancer pain theoretical model. The structural equation modelling (SEM) techniques were used to test the theoretical model. 265 Thai cancer patients were recruited from three institutions in the northern and central parts of Thailand. The model of Beliefs and Cancer Pain Experience Model was presented. During the analysis process, several issues and problems of the SEM use were encountered. Fit indices were used as criteria to determine the acceptability of the model for the study's data. The model trimming and model building techniques were used to create the more acceptable model. The major issues in the analysis process were the complexity of the proposed model and the similarity of the items on several instruments used to measure the variables. The solutions for these issues were suggested. This study is an example of the SEM use for a complex model for pain phenomenon. The issues' solutions suggested in this study can be suggested solutions for similar issues in the future use of SEM.