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Original Article
Insomnia, Pain, and Pain-Related Dysfunctional Beliefs About Sleep among Patients with Cancer
Seockhoon Chung1,2orcid , Soobeen Lee3, Mohd. Ashik Shahrier4, Saebom Jeon5orcid

DOI: https://doi.org/10.4143/crt.2025.372 [Accepted]
Published online: June 25, 2025
1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Life Care Center for Cancer Patient, Asan Medical Center Cancer Institute, Seoul, Korea
3University of Ulsan College of Medicine, Seoul, Korea
4Department of Psychology, Faculty of Biological Sciences, University of Rajshahi, Bangladesh
5Department of Marketing Bigdata, Mokwon University, Daejeon, Korea
Corresponding author:  Seockhoon Chung
Tel: 82-2-3010-3411 
Email: schung@amc.seoul.kr
Saebom Jeon
Tel: 82-42-829-7776 
Email: alwaysns@mokwon.ac.kr
Received: 1 April 2025   • Accepted: 24 June 2025
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Purpose
We explored the reliability and validity of the Pain-related Beliefs and Attitudes about Sleep (PBAS) scale among patients with cancer. Further, we compared the usability of the PBAS scale with that of the Cancer-related Dysfunctional Beliefs and Attitudes about Sleep-14 (C-DBAS-14) among patients with cancer.
Materials and Methods
The medical records of 252 patients with cancer who visited the Sleep Clinic from August 1, 2023 to June 30, 2024 were retrospectively analyzed. The responses of the enrolled patients to the PBAS, C-DBAS-14, Insomnia Severity Index (ISI), and Numeric Rating Scale of pain were collected.
Results
The internal consistency reliability of the PBAS scale was excellent (Cronbach’s alpha of 0.96). Confirmatory factor analysis showed that the two-factor structure of the PBAS for patients with cancer is a good fit for the model (CFI=0.99, TLI=0.99, RMSEA=0.14, SRMR=0.05). The convergent validity of the Korean version of the PBAS in patients with cancer was good, as indicated by its significant association with pain severity (r=0.63, p<0.001), C-DBAS-14 (r=0.33, p<0.001), and ISI (r=0.21, p<0.01). The PBAS adequately reflected an increase in pain severity and was more effective and appropriate for capturing pain-related dysfunctional sleep beliefs than the C-DBAS-14.
Conclusion
The Korean version of the PBAS showed high reliability and validity in patients with cancer, and applicability across cancer types and cancer-related beliefs.

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