Received: 14 June 2022 - Revised: 17 September 2022 - Accepted: 18 September 2022 DOI: 10.1002/pon.6043 ORIGINAL ARTICLE Modeling psychological well‐being among abdominal and pelvic cancer patients: The roles of total pain, meaning in life, and coping Dariusz Krok 1 | Ewa Telka 2 | Beata Zarzycka 3 1 Institute of Psychology, University of Opole, Opole, Poland 2 The Maria Sklodowska‐Curie Cancer Center and Institute of Oncology in Gliwice, Gliwice, Poland 3 Institute of Psychology, John Paul II Catholic University of Lublin, Lublin, Poland Correspondence Dariusz Krok, Institute of Psychology, University of Opole, Plac Staszica 1, Opole 45‐ 052, Poland. Email: dkrok@uni.opole.pl and dkrok@post.pl Abstract Objective: Relationships between pain and well‐being are mediated by a variety of factors. This study examines a serial mediating role of meaning in life and coping in the relationship of total pain with psychological well‐being in abdominal and pelvic cancer (APC) patients. Total pain is understood in terms of physical, psychological, social, and spiritual components interacting upon one another. Methods: Adult patients diagnosed with the APC (N = 333) who were undergoing radiotherapy/chemotherapy treatment in two inpatient units of university hospitals completed questionnaires measuring total pain, psychological well‐being, meaning in life, and coping. SEM analysis was used to examine serial mediation effects. Results: All the dimensions of total pain were negatively associated with presence of meaning, coping strategies, and psychological well‐being. In contrast, the pain dimensions were positively associated with search for meaning. Presence of meaning, search for meaning, emotion‐ and meaning‐focused coping were serial mediators in the relationship between total pain and psychological well‐being. Conclusions: Our results strongly suggests that a holistic examination of pain among patients with cancer is important for several reasons. They also indicate that psychological well‐being is signifcantly infuenced by the serial interplay of personal meaning structures and coping abilities. KEYWORDS cancer, coping, oncology, psychological well‐being, psycho‐oncology, serial mediation, total pain 1 | BACKGROUND An interesting, though empirically understudied, approach to the examination of pain is the concept of total pain proposed by Saunders who defned it in terms of physical, psychological, social, and spiritual components interacting upon one another. 1,2 This was based on clinical observations that patients often experience not only sensory and physiological symptoms of pain, but also psychological (i.e. emotional distress, anxiety), social (i.e., social isolation, lack of family interactions), and spiritual (i.e., lack of meaning in life, feelings of abandonment by Higher Power/God) symptoms. To manage pain effectively, there is a need to understand the specifcity of pain in all its dimensions and identify potential factors and mechanisms responsible for its outcomes. As regards physical pain, approximately 50% of patients at some point, and nearly 80% of those with advanced‐stage cancer, are strongly affected by it. 3 Research has demonstrated that higher levels of physical pain are related to poorer mental health in patients with various cancers, 4 lower existential and spiritual well‐being in patients with terminal cancer, 5 and worse health‐related quality of 1852 - Psycho‐Oncology. 2022;31:1852–1859. wileyonlinelibrary.com/journal/pon © 2022 John Wiley & Sons Ltd.