Perceived injustice of pain in paediatric cancer related pain outcomes
Research type
Research Study
Full title
Perceived injustice as a driver of prolonged pain, distress and impaired recovery in children and young people with cancer and their parents
IRAS ID
360432
Contact name
Emma Fisher
Contact email
Sponsor organisation
APVC of Research, University of Bath
Duration of Study in the UK
2 years, 4 months, 21 days
Research summary
Each year, around 400,000 children and young people worldwide are diagnosed with cancer — a figure that has risen by 12% since the 1990s. A cancer diagnosis profoundly impacts the child, their parents, and wider family. Treatment often brings pain, fatigue, and visible changes such as weight, hair, or skin alterations, along with major disruptions to daily life, school, and friendships. Emotionally, many young people experience low mood, anxiety, and fear that the illness may return.
A potentially important factor in how young people and families cope is their sense of fairness about the illness — whether they feel cancer is “unfair.” This feeling, called perceived injustice, includes beliefs about loss, blame, and unfairness. In adults with chronic pain, perceived injustice is linked to greater pain intensity, emotional distress, and disability. Other studies suggest similar patterns in children with chronic pain, where strong beliefs about unfairness are associated with higher pain, worse mood, and poorer quality of life. Parental beliefs also appear to matter: when a child feels their pain is unfair but their parent does not, the child often experiences worse outcomes. Yet, no studies have explored perceived injustice in children and young people with cancer or their parents.
Our research aims to fill this gap by examining how feelings of unfairness relate to pain, mental health, parenting, and physical functioning in families affected by childhood cancer. Understanding these links will help identify modifiable psychological factors that could be addressed through psychosocial interventions.
Ultimately, this work aims to support better emotional and physical outcomes for children with cancer and their families by developing new ways to reduce pain, distress, and the lasting impact of perceived injustice.
REC name
London - City & East Research Ethics Committee
REC reference
26/LO/0032
Date of REC Opinion
12 Jan 2026
REC opinion
Favourable Opinion