The Value Experience of Intrathecal Pump Implantation for Cancer Pain Patients: A Qualitative Study Focusing on Family Caregivers

Background Cancer represents a major public health challenge globally and in China, with its incidence continuing to rise, imposing a heavy physical and psychological burden on patients and diminishing their quality of life. Cancer pain, one of the most common and complex symptoms experienced by cancer patients, has a high prevalence and diverse origins, severely impacting patients' quality of life. Opioids remain central to cancer pain management, yet their efficacy is often suboptimal. Intrathecal drug delivery systems, a highly effective and safe treatment for refractory cancer pain, remain underutilized in clinical practice. Concurrently, family caregivers play a pivotal role in pain management decisions, with their perception of treatment value directly influencing acceptance and implementation. Therefore, exploring family caregivers' value perceptions, decision-making motivations, and core needs regarding intrathecal pumps holds significant importance for optimizing patient-centered, precision pain management pathways. Method This study aims to uncover the decision-making factors influencing family caregivers' acceptance of intrathecal analgesic pumps, their core demands regarding pain management value, and pain points in caregiving needs among cancer pain patients. It seeks to provide empirical evidence for optimizing precision pain management pathways centered on preserving patients' dignity and quality of life. This qualitative descriptive study conducted in-depth semi-structured interviews at the Pain Management Department of Shanghai East Hospital, Tongji University, from April to September 2025. All interviews were audio-recorded and transcribed. Analysis followed Colaizzi's seven-step method, identifying and organizing thematic clusters from statements within the transcribed interviews. MAXQDA software was used to code and identify relationships between themes and subthemes. Results Data saturation was achieved with 20 participants. Based on value perception theory, analysis from the primary family caregiver perspective revealed six themes and 15 subthemes: (1) core objectives of pain management (improve patients' quality of life, achieving physical and mental liberation for caregivers); (2) preoperative decision-making motivations and perceptions (source of motivation, cognitive preparation for caregivers); (3) multidimensional manifestations of value perception (improving patients' physical and mental well-being, reduce the burden on caregivers); (4) key trigger points for surgical acceptance (external support system evaluation, assessment of disease severity, patient eligibility assessment, surgical value assessment); (5) key focus areas and pain points in care needs (perioperative comprehensive management, pain management throughout the entire process); (6) Postoperative rational expectations regarding the condition (effective pain control, anticipating synergy and continuity in cancer treatment, rational understanding of the underlying disease). Conclusion Pain management teams must establish an integrated care model anchored in the educational principle of “pain controllability,” guided by shared decision-making between physicians and patients, and culminating in holistic care addressing physical, psychological, and social dimensions. By early assessment of factors delaying patient decision-making, this approach breaks the “endure pain-breakdown” cycle. Technical precision safeguards patients' dignity in living, while sustained social support systems address gaps in care.