Table 2 The themes, subthemes, and categories

Theme 1: Pain and distress

Sub-Theme 1: Dealing with constant, severe, and sudden pain

1. Inseparable part of life

2. Severe pain

3. Pain tolerance

4. Fluctuating pain

5. Sudden pain

6. Trying to live without drugs

7. Inadequate prescribing of opioids

Sub-Theme 2: A debilitating body

1. Fatigue

2. Inability to perform daily living activities

3. Shortness of breath and insomnia

4. Lack of appetite

5. Lack of sexual relations

Sub-Theme 3: Hopelessness

1. Pessimism and fear about the future

2. Fear of death

3. Losing interest in performing enjoyable activities

4. Losing family roles

Sub-Theme 4: Social distress

1. Negative impact of the imminent death on family members.

2. Losing some friendships

Theme 5: Spiritual distress

1. Lacking life purpose and meaning

2. God will help

3. Inability to pray

Theme 2: Spiritual coping

Sub-Theme 1: Wishing for a peaceful death

If one dies, it will be better for all

Wish to die at home

Sub-Theme 2: Accepting death

1. Death is one aspect of faith and destiny

2. Accept reaching the terminal stage of illness as a normal life cycle

3. Telling me to make my faith in Allah great

Sub-Theme 3: Surrender to fate

1. Committed to praying

2. I must get closer to Allah

3. Submitting to fate

4. Affliction is as much as Allah loves us