Suffering With Advanced Cancer
- 1 May 2007
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 25 (13), 1691-1697
- https://doi.org/10.1200/jco.2006.08.6801
Abstract
Purpose The alleviation of suffering is a central goal of palliative care, but little research has addressed the construct of suffering as a global experience of the whole person. We inquired into the sense of suffering among patients with advanced cancer to investigate its causes and correlates. Patients and Methods Semistructured interviews were administered to 381 patients. The interviews inquired about physical symptoms, social concerns, psychological problems, and existential issues. We also asked, “In an overall, general sense, do you feel that you are suffering?” Results Almost half (49.3%) of respondents did not consider themselves to be suffering, and 24.9% felt that they suffered only mildly. However, 98 participants (25.7%) were suffering at a moderate-to-extreme level. The latter participants were more likely to experience significant distress on 20 of the 21 items addressing symptoms and concerns; the highest correlations were with general malaise (rho [ρ]= 0.56), weakness (ρ = 0.42), pain (ρ = 0.40), and depression (ρ = .39). In regression analyses, physical symptoms, psychological distress, and existential concerns, but not social issues, contributed to the prediction of suffering. In qualitative narratives, physical problems accounted for approximately half (49.5%) of patient reports of suffering, with psychological, existential, and social concerns accounting for 14.0%, 17.7%, and 18.8%, respectively. Conclusion Many patients with advanced cancer do not consider themselves to be suffering. For those who do, suffering is a multidimensional experience related most strongly to physical symptoms, but with contributions from psychological distress, existential concerns, and social-relational worries.Keywords
This publication has 22 references indexed in Scilit:
- Dying Young, Dying Poor: A Sociological Examination of Existential Suffering Among Low-Socioeconomic Status PatientsJournal of Palliative Medicine, 2004
- The Face of Suffering Among Women With Breast Cancer—Being in a Field of ForcesCancer Nursing, 2002
- Can we Research Suffering?Qualitative Health Research, 2001
- The relationship of pain and suffering in a hospice populationAmerican Journal of Hospice and Palliative Medicine®, 2000
- Diagnosing Suffering: A PerspectiveAnnals of Internal Medicine, 1999
- Suffering: the contributions of persistent painThe Lancet, 1999
- Cancer patients' reported experiences of sufferingCancer Nursing, 1998
- A conceptual foundation for human suffering in nursing care and researchJournal of Advanced Nursing, 1997
- THE EXPERIENCE OF SUFFERING - CONCEPTUAL CLARIFICATION AND THEORETICAL DEFINITIONJournal of Advanced Nursing, 1986
- The Nature of Suffering and the Goals of MedicineThe New England Journal of Medicine, 1982