Suffering, or pain in a broad sense, can be an experience of dislike or aversion, possibly associated with a person's perception of harm or threat of harm. Suffering is the basic element that makes up the negative valence of affective phenomena. The opposite of suffering is pleasure or happiness. The challenge of medicine based on observation, the objective description of symptoms and diseases. Note 4 and experimentally tested treatments is to deal with a phenomenon such as pain, which may or may not be correlated with physical symptoms, whose relief may or may not be affected by the administration of certain medications, but not always and not to the same degree, and which is definitely modulated by circumstances that are difficult or impossible to measure scientifically, such as educational factors, moral beliefs or religious or personal attitudes. Pain is not a kind of spring, and bodies are much more than mere mechanisms, as phenomenologists have endeavored to demonstrate in the 20th century.
Abstracting the “pathological” fact of the person's body and body provided a series of impressive results, treatments and medical advances. However, it also proved to have its limitations. However, Cassell's conceptualization of suffering poses at least two problems. The first is that their definition of suffering depends on a questionable understanding of the person and is too restrictive.
Defining suffering as a threat to a person's “integrity” involves assuming what an “intact person” is. Cassell's normative definition of “person” includes a series of dimensions, such as the perception of the future, personality and character, the body, experiences and memories of the past, cultural background, behavior, relationships with others, a political dimension, and a secret life. This “intact person” would have developed a kind of balance, or coherence and integrity, between all these dimensions. A definition of pain cannot be based solely on the neurological understanding of it, but must incorporate other relevant factors, such as cognitive awareness, interpretation, behavioral provisions, as well as cultural and educational factors beyond the medical field.
Therefore, a formal, non-essential and non-naturalistic conceptualization of both terms is proposed. Suffering is an unpleasant or even distressing experience that can seriously affect a person on a psychophysical and even existential level. Like suffering, so does pain it's unpleasant. Both are experiences that affect the whole person (not just their “body” or “mind”), and a crucial aspect of them is attitude and personal choices, which in turn are influenced by cultural and social patterns.
Not only the natural sciences, but also the social sciences and the humanities play a crucial role in understanding all dimensions of these phenomena. In addition, the vision of a person as a psychophysical being and not as a dualistic being requires a total paradigm shift in medicine and new research approaches that can challenge the limits of several disciplines. This article deals with the phenomenon of human suffering and is an attempt to justify and initiate the theoretical development of this phenomenon for the science of infirmary. The document is divided into three sections.
The first section describes the interest of nursing science in the phenomenon and critically examines the relevant literature in order to further conceptualize development and clarification. This section concludes with a theoretical definition of suffering derived from this criticism. Suffering is defined as the individual experience of a threat to oneself and is the meaning given to events such as pain or loss. The second section develops this definition and examines how it can inform theoretical debate in two important areas for nursing: the patient's experience of suffering and the nurse's experience of patient suffering.
Some implications for clinical research are briefly examined in the last section. Although sometimes identified with pain, suffering is best understood as a very unpleasant emotional state associated with significant pain or distress. The degree of suffering may vary depending on the meaning attributed to the associated pain or distress, or depending on expectations regarding the future. Because suffering can be affected by thoughts about meaning or about the future, some have focused on this dimension of suffering and have stated that only humans can suffer. However, there is very strong empirical evidence that many non-human animals suffer.
Suffering causes moral concern, especially when suffering is needlessly caused, and raises ethical questions, primarily in relation to the nature and extent of our obligations to those who suffer. Suffering is also an important source of personal or religious meaning in many people's lives. Suffering involves conscious resistance to pain or distress. Misery accentuates the unhappiness that accompanies illness, poverty, or loss in particular.
A deep respect for reality implies the acceptance of our potential, our limitations and our humanity. By recognizing that suffering is an integral part of our lives and that pain has other benefits, such as the cultivation of wisdom and compassion, we better accept our suffering. And when we truly accept pain and grief as inevitable, we actually suffer less. Nathaniel Branden refers to self-esteem, for which self-acceptance is fundamental as the immune system of consciousness. A strong immune system doesn't mean that we don't get sick, but that we get sick less often and that, when we get sick, we recover faster.
In the same way, suffering is unlikely to go away completely, but as our consciousness's immune system strengthens, we suffer less frequently, and when we do, our recovery is faster. The first of the Buddha's Four Noble Truths is the truth of suffering, a truth that we can reject or accept as an inevitable part of being human. And when we learn to accept, and even accept, difficult experiences, our suffering becomes a tool, an instrument, for growth. For that purpose, the contributions of classical medicine based on evidence, the humanistic turn of medicine, as well as phenomenological and narrative theories of suffering and pain, together with certain conceptions of the person who is beyond them (the mind-body dichotomy, Cassel's idea of people as “intact beings”) are critically discussed. The present study develops a definition and a conceptual framework that reflect all the important theoretical viewpoints on pain-related suffering and can be operationalized for empirical validation. We developed a systematic procedure to manually extract and analyze the data from the selected articles, with the objective of identifying the defining aspects and dimensions in the different conceptualizations of suffering related to pain.
In the second step, a manual and systematic extraction of verbatim citation data was carried out with information relevant to the conceptualization of pain-related suffering. However, we expect that the similarity values when comparing our manual definition with the definitions provided by the most extensive linguistic models will come considerably closer to 1, since they not only attempt to define the same concept, but are also based on exactly the same body of text. On the contrary, Cassell's conceptualization of pain and suffering emphasizes its significant dimensions and the negative consequences of abstracting pain from the person who suffers. However, while summaries of 58 keywords on the background and consequences of suffering provide a systematic overview of the conceptualizations of the literature and are useful for specifying in detail the dimensions of pain-related suffering, in order to create an accessible and ready-to-use framework for construction on a future scale, their level of detail is too complex.
We suggest that the ideas expressed in definitions such as those of Cohen and his colleagues are better placed if we delve deeper into the concept of suffering related to pain, which highlights all the complexity of pain, without expanding the concept of pain too much and, therefore, abandoning the consensus reached in the IASP definition of pain.