Someone who is diagnosed with a severe illness experiences feelings of threat, loss, uncertainty, finitude, anxiety and of deprivation of basic needs, which cause discomfort and suffering. Suffering is part of the personal experience of cancer patients, particularly terminal patients who not only have to face physical symptoms, but are also confronted with the idea of death being near and, therefore, feel their integrity is threatened. In addition, cancer patients experience discomfort resulting from the treatment itself, which can add to this sense of threat to physical integrity.
Nevertheless, individuals may have health projects encompassing a vital capacity and resilience to fight for life, in order to overcome the ontological condition of suffering and try to achieve levels of comfort that are necessary for existence, for life to go on.
Analysing the concept of suffering
Suffering is a fundamental and universal experience of the human condition. It has been described as an inevitable human experience (Frankl, 2004), as the state of severe distress associated with events that threaten the integrity or continued existence of the person as a whole (Cassell, 1991). Suffering involves the construction of personal meanings that carry a strong affective load. Therefore, the way in which people deal with suffering is highly subjective and individual, and in order to understand it, one must access the individual meanings attributed and ways of responding to suffering, i.e. the subjective experiences of suffering (Gameiro, 2000; Mcintyre, 2004).
Most people find it hard to distinguish pain from suffering; however, these are very different entities that can be inter-related. Suffering it is not limited to physical pain. It is always experienced by the whole-person and not merely on the body level (Cassell, 1991; Cassel, 1999; Fleming, 2003; Neto, 2004).
Analysing the concept of comfort
- Comfort has come to acquire a significant role in health care philosophy and it is recognised as a holistic outcome related to the responses of the whole-person. The comfort theory has been used to explain and predict phenomena of human responses to the health-illness process, and has contributed to a proper evaluation of care and to the assessment of intervention outcomes (Kolcaba, 1991; Kolcaba, 2003).
In this way, comfort as a process (of comforting) or as a product (of interventions) is a noble concept that underlies the interventions of health professionals in the health-illness continuum, as well as the human responses to this process (Kolcaba, 1991; Kolcaba, 2003).
Instruments:
1) Sociodemographic and clinical questions;
2) Comfort Chemotherapy Scale (CCS) (Apóstolo, et al. 2006): five point Likert-type scale with 33 items, based on the operational model of “comfort” to assess the three states of comfort (relief, ease and transcendence) in the four contexts described;
3) The Inventory of Subjective Suffering Experiences in Illness – ISSEI – (Gameiro, 2000): five point Likert-type scale with 44 items to assess the five dimensions of suffering (psychological, existential, sociorelational and positive experiences of suffering).
01/01/2021
Self-care and health-disease