The relationship of pain and suffering in a hospice population

Although suffering is frequently encountered in the hospice setting, few studies examine this condition. The purpose of this study was to examine the relationship between terminally ill hospice patients' pain and their physical, spiritual, and personal or family suffering. Using a tool developed to measure suffering in those categories, a convenience sample of 92 patients were asked to rate their worst pain within the last 24 hours, and to rate their suffering at the time of the interview. All items were rated on a 0-10 Numeric Intensity Scale. Pain scores and suffering scores were divided into four categories; no pain or no suffering (0), mild pain or mild suffering (1-3), moderate pain or moderate suffering (4-6), and severe pain or severe suffering (7-10). Mean scores were compared for pain and suffering. More patients experienced suffering than pain. The highest mean suffering scores occurred in the severe pain category. Correlation coefficients for each suffering and pain category were also calculated. Results indicated a statistically significant correlation only between severe pain and suffering in the categories of loss of enjoyment of life, unfinished business, and concern for loved ones. Data indicated that patients view pain and suffering as separate entities. Further research is needed to better define the relationship between pain and suffering in order to improve assessment and intervention in a hospice setting.