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Sufrimiento: las contribuciones del dolor persistente
1Department of Anesthesiology, School of Medicine, University of Washington, Seattle 98195, USA. crc@u.washington.edu
Lancet (London, England)
|July 7, 1999
Resumen
El sufrimiento surge cuando el dolor crónico daña el sentido de uno mismo, creando un ciclo de estrés. Los médicos pueden aliviar el sufrimiento mediante el manejo eficaz del dolor, distinguiéndolo del concepto más amplio de sufrimiento.
Área de la Ciencia:
- Las Humanidades Médicas.
- Psicología Psicología Psicología.
- Medicina para el dolor Medicina para el dolor Medicina.
Sus antecedentes:
- El dolor es una amenaza para la integridad biológica, mientras que el sufrimiento implica una amenaza para el yo.
- El dolor crónico puede alterar la identidad de un paciente, lo que lleva a respuestas fisiológicas al estrés.
- Una discrepancia entre la auto-percepción y la realidad contribuye al sufrimiento.
Objetivo del estudio:
- Para definir el sufrimiento de una manera médicamente útil, diferenciándolo del dolor.
- Para explicar cómo el dolor actúa como un estresante que contribuye al sufrimiento.
- Explorar las implicaciones clínicas para el cuidado del paciente.
Principales métodos:
- Revisión conceptual del dolor y el sufrimiento.
- Análisis de la relación entre el dolor crónico, el estrés y la identidad del paciente.
- Exploración del papel del médico en el manejo del sufrimiento.
Principales resultados:
- El sufrimiento surge de una amenaza percibida para el yo, a menudo exacerbada por el dolor crónico.
- El dolor crónico desencadena una respuesta al estrés (disregulación neuroendocrina, fatiga, disforia) que puede crear un ciclo de discapacidad.
- La percepción de un dolor incontrolable intensifica el estrés y el sufrimiento.
Conclusiones:
- El sufrimiento es distinto del dolor, aunque el dolor puede ser un contribuyente significativo.
- Comprender el dolor como un factor estresante es crucial para los médicos.
- El manejo efectivo del dolor por parte de los médicos puede prevenir o aliviar el sufrimiento del paciente.
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