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September 23-24, 2019 | Prague, Czech Republic
2
nd
International Conference on
Palliative Care
Clinical Trials and Pharmacovigilance
Joint Event
&
Pain and suffering: Same or not?
Syed Qamar Abbas
St Clare Hospice, UK
P
alliative care is defined as an approach that improves
the quality of life of patients and their families facing
the problem associated with life-threatening illness, through
the prevention and relief of suffering by means of early
identification and impeccable assessment and treatment of
pain and other problems, physical, psychosocial and spiritual.
(WHO 2002)
This entails that clinical staff managing a patient should be
able to identify and manage their physical symptoms as well
as non-physical issues. There is a great need to understand
train Palliative care staff in identifying and supporting both
components. Cecily Saunders had defined ‘Total pain’
as suffering that encompasses all of a person's physical,
psychological, social, spiritual, and practical struggles.
Sufferingoccurswhenan impendingdestructionof theperson
is perceived; it continues until the threat of disintegration has
passed or until the integrity of the person can be restored in
some other manner.' To appreciate the suffering of others
requires a full understanding of the personal narrative of the
individual(Cassell 1991). Whereas it is important to manage
physical pain, limited prognosis and physical symptoms
together give rise to suffering, loss of meaning, spiritual
questions and family helplessness. Medical management of
death can often conceal the realisation of suffering. Patients
do not tend to talk about it as they encounter more clinical
questions than meaningful supportive discussions. Suffering
can also stem from overzealous medical treatment and
avoided conversations.
Clinicians often withdraw from those who suffer because
of being unsure about further course of action, personal
anxieties, fear of facing their own mortality and lack of own
coping mechanisms. In an economic model, it can have
impact on long term well-being as it leads to unanswered
questions, unnecessary hospitalisations, difficult pre and post
bereavement situation for families and unresolved questions
for caring clinical team.
Conclusion:
Suffering is a multidimensional experience
related to physical, financial, social, psychological, emotional,
spiritual, and existential anxieties. While training clinical
staff in physical management of Palliative care patients, it is
imperative that they are educated in recognising, researching
and treating suffering of patients and their families (Breitbart
2007).
e
:
qamar.abbas@stclarehospice.org.ukJournal of Primary Care and General Practice | Volume 2
J Prim Care Gen Pract, Volume:2