Predictors of Suffering in Advanced Cancer

Alicia Krikorian, Joaquín T. Limonero, Juan Pablo Román, John Jairo Vargas, Carolina Palacio

    Research output: Contribution to journalArticle in an indexed scientific journalpeer-review

    31 Scopus citations


    Context: Suffering is a complex experience. Identifying its predictors is useful to signal at-risk patients. Objective: To identify suffering predictors in patients with advanced cancer in palliative care. Methods: A total of 98 patients participated in the study. A semistructured interview examining suffering levels and physical, psychological, social, and spiritual aspects was used. Instruments included Pictorial Representation of Illness and Self Measure (PRISM), Edmonton Symptom Assessment System (ESAS), Detection ofemotional distress (DED), and Structured Interviewof Symptoms andConcern (SISC). Variance-based structural equationmodel was used for the data analysis. Results: All measures were valid and reliable. The structural model explained 64% of the variance. Suffering levels were directly determined by psychological and adjustment problems and indirectly determined by physical, psychological, and spiritual aspects and coping strategies. Conclusion: Our study supports the proposed theoretical model and signals the important mediating effect of psychological and spiritual variables between physical symptoms and suffering.

    Original languageEnglish
    Pages (from-to)534-542
    Number of pages9
    JournalAmerican Journal of Hospice and Palliative Medicine
    Issue number5
    StatePublished - Aug 2014


    • associated factors
    • cancer
    • distress
    • end of life
    • predictors
    • suffering


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