Psychological and family-related facts of suffering in patients with chronic diseases

Illnesses that limit life or functioning have the potential to cause significant distress and lead to suffering. Suffering is a subjective and multidimensional experience that results from the person's appraisal of threat and exhaustion of coping resources. Detection and management of suffering in patients who are chronically ill have become of great interest in the last few years as relief from suffering was established as one of palliative care main goals. Psychological, sociocultural, and family issues that contribute to suffering are discussed. Also, assessment strategies and instruments, as well as interventions toward relief from suffering, are described. Therapeutic approaches should be individualized and include issues in the physical, psychological, sociocultural, and spiritual domains to plan for comprehensive interventions suited to the patient's needs and to attain better symptom control. Regarding family suffering, interventions that reinforce the perceived social support, facilitate communication and emotional disclosure, effect on the family's level of cohesion and flexibility, and enable role distribution, resilience, and meaning of the illness as a learning experience will reinforce adaptation and alleviate suffering.