Factores asociados a la experiencia de sufrimiento en pacientes con cáncer avanzado

Objective: To examine the experience of suffering and its relation with physical, psychological, social and spiritual problems in advanced cancer patients. Methods: Ninety-eight patients attending the palliative care unit of an oncologic institution participated in the study. The level of suffering and the intensity and threat perceived from symptoms and a series of physical, psychological, social and spiritual problems were examined, as well as adjustment levels, illness awareness and coping strategies. Descriptive and comparative statistics were obtained. Results: Nearly 50% of participants manifested moderate suffering. The most frequent problems encountered were: general distress, asthenia, emotional distress, loss of autonomy, sadness, concern for the family´s future and suffering. Severe suffering was associated to adjustment problems and use of wishful thinking. Lower levels of suffering were associated with cognitive restructuring and avoidance strategies. Conclusions: Results indicate the importance of focusing on the subjective aspects of the illness experience. Any symptom or problem has the potential to become a source of suffering when perceived as threatening and when the person´s regulatory processes are insufficient for adaptation.