Concept Analysis: Suffering

Concept Analysis: Suffering

A concept is the glue that ties conceptual frameworks, models, and theories together. The concepts in a framework or theory relate to each other in some way. This is what gives them meaning. A concept analysis is an exploration of how a concept ties a framework together.

Instructions:

  1. The concept is suffering
  2. Determine the aim or purpose of your analysis; what do you want to accomplish by conducting this concept analysis? Answer the questions “Why am I doing this?” and “Why is this relevant to nursing knowledge and nursing science?”
  3. Conduct your literature review by identifying all uses of the term that you can discover. Answer “What are the known conceptualizations?”
    • Locate and use a minimum of 3 dictionary definitions, 1 thesaurus entry, and 5 scholarly references from the nursing literature (you may use non-nursing literature, if necessary). Combined, these references will be the basis for identifying and defining attributes of your selected concept.
  4. Determine the critical or defining attributes of the concept by identifying what each instance or use of the term has in common with the other uses. The more scholarly references you locate and use, the easier it is to determine critical attributes of a concept.
  5. Define the 4 cases using the critical attributes:
    • Construct a model case or a real-life scenario that uses the concept and includes all critical attributes of the concept. Explain how you use each critical attribute. This case should be an accurate representation or model of your concept.
    • Construct a contrary case or one that is opposite of the concept. Support the claims you make by explaining how and why the contrary case does not contain any of the critical attributes of your concept.
    • Construct a borderline case or one that is related to the concept but is not actually an example of the concept. Support the claims you make by explaining how and why the borderline case differs from the model and contrary cases (i.e., does not contain all of the critical attributes of your concept, etc.)
    • Construct an invented case or fictitious scenario that uses the concept and includes all of the critical attributes. Explain how you use each of the critical attributes.
  6. Identify related concepts; provide a list of terms that are related to or similar to the concept.
  7. Identify an inaccurate use of the concept. Provide an example of how the concept is used in a way that is improper or incorrect.
  8. Identify concept antecedents and consequences. This should include a description of (1) concepts or traits that precede (antecedent) the existence of the concept and (2) concepts or traits that follow (consequence) the existence of the concept. An antecedent cannot be one of the attributes, but a consequence may be.

The paper should be written in a professional, scholarly manner (i.e., no errors in APA formatting, spelling, or grammar). As a guideline, the body of the paper (excluding title page and reference list) should be 7 pages

Answer

 

Concept Analysis: Suffering

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Identification of Concept

Suffering, the concept of choice, is experienced individually. People could be broken due to emotional, mental, or physical situations. Nursing may not share or identify with the suffering of individuals but could identify and support patients in those situations. Nurses’ focus is to alleviate pain and suffering while helping patients find meaning and respond better to perpetrating situations (Beserra et al., 2014). The objective of nursing care in alleviating suffering is to manage the conditions mainly perpetrated by disease occurrences. Also, professional practice in nursing requires them to understand the different aspects that predispose patients to suffer as they identify the best way to support these patients (Bueno-Gómez, 2017). They realize that suffering is associated with physical, psychological, and social aspects.  It is mainly self-report that helps identify the presence of suffering in individuals since it may not be physically identified in the absence of disease.

Apart from disease occurrence, suffering could be experienced through loss, torture, isolation, betrayal, fear, or even unemployment. It is more than a feeling or an experience of emotions but a situation that encompasses the mind with thoughts and negative emotions and beliefs (Fagerström et al., 2020). For instance, a person could suffer due to rejection from a loved one as they make efforts to analyze and reconsider the situation. The whole of their being is involved in contemplating the case as they become sad, may fail to eat, and experience a significant surge of emotions. They could also start blaming themselves and considering aspects they could change to be accepted. As such, people experience suffering differently even though their experiences are interrelated. Nurses need to understand these different behaviors to effectively support individuals in dealing with the surrounding situations and help alleviate suffering.  As such, nursing involvement in alleviating suffering is critical in their professional practice making it a necessary concept of study.

Purpose of Analysis

Suffering is a concept that nurses experience in their day-to-day work as they deal with patients who are experiencing suffering due to their ailment and the ripple effect of such suffering on family members and loved ones. Therefore, this concept analysis aims to show the attributes of suffering, expand its understanding and its impact on the nursing profession. The meaning of suffering and its impact on nursing care will be revealed while providing tentative criteria to classify the same. The analysis aims to holistically present the concept of suffering and its impact on nursing care. To understand the elements that nurses could employ to better support their patients by alleviating suffering.

Definitions

The webster dictionary defines suffering in four ways. 1. The state of being in great trouble 2. The conscious endurance of pain or distress 3. An external and usually temporary cause of significant physical or mental strain and stress 4. A pain that is too intense for one to endure.  The Cambridge dictionary defines suffering as the physical or psychological pain that a person or animal feels. Additionally, the COBUILD advanced English dictionary defines suffering as; 1. Severe pain felt in the body or mind 2. The state or an instance of enduring pain 3. The bearing or undergoing distress, pain, or injury.

Defining Attributes

Suffering is presented in different interfaces.  It could involve spiritual, biological, social, socio-economic, and cultural aspects. Physical pain is mainly related to the bodily elements that nurses could review to identify the underlying problem (Fochtman, 2006).  The interrelatedness between these dimensions defines how much a person suffers within a given situation. Suffering could also take different forms related to their source or origin (Smith et al., 2014). They could be intrapersonal, attributed to a higher power, considered a natural occurrence, or technical in its modality (Iraqi & Hughes, 2009). These defining attributes of suffering make it a complex concept that may not be fully comprehensible. Besides, suffering is a personal experience that uniquely affects individuals (Bueno-Gómez, 2017). It is associated with negative impacts on the sufferer as they lose hope and meaning in life (Fagerström et al., 2020). The person also feels helpless and alienates themselves from the society.

The nursing view of suffering incorporates the different meanings and attributes associated with suffering to ensure that they make the best efforts to manage patients and restore health through holistic care. The profession employs the different dimensions and forms of suffering to boost its purpose in helping and supporting individuals who experience challenging and adverse situations (Karsoho et al., 2016). Nurses also attempt to understand the instincts of human beings and their response to adverse effects through their weaknesses, vulnerabilities, individuality, and complexities to direct care to specific needs (Ferrell & Coyle, 2008).  They aim to protect, promote and preserve health while helping people find meaning in suffering and during their most vulnerable situations (Morasz, 2012).

Development of Cases

Model Case

John D, a 72-year-old male, was admitted to the hospital one month ago due to congestive heart failure and chronic kidney disease. He had a history of DM and Hypertension for the last 20 years, which had been well managed over time until before admission. During admission, the physicians and nurses made necessary critical assessments and decided that his condition could be contained in the general ward if dialysis was started on time. However, his condition deteriorated over time, and he began experiencing episodes of confusion, shortness of breath and had to depend on oxygen. The new presentation prompted him to be stepped up to the critical care unit for closer monitoring. He was placed on a support machine, and the doctor recommended comfort care to maximize the quality of life. His condition kept worsening even with treatment, and he survived barely on the supporting machine.

Danny, a registered nurse, was on duty when the physicians held discussions during the morning rounds to extubate John D and allow him to die comfortably. Danny must communicate the news to his family members in the following visiting hours and understood the concept of suffering. She had to ensure that as they considered alleviating the patient’s current suffering from worsening illness, the family would also be able to understand the reason for their suffering through loss while allowing them to make an informed decision towards the case. Her caring in supporting the alleviation of pain extended beyond the situation of the patient to the family members

The case shows that Danny understood the different dimensions of suffering and her position in providing the best care to those involved. She makes efforts to help the family understand situations while allowing them to make the best decisions. She acts in the best interest of the family to support them through the suffering they experienced. The acts of care helped keep them in understanding suffering and making efforts to become better.

Contrary Case

A contrary case to demonstrate nursing care in alleviating suffering is as follows. A patient calls upon the nurse on duty to help with his increasing hip pain. The nurse is frustrated since she had already administered all the pain medications indicated in his prescription. She ignored him several times, but when he insisted, she shouted that she was tired of the nagging. The patient was in much pain that he was in tears which other patients made efforts to plead for his case. In this case, the nurse was not caring enough to support the patient in his suffering and reach out to his physician for further care. The contrary case indicates a lack of deliberate efforts from the nurse in alleviating suffering through compassionate care.

Related Case

A related case is when a nurse makes necessary consultations to support other needs of a patient other than managing the current situation. For example, a patient may be concerned that their life is full of problems, and they do not know how they will survive even after leaving the hospital. In this case, a nurse reaches out to a psychologist to talk to the patients and find out more about their concerns. In this way, the nurse is not making direct efforts to alleviate suffering but supports the process.

Invented Case

As a nurse faced with an anxious patient concerned about both her family and her health, I would consider the different aspects of suffering. First, I would provide care and support for her physical well-being and seek to understand the problem in her physical well-being. Second, I would probe to understand the reasons for anxiety as the psychological aspect of suffering. Third, I would seek to learn about the family situation that was the reason for her distress to address the social problem leading to despair. Finally, I would seek to understand why she thinks she was experiencing the issue as I try to address the spiritual relationship to her anguish. In this way, I will use the different attributes in suffering to understand the patient’s perspective and make the best decision to help the patient prevent further suffering and learn to manage the current situation.

Related Concepts

The definitions of suffering are similar in their description: a physical and mental strain that causes distress or severe pain. It is supported through research as an intrinsic concept to humanity and part of the healthcare system (Best et al., 2015). The descriptions also present sufferings as agony, pain, distress, injury, or misery. As demonstrated in the Praxis theory of suffering, it is a higher concept than sickness since it integrates the psychological, physical, and spiritual aspects that affect an individual’s standard cognition mechanisms. Consequently, Beserra et al. (2014) demonstrated suffering as a core in the human origin when dealing with anguish and pain. It is also a phenomenon presented in different forms from anthropology, philosophy, psychology, nursing, and human care.

Inaccurate Use of the Concept

Sometimes, the concept of suffering is not well understood and is used to mean other situations that may not present the defining attributes of suffering.  For example, suffering is used to explain a child’s condition take the hospital for routine immunizations. The child comes to the hospital crying and clinging tightly to the mother since she is afraid of the nurse’s attire. She refuses to let go of the mother, closes her eyes, and whines about going back home. The people around exclaim that the child is suffering.

The case is an inaccurate use of the concept since it lacks the defining attributes of suffering as an intense physical and mental feeling. The child in the case shows fears since the situation is solved once they leave the clinic’s premises.

Antecedents and Consequences

Antecedents are prior events related to the existing concepts such as cultural, social, and individual characteristics associated with the idea of suffering.  They are situations related to the events that trigger suffering.  On the other hand, consequences are the results related to the concept.  They define the reactions that are initiated through the existence of the concept.

The presence of disease and pain are antecedents of the concept of suffering. Many people experience suffering after being diagnosed with a terminal illness such as cancer. They start experiencing mental and emotional suffering since they feel that the situation is beyond their level of intervention. Pain also causes physical suffering and emotional turmoil, though it may not always define the multidimensional concept.

The consequences of the concept of suffering could include negative or positive. Through support, individuals may use their experience of suffering to identify better coping mechanisms. They learn new skills in dealing with the prevailing situations as they manage and even alleviate the current suffering.  Consequently, individuals could slip into a condition of hopelessness as they feel that their suffering has no end and as they face the reality of death.

Conclusion

In nursing care, suffering tends to adopt a holistic approach since it is built around help and caring for humanity. The nursing profession approaches suffering from a holistic perspective as they aim to alleviate pain and suffering (Fagerström et al., 2020).  Besides, this view is supported by their value of human life and duty and commitment to preserving health. The efforts in care may protect people from suffering or help them alleviate current suffering as they learn better approaches and adopt coping mechanisms. In the nursing science of caring, the idea of suffering is well understood and appreciated as a point where health begins.

 

References

Beserra, E. P., Oliveira, F. C. D., Ramos, I. C., Moreira, R. V. O., Alves, M. D. S., & Braga, V. A. B. (2014). Human suffering and nursing care: multiple views. Escola Anna Nery18(1), 175-180.

Best, M., Aldridge, L., Butow, P., Olver, I., & Webster, F. (2015). Conceptual analysis of suffering in cancer: A systematic review. Psycho‐Oncology24(9), 977-986. https://doi.org/10.1002/pon.3795

Bueno-Gómez, N. (2017). Conceptualizing suffering and pain. Philosophy, Ethics, and Humanities in Medicine12(1), 1-11. https://doi.org/10.1186/s13010-017-0049-5

Fagerström, L. M., Hemberg, J., Koskinen, C., Östman, L., Näsman, Y., Nyholm, L., & Santamäki Fischer, R. (2020). The core of Katie Eriksson’s caritative caring theory–a qualitative study from a postdoctoral perspective. Scandinavian journal of caring sciences. https://doi.org/10.1111/scs.12942

Ferrell, B., & Coyle, N. (2008). The nature of suffering and the goals of nursing. doi:10.1001/jama.2008.874

Fochtman, D. (2006). The concept of suffering in children and adolescents with cancer. Journal of Pediatric Oncology Nursing23(2), 92-102. https://doi.org/10.1177/1043454205285870

Iraqi, A., & Hughes, T. L. (2009). The concept of suffering: how it may impact end of life. Journal of palliative medicine12(3), 211-211.

Karsoho, H., Fishman, J. R., Wright, D. K., & Macdonald, M. E. (2016). Suffering and medicalization at the end of life: The case of physician-assisted dying. Social Science & Medicine170, 188-196. https://doi.org/10.1016/j.socscimed.2016.10.010

Morasz, L. (2012). Suffering and pain in psychiatry. Soins. Psychiatrie, (282), 16-21.

Smith, L. W., Amella, E., Edlund, B., & Mueller, M. (2014). A dimensional analysis of the concept of suffering in people with dementia at end of life. Journal of Hospice & Palliative Nursing16(5), 263-270.

 

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