Table 2.

Integrative definition of pain-related suffering.

Definition

A severely negative, complex, and dynamic experience in response to a perceived threat to an individual's integrity as a self and identity as a person.

Expansions

Pain-related suffering is experienced to different degrees on a physical, spiritual, existential, personal, social, cultural, affective, and cognitive level.

Pain-related suffering is often associated with feelings of loss, lack of control, illness, alienation, and reduced quality of life. However, none of these can in itself be considered suffering, if it is not experienced as a threat as defined above.

Pain-related suffering is often a long-term experience but not necessarily so.

Pain and pain-related suffering are related but distinct phenomena. Either can cause or enhance the other.

The experience of pain-related suffering depends on the complexity of the affected individual. Newborns do suffer, but their suffering is not taking place on, eg, an existential or spiritual level, and they are not threatened as persons but rather as selves.

The table shows our integrative definition of pain-related suffering based on the examined literature. The definition is amended by expansions that further describe the multidimensional character of pain-related suffering. Taken together, definition and expansions include all aspects of pain-related suffering that were used in the definitions of at least 2 articles from our text corpus.