Table 1.

Categorization of qualitative data

Category of suffering	Indications for assigning category	Example of categorization
Physical	Medical morbidity, the physical symptom itself, physical symptoms which result in physical experienced suffering	Pain: I have pain all day, it occupies me continuously, there is little distraction
Loss of meaning	Loss of: identity, capacity of self-fulfillment, communication, social role, social interaction, intimacy	Impaired working capacity: I miss the contact with people. The only one left is my wife
Loss of autonomy	Suffering acknowledged to be caused by loss of autonomous functioning and occurrence of dependency (presence itself of loss of autonomy is not sufficient for assigning)	Trouble accepting present situation: The dependency on other people
Loss of dignity	Socially embarrassing symptoms, shame, body image concerns, not taken seriously, worthlessness	Impaired comprehension of speech: I feel stupid, I can’t come along
Burden to others	Experience to be a burden to others	Feeling to be a burden to others: I feel troubled to ask other people for help
Loss of sexual role	Loss of capability of sexual functioning; loss of sexual role	Restricted sexuality: my sexual life is destroyed, it is gone, not only for me, but also for my wife
Fear of future suffering	Fear caused by awareness of possible suffering related to progress of disease	Fear to lose the strength to bear the suffering: Pain, I have fear for pain
Anxiety	Anxiety	Not sleeping well: I have these nightmares, it wakens me up and makes me frightened
Death anxiety	Anxiety related to awareness of the process of dying and what may come along with that, and anxiety related to the actual dying process	Fear of future suffering: I am afraid to suffocate
Depressiveness	Suffering caused by the presence of depressive thoughts	Feel depressed: It is an annoying feeling. It is also influenced by the situation of my daughters: they are not doing well
Worrying	Negative thoughts which cannot be turned off	Impaired coordination of movements: I am afraid to fall, I hold on to everything
Feeling tensed	Feeling tensed in mind or body	Feel tensed: Especially in bed; each time again I feel tense and keep saying “relax”
Hopelessness	Loss of possibility of meaning	Hopelessness: To say farewell is what makes me feel hopeless
Pointlessness	Total loss of meaning; nothing left	General discomfort: Not being able to do a thing, just waiting for death