suffering

The concept of suffering is fundamental when dealing with life-threatening diseases like cancer, affecting both patients and their families. However, this concept has not been thoroughly examined in nursing culture. Therefore, this study aimed to analyze the concept of suffering among parents of children with cancer. Walker and Avant’s eight-step method was used to analyze this concept. The literature review was conducted using Google Scholar, Ovid, Medline, and CINAHL databases from 2000 to 2022 focusing on suffering, conceptual analysis of suffering, and cancer and suffering as keywords. Initially, 138 articles were obtained. After reviewing the articles and eliminating the irrelevant ones, 47 articles were deemed pertinent for further analysis. Among these, 10 articles directly related to the topic of suffering in families due to cancer were chosen as the basis for concept analysis. The analysis of the concept of suffering in parents of children with cancer involved choosing the concept, defining the purpose of analysis, identifying all potential uses of the concept, describing its attributes, presenting a model case, determining borderline, related, contrary, and unrelated cases, identifying antecedents and consequences (preliminaries and delays), and detailing empirical referents.

Human beings and their storytelling mind, sometimes, through imagination and exaggeration, move beyond the obvious signs of an event and its consequences, completely removing or devoiding it of its original meaning, dissociating it from daily life, and turning it into a tool to justify their attitudes and beliefs. One of the bitterest examples of this, in human history, is about the way the story of the prophet Job and the cause of his suffering and illness, along with its treatment, have been reported. Throughout history, most related interpretations have been based on the Torah’s outlooks and writings, resulting in changing the main message of the prophet Job’s story and life.

The purpose of the article is to consider the problematic issues of forming an understanding of such concepts as "health", "pain" and "suffering".

A set of general scientific and special methods was used in the work: dialectical, dogmatic, hermeneutic, comparative legal method, statistic and sociological method.

Considered the category of "health" in various humanities, compared the characteristics of "physical pain" and "physical and moral suffering" as possible consequences of criminal offenses that harm the health of the individual.

The research of such problematic issues allowed to develop of a unified approach to understanding of such concepts as “health”, “pain” and “suffering”, this, in turn, will make possible to unify legislation in this area.

The use of chemical weapons by Iraq against Iran leads to the death of thousands of civilians, and it left hundreds of thousands of wounded and chemical injured that most of them still suffer from its side effects and to show themselves a strong man, they suppress their physical and mental symptoms. This study aimed to explore the experiences of the silent suffering on the chemical injured of the Iran-Iraq war.

This qualitative research was conducted in 2019 on 16 chemical casualties in Amir Al-Momenin Hospital, Isfahan, Iran. 16 chemical injured that had the login characteristics of the study were selected by purposeful sampling method and for data collection of deep unstructured interviews. The interviews were analyzed by the Colaizzi method.

Generally from 16 interviews, 345 primary codes, 28 primary concepts, one sub-themes of 5 main themes of ideals, gradual disintegration, and blame were extracted.

Conclusions:

 Experiences of participants show the experience of silent suffering of war. Physical, psychological, and spiritual support in these victims is one of the important factors reducing their silent suffering.

Spirituality can be an important source of coping with the disease, reduce feelings of suffering and improving quality of life in patients with chronic diseases.  The purpose of this study was to determine the relationship of spirituality with the Perception of suffering and Quality of Life in Patients with Type 2 diabetes.

This was a descriptive-correlation study. Participants were 145 patients with type 2 diabetes of rural health clinics and the valley hospital in khorramshahr city which were selected via stratified random and available sampling methods. Data collection tools were version of 29-item of the spiritual questionnaire (Parsian and Dunning), Experience and Perception of Suffering Questionnaire (Schulz) and version of 26-item of the Quality of Life Questionnaire (WHO). Data were analyzed using SPSS, version 16.0 software and Pearsonchr('39')s correlation, T-test, ANOVA, Post Hoc and Stepwise Regression analytical statistics.

The spirituality average scores were 79.41±15.82, Perception of Suffering average scores, 54.89±2.14 and Quality of Life 74.44±1.65. There was a significant negative relationship between spirituality and feelings of suffering (p<0.05) and significant positive relationship between spirituality and quality of life (p<0.0001).

 A strong correlation between spirituality with quality of life and, Suffering in patients with type II diabetes, demonstrate the roles and responsibilities of healthcare providers, including physicians and nurses and the patientchr('39')s family in meeting the varied spiritual and religious needs of patients along with therapeutic actions. Paying attention to improve spiritual health is also important in education programs for these patients.

Recognition of labor pain is a primary concern of physicians, midwives and their clients in controlling labor pain and preventing the resulting suffering. The purpose of this study was to assess the relationship between self-esteem and anxiety with severity of pain and suffering of labor in women.

This cross-sectional study was conducted on 365 mothers who experienced delivery at Shahidan Mobini hospital in Sabzevar in 2014. The data were collected using Rosenberg Self-esteem questionnaire and Spielberger State-Trait Anxiety scales, visual analogue scale (VAS) for pain, and experience and perception of suffering. Data were analyzed using t-test, Pearson correlation coefficient and chi-square test considering level of significance equal to 0.05.

The mean age was 26.4± 4.7 years old. In this study, 119 (44.9%) samples were nulliparous, 20 (7.5%) were employed and 196 (74%) were urban citizens. There was no significant difference between the pain of labor score in terms of self-esteem levels (p=0.84) and the level of covert anxiety (p=0.15) and overt anxiety (p=0.06). However, there was a significant differences between the suffering of labor scores in terms of selfesteem levels (p<0.001),the covert anxiety levels (p<0.001) and the overt anxiety levels (p<0.05).

Considering pregnant women with higher self- esteem and lower anxiety score had a lower score on labor suffering in this study, it seems health care providers can help reduce pregnant women’s suffering of labor through strengthening the well-being and health of pregnant women and supporting them during pregnancy and labor

Many researches are seeking evidence and ways in which spirituality can improve the feeling of suffering and quality of life in drug abuse addicts. This study was aimed to investigate the role of spirituality in feelings of suffering and quality of life in self-introduced addicts referring to addiction treatment centers. The statistical population consisted all of self-introduced addicts referring to addiction treatment centers in Yasuj city. 120 participants were selected by convenience sampling. Following instruments were used for data collection; spirituality questionnaire, scale of experience and perception of suffering and the world health organization quality of life questionnaire. The results showed that there was a significant negative correlation between spirituality and feelings of suffering. There was a significant positive correlation between spirituality and quality of life. Stepwise regression results showed that the best predictors of spiritual/existential suffering were self- awareness and spiritual activities. Also, the component of self-awareness was the best predictor of physical health, psychological health, environmental health and quality of life and social relations. Therefore, reinforcement of spirituality in addicts and encouraging them to perform the related activities can reduce the feeling of pain among them and improve their quality of lives.

Breast cancer is the most common type of cancer and second leading cause of death in women after lung cancer. The World Health Organization has reported that breast cancer, with 502,000 deaths in 2005, surpassed lung, stomach, colorectal, and cervical cancers as the leading cause of death in women. The main objective of the current study was to examine the predictive role of emotional selfregulation in quality of life and perception of suffering among patients with breast cancer.
This was a descriptive-analytical study followed by a correlational design. The sample population consisted of 42 patients with breast cancer selected by the census method. Participants completed questionnaires on emotional self-regulation, quality of life (Aaronson et al., 1987), and perception of suffering. The obtained data was statistically analyzed using the Pearson correlation coefficient and regression analysis via SPSS 22.
There was a significant, positive association between emotional selfregulation and the functional and general dimensions of quality of life. A significant, inverse correlation existed between emotional self-regulation and the symptoms dimension of quality of life. The results of the enter regression analysis showed that selfregulation respectively predicted 0.18 of variance in the functional, 0.26 in symptoms, and 0.37 of the variance in the general health dimensions of the quality of life. Emotional self-regulation had a significant, diverse relationship to the physical, psychological, and existential dimensions of perception of suffering. The results of the regression analysis carried out to predict perception of suffering indicated that emotional self-regulation respectively predicted 0.33 of variance in the physical, 0.19 in psychological, and 0.06 of the variance in the existential dimensions of perception of suffering.
A major step forward can be taken towards improving the level of quality of life among breast cancer patients through the use of books and educational brochures, individual and group counseling sessions associated with emotional self-regulation, and encouragement of patients to participate in cultural and sports activities.

Thalassemia major is the most common hereditary anemia in Iran. Thalassemia major patients require lifelong care and suffer much pain during self-care. Knowledge of the nature, meaning, and impact of suffering from the perspective of patients is needed to determine which interventions are helpful. This study was designed to understand the experience of suffering in patients with thalassemia. This was a qualitative study conducted with content analysis method. In the present study, 21 patients with thalassemia were selected by purposive sampling. The research was performed at Kerman Samen Alhojaj Medical Center, Iran, in 2013. Data collection method was conducting unstructured interviews using open-ended questions and fi eld notes. In addition, data were analyzed using qualitative content analysis and conventional approach. Data analysis resulted in the emergence of the four central categories of physical exhaustion, mental and spiritual restlessness, society’s behaviors and beliefs, and surviving a hard life, which were the suffering themes of the patients. Results showed that thalassemia in the physical, psychological, social, and spiritual aspects is very stressful for patients. Moreover, culture plays an important role in the patients’ experience of suffering. Results of this study can help nurses improve nursing care to alleviate suffering based on these experiences.