title: Spiritual pain and its care in patients with terminal cancer: construction of a conceptual framework by philosophical approach.
abstract: OBJECTIVE
  In discussing spiritual care of patients with terminal cancer, it is important to clarify the structure of spiritual pain to be evaluated.
  
  
  METHODS
  In this article, spiritual pain is defined as "pain caused by extinction of the being and the meaning of the self," and its structure was evaluated according to the three dimensions of the human being, that is, a being founded on temporality, a being in relationship, and a being with autonomy.
  
  
  RESULTS
  As a result, spiritual pain of patients with terminal cancer could be described as meaninglessness of life, loss of identity, and worthlessness of living derived from loss of the future, loss of others, and loss of autonomy of a dying individual.
  
  
  CONCLUSIONS
  On the basis of these understandings, the author deduced principles of spiritual care of terminally ill cancer patients as recovery of the future beyond death, others beyond death, and autonomy toward death in each dimension of the human being.
authors.affiliation: School of Health Sciences, Tokai University, Bohseidai, Isehara, Japan. h-murata@is.icc.u-tokai.ac.jp
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Murata
mesh_terms: D000223:Adaptation, Psychological; D006801:Humans; D007564:Japan; D009369:Neoplasms / Q000523:psychology*; D010146:Pain / Q000523:psychology; D029181:Spirituality; D013315:Stress, Psychological / Q000209:etiology*; D013727:Terminal Care