title: Extensive human suffering: a point prevalence survey of patients' most distressing concerns during inpatient care.
abstract: OBJECTIVE
  To explore patients' most distressing concerns during a hospital stay.
  
  
  BACKGROUND
  The characteristics of hospitalised patients have changed. Care is provided at a higher age, lengths of stay have fallen and the nursing workload is increasing. It is presumed that hospitalised patients are more seriously ill and have more palliative needs than previously. Studies show that inpatients suffer from more distress than similar outpatients although there is a lack of overall knowledge about inpatients' distress and major concerns, regardless of age, diagnosis or care setting.
  
  
  METHODS
  This study was part of a point prevalence survey (PPS) concerning symptom prevalence. Of the 710 patients who participated in the PPS, 678 (95%) answered an open-ended question in a questionnaire: What is your main concern or what is most distressing or troublesome for you at present? Using a life-world approach, the text was analysed qualitatively and patients' concerns were interpreted in two main dimensions, an intersubjective dimension and a temporal dimension.
  
  
  RESULTS
  The patients reported extensive suffering due to illness, symptoms and failing health. Patients were concerned about family members, existential issues and the future. Three aspects of the patients' most distressing concerns were interpreted: The suffering self, The suffering person in close relations and The suffering person in a threatening world.
  
  
  CONCLUSIONS
  Hospitalised patients are affected by severe illness, distressing symptoms and existential quandaries, revealing extensive human suffering in the midst of the demanding activities that take place during an ordinary day in a hospital. To support patients and alleviate suffering, hospital staff need to be more sensitive to patients' most distressing concerns. This presupposes a hospital environment in which the value system supports caring and comforting behaviour.
authors.affiliation: School of Health Sciences, University of Borås, Borås, Sweden.|Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Isabell
authors.initials: I
authors.lastname: Fridh
authors.affiliation: Head of Research and Development Centre, Skaraborg Hospital, Skövde.|Palliative Research Centre, Ersta Sköndal University College, Ersta Hospital, Stockholm, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kenne Sarenmalm
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kristin
authors.initials: K
authors.lastname: Falk
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Henoch
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Palliative Research Centre, Ersta Sköndal University College, Ersta Hospital, Stockholm, Sweden.|Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Joakim
authors.initials: J
authors.lastname: Öhlén
authors.affiliation: Department of Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anneli
authors.initials: A
authors.lastname: Ozanne
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Jakobsson Ung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015995:Prevalence; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: acute care; distressing concerns; hospitalisation; inpatients; life-world research; point-prevalence survey; qualitative research