title: A Comprehensive Approach to the Patient at End of Life: Assessment of Multidimensional Suffering.
abstract: Pain is a multidimensional, complex experience. There are many challenges in identifying and meeting the needs of patients experiencing pain. Evaluation of pain from a bio-psycho-social-spiritual framework is particularly germane for patients approaching the end of life. This review explores the relation between the psychospiritual dimensions of suffering and the experience of physical pain, and how to assess and treat pain in a multidimensional framework. A review of empirical data on the relation between pain and suffering as well as interdisciplinary evidence-based approaches to alleviate suffering are provided.
authors.affiliation: From the Department of Psychiatry, the Division of Palliative Medicine, and the Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worchester.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wachholtz
authors.affiliation: From the Department of Psychiatry, the Division of Palliative Medicine, and the Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worchester.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Fitch
authors.affiliation: From the Department of Psychiatry, the Division of Palliative Medicine, and the Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worchester.
authors.forename: Suzana
authors.initials: S
authors.lastname: Makowski
authors.affiliation: From the Department of Psychiatry, the Division of Palliative Medicine, and the Department of Quantitative Health Sciences and Medicine, University of Massachusetts Medical School, UMass Memorial Medical Center, Worchester.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tjia
mesh_terms: D001293:Attitude to Death; D006801:Humans; D010146:Pain / Q000175:diagnosis / Q000523:psychology*; D059408:Pain Management / Q000941:ethics / Q000379:methods* / Q000523:psychology; D010166:Palliative Care / Q000941:ethics / Q000379:methods* / Q000523:psychology; D011584:Psychology; D029181:Spirituality; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D013727:Terminal Care / Q000941:ethics / Q000379:methods* / Q000523:psychology