A Comprehensive Approach to the Patient at End of Life: Assessment of Multidimensional Suffering

South Med J. 2016 Apr;109(4):200-6. doi: 10.14423/SMJ.0000000000000439.


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.

Publication types

  • Review

MeSH terms

  • Attitude to Death*
  • Humans
  • Pain / diagnosis
  • Pain / psychology*
  • Pain Management / ethics
  • Pain Management / methods*
  • Pain Management / psychology
  • Palliative Care / ethics
  • Palliative Care / methods*
  • Palliative Care / psychology
  • Psychology
  • Spirituality*
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Terminal Care / ethics
  • Terminal Care / methods*
  • Terminal Care / psychology