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Betty Ferrell

and Catherine Del Ferraro

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date: 01 July 2022

At the end of life, the spiritual needs of a patient can transcend physical needs, and unmet spiritual needs can contribute to pain and suffering. Spirituality is most broadly defined as the quest for meaning and purpose in life, while religion provides a means to express spirituality. The spirit is part of our being and religion is viewed as a structured belief system that provides a philosophy and ethical code for living. Suffering is seen in patients who are confronted with lifethreatening diseases for which there is no known cure and who are suddenly forced to face their own mortality. Life-threatening illnesses often cause people to reflect on their lives, and question life’s meaning and its purpose. These individuals begin to mourn the life they lived and shared with loved ones. Over the past 20 years, our programme of research at the City of Hope Medical Center has been guided by a model of quality of life (QOL) including four domains of physical, psychological, social and spiritual wellbeing. Case examples are presented in order to illustrate aspects of suffering associated with each domain. The cases also demonstrate how spirituality transcends all domains and influences the experience of suffering. The chapter also covers suffering as witnessed in patients, family caregivers, and healthcare professionals, and suffering across the trajectory of a disease.

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