Defining suffering in pain: a systematic review on pain-related suffering using natural language processing

Understanding, measuring, and mitigating pain-related suffering is a key challenge for both clinical care and pain research. However, there is no consensus on what exactly the concept of pain-related suffering includes, and it is often not precisely operationalized in empirical studies. Here, we (1)...

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Hauptverfasser: Noe-Steinmüller, Niklas (VerfasserIn) , Scherbakov, Dmitry (VerfasserIn) , Zhuravlyova, Alexandra (VerfasserIn) , Wager, Tor D. (VerfasserIn) , Goldstein, Pavel (VerfasserIn) , Tesarz, Jonas (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: March 5, 2024
In: Pain
Year: 2024, Jahrgang: 165, Heft: 7, Pages: 1434-1449
ISSN:1872-6623
DOI:10.1097/j.pain.0000000000003195
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/j.pain.0000000000003195
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/pain/fulltext/9900/defining_suffering_in_pain__a_systematic_review_on.542.aspx
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Verfasserangaben:Niklas Noe-Steinmüller, Dmitry Scherbakov, Alexandra Zhuravlyova, Tor D. Wager, Pavel Goldstein, Jonas Tesarz

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520 |a Understanding, measuring, and mitigating pain-related suffering is a key challenge for both clinical care and pain research. However, there is no consensus on what exactly the concept of pain-related suffering includes, and it is often not precisely operationalized in empirical studies. Here, we (1) systematically review the conceptualization of pain-related suffering in the existing literature, (2) develop a definition and a conceptual framework, and (3) use machine learning to cross-validate the results. We identified 111 articles in a systematic search of Web of Science, PubMed, PsychINFO, and PhilPapers for peer-reviewed articles containing conceptual contributions about the experience of pain-related suffering. We developed a new procedure for extracting and synthesizing study information based on the cross-validation of qualitative analysis with an artificial intelligence-based approach grounded in large language models and topic modeling. We derived a definition from the literature that is representative of current theoretical views and describes pain-related suffering as a severely negative, complex, and dynamic experience in response to a perceived threat to an individual's integrity as a self and identity as a person. We also offer a conceptual framework of pain-related suffering distinguishing 8 dimensions: social, physical, personal, spiritual, existential, cultural, cognitive, and affective. Our data show that pain-related suffering is a multidimensional phenomenon that is closely related to but distinct from pain itself. The present analysis provides a roadmap for further theoretical and empirical development. 
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