Extensive human suffering: a point prevalence survey of patients' most distressing concerns
during inpatient care
Sammanfattning
Aim: 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.
Findings: 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.
Conclusion: 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.