Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources

Abstract Background According to the concept of Total Pain proposed by Cicely Saunders (1967), the treatment of pain for patients in need of palliative care requires considering its multidimensional nature, encompassing physical, social, psychological, and spiritual aspects. The aim of this study wa...

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Main Authors: Maya Corman, Michaël Dambrun, Angeline Ginzac, Katell Ménard
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Palliative Care
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Online Access:https://doi.org/10.1186/s12904-025-01719-0
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author Maya Corman
Michaël Dambrun
Angeline Ginzac
Katell Ménard
author_facet Maya Corman
Michaël Dambrun
Angeline Ginzac
Katell Ménard
author_sort Maya Corman
collection DOAJ
description Abstract Background According to the concept of Total Pain proposed by Cicely Saunders (1967), the treatment of pain for patients in need of palliative care requires considering its multidimensional nature, encompassing physical, social, psychological, and spiritual aspects. The aim of this study was to update the concept of Total Pain and explore the resources used by patients with cancer. Methods Fourteen semi-structured interviews were conducted in one oncology center and one oncology rehabilitation center (median age = 70.5, range [55–77]; 8 women). The interview guide explored various dimensions of suffering, including physical (e.g., pain), social (e.g., isolation), psychological (e.g., emotional state), and spiritual (e.g., the role of spirituality in illness experience), as well as connections to nature, and patients’ internal and external resources related to each sphere of suffering. Interpretative Phenomenological Approach (IPA) was employed to analyze the interviews. Results The findings highlight several important aspects of suffering: the unpredictability of pain (physical sphere), loss of social roles (social sphere), negative affects (psychological sphere), evocation of the end of life (spiritual sphere), and loss of contact with nature. Besides in terms of resources, the study identifies several key coping mechanisms, such as mind-body practices for relieving physical and psychological pain, distraction engaging with the environment, nature as a source of positive emotions, and the search for meaning. Conclusions Despite experiencing total pain, some patients utilize internal and external protective resources in the face of life-threatening illness. These findings underscore the importance of viewing Total Pain under its multidimensional aspect and as a dynamic process involving the individual’s connection with their community and environment. Trial registration This study received approval from the Ethical Committee of CPP SUD EST 1 (National number: 2019-A02263-54).
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spelling doaj-art-e21a10a1ee934dd98acf0178e0cbc62f2025-08-20T02:10:17ZengBMCBMC Palliative Care1472-684X2025-03-0124111710.1186/s12904-025-01719-0Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resourcesMaya Corman0Michaël Dambrun1Angeline Ginzac2Katell Ménard3Université Clermont Auvergne (UCA), LAPSCO UMR CNRS 6024Université Clermont Auvergne (UCA), LAPSCO UMR CNRS 6024INSERM U1240 Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont AuvergneCentre de Lutte Contre le Cancer Jean PerrinAbstract Background According to the concept of Total Pain proposed by Cicely Saunders (1967), the treatment of pain for patients in need of palliative care requires considering its multidimensional nature, encompassing physical, social, psychological, and spiritual aspects. The aim of this study was to update the concept of Total Pain and explore the resources used by patients with cancer. Methods Fourteen semi-structured interviews were conducted in one oncology center and one oncology rehabilitation center (median age = 70.5, range [55–77]; 8 women). The interview guide explored various dimensions of suffering, including physical (e.g., pain), social (e.g., isolation), psychological (e.g., emotional state), and spiritual (e.g., the role of spirituality in illness experience), as well as connections to nature, and patients’ internal and external resources related to each sphere of suffering. Interpretative Phenomenological Approach (IPA) was employed to analyze the interviews. Results The findings highlight several important aspects of suffering: the unpredictability of pain (physical sphere), loss of social roles (social sphere), negative affects (psychological sphere), evocation of the end of life (spiritual sphere), and loss of contact with nature. Besides in terms of resources, the study identifies several key coping mechanisms, such as mind-body practices for relieving physical and psychological pain, distraction engaging with the environment, nature as a source of positive emotions, and the search for meaning. Conclusions Despite experiencing total pain, some patients utilize internal and external protective resources in the face of life-threatening illness. These findings underscore the importance of viewing Total Pain under its multidimensional aspect and as a dynamic process involving the individual’s connection with their community and environment. Trial registration This study received approval from the Ethical Committee of CPP SUD EST 1 (National number: 2019-A02263-54).https://doi.org/10.1186/s12904-025-01719-0Total PainPalliative careCopingQualitative research
spellingShingle Maya Corman
Michaël Dambrun
Angeline Ginzac
Katell Ménard
Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
BMC Palliative Care
Total Pain
Palliative care
Coping
Qualitative research
title Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
title_full Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
title_fullStr Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
title_full_unstemmed Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
title_short Exploring the concept of Total Pain in contemporary oncology palliative care: a qualitative study on patients' resources
title_sort exploring the concept of total pain in contemporary oncology palliative care a qualitative study on patients resources
topic Total Pain
Palliative care
Coping
Qualitative research
url https://doi.org/10.1186/s12904-025-01719-0
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