The purpose of this study is to help understand what suffering is, i.e. how patients and nurses describe suffering, and how suffering can be alleviated. The study has a descriptive-explorative design and its approach is phenomenological-hermeneutical. The informant (research group) are 11 nurses (nurses, doctors, hospital theologians) and five patients in a social-psychiatric nursing unit, based on Christian ideology. The results of the study show that the 'what' of suffering is unclear. The nurses tend to describe more the 'why' of suffering, i.e. the reason for suffering. The what of suffering is pain, fear, despair, lack of strength. It is a form of lack of freedom and non-motion. It is a struggle between wanting and knowing, between guilt and responsibility. The form of suffering tends to mould the caring relation. To be touched in some way by another in a meeting can alleviate the deepest suffering. Compassion will always alleviate suffering.

Hermeneutics and narration: a way to deal with qualitative data This article focuses a hermeneutic approach on the interpretation of narratives. It is based on the French philosopher Paul Ricoeur's theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur's theory of interpretation, before going on to describe the interpretation process as modified by the authors. The interpretation process, which consists of several stages, is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur's theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur's thinking, is not the goal of the process but rather a means to deal with the researcher's pre-understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text 'as text' and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretation process. The researchers further argue that distanciation must be followed by reflection, where the interpretations are linked back to the empirical context.

A previous study indicated that patient narratives include experiences of suffering caused or increased by health-care encounters. The aim of this study was to interpret and understand the meaning of patients' experiences of suffering related to health care from an ethical, existential and ontological standpoint. Sixteen women with breast cancer in Sweden and Finland took part in qualitative interviews analysed with a hermeneutic, interpretive approach. The outcome showed that suffering related to health care is a complex phenomenon and constitutes an ethical challenge to health-care personnel. The women's experiences of suffering related to health care tended to be of similar seriousness as their experiences of suffering in relation to having cancer. In an ethical, existential and ontological sense, suffering related to health care is basically a matter of neglect and uncaring where the patient's existential suffering is not seen and she is not viewed as a whole human being.

Through qualitative interviews, the suffering experiences of women with breast cancer and their significant others were disclosed. Seventeen women with different stages of breast cancer and 16 significant others from 4 different care cultures in Sweden and Finland participated. Five of the women had advanced metastatic breast cancer, and 12 had a localized disease. Mean age was 48 years. As a methodology, a team approach, inspired by the Vancouver School of Doing Phenomenology, was used. The findings elucidate how the suffering experience touched the women's inner existence and values. This can metaphorically be described as a "field of force" and affected everything in the women's lives, including their views of themselves and their relationships. Existential questions were raised about life and death and the meaning of life. In their suffering, the women's dependency upon significant others, as well as healthcare personnel, was prominent. Suffering related to healthcare was a strong theme. Different faces of suffering related to breast cancer may still be unknown by healthcare professionals working in cancer care.