Suffering and salutogenesis

Abstract

In considering pain and suffering, some considerations will appear about epistemological beliefs shaping the clinical practices of health-care workers. With this, we try to understand the usual omission of human suffering in the training of many health professionals. So, we emphasize the role of the pathogenic paradigm in how human suffering is viewed in health care. In contrast to those who see suffering only as pathogenic, we defend that suffering can be a source of significant learning for both the sufferer as well as those who undertake caring in certain circumstances. We therefore argue that it is necessary to educate for health and not only for illness, choosing a holistic paradigm: Aaron Antonovky's salutogenic model that encloses positive aspects of human suffering when it is lived with an internal sense of coherence.

The Handbook of Salutogenesis

“…Professional salutogenic healthcare places special responsibility on health professionals (Oliveira, 2015). Oliveira points out why, explaining that working salutogenically might involve supporting people in uprooting and changing health detrimental situations, counseling in establishing new relationships and activities, and facilitating and joining in dialogues about finding meaning in everyday life (ibid).…”

“…Antonovsky spent a Sabbatical in Lund, Sweden (1987-1988 and initiated salutogenic research both in Sweden and Scandinavia through his contacts at the Nordic School of Public Health in Gothenburg. He later became an Honorary Doctor at the Nordic School (1993).…”

Psychometric properties of the suffering assessment questionnaire in adults with chronic diseases or life‐threatening illness

“…The authors emphasise that the decision‐making process and the adequacy of interventions to support these patients must be based on an instrument that holistically addresses all the individual dimensions to assess their uniqueness and, at the same time, takes into account intra‐ and interpersonal dimensions. This idea can be summed up as follows: ‘Epistemological holism long ago argues that a living organism is not just the sum of its components (e.g., organs), defending that the whole is greater than the sum of its parts’ (: 224).…”

“…Antonovsky's work (1989) enunciated some possible GRR, including natural, physical/biochemical, emotional, interpersonal, socio‐cultural, environmental and spiritual methods, from which emerge senses of comprehensibility, manageability and of meaningfulness . Generalised resistance resources can, in themselves, given an individual, group or population a Sense Of Coherence (SOC) . As (10, p. 57) put it, ‘suffering is good only to the extent that it provides one with the engine that drives toward enrichment’.…”

Para compreender o sofrimento humano

“…Only knowing them as human beings, and not only as patients, will we be able to identify if there is suffering or not and of what type it is. Informal caregivers are Informal caregivers are essential to this, and any health professional should have communication, anthropological and ethical training to learn to identify situations in which their patients need help in addition to medicines and more or less invasive treatments 49 . It is impossible (not merely difficult, but impossible) to base solid clinical decisions solely on the scientific evidence because, as all science, the evidence is on generalities and patients are particular, unique individuals 50 .…”