RESUMEN
BACKGROUND: In spite of the evident importance of suffering, the medical and psychological literature, with some exceptions, contains few contributions toward an understanding of its phenomenology, etiology, and alleviation. OBJECTIVE: To enhance understanding of suffering in chronic physical disease, the authors applied qualitative content analysis to semistructured interviews with 12 patients with systemic lupus erythematosus. METHOD: This study was intended to be exploratory, adopting a predominantly qualitative approach, supplemented with quantitative data. Case reports, complemented by psychometric and objective illness-related data, were used to elucidate a model of suffering and to explain its etiology and its interaction with personal growth. RESULTS: Findings were consistent with the concept of suffering as a psychological process triggered and sustained by an appraised threat to the "Self" or "Personhood." CONCLUSION: Results indicate that various types of suffering have to be differentiated. Recognizing personal growth in response to the illness-experience may reduce suffering.