Total pain, a concept introduced by Dame Cicely Saunders, encompasses the integration of four distinct factors: physical, psychological, social, and spiritual pain experienced by patients. While pain is commonly understood as an unpleasant sensory and emotional experience, total pain expands this definition to encompass the entirety of the patient’s being. Saunders, known for her work with patients with cancer, emphasized that pain extends beyond physical discomfort to include aspects of psychological distress, social detachment, and existential anguish.

This holistic perspective acknowledges that pain is complex and interconnected, with each aspect influencing and exacerbating the others. For example, psychological pain such as anxiety or depression can manifest as physical symptoms, which, in turn, affect social interactions and existential perceptions of life’s meaning. Total pain affects patients and their families, creating a cycle of distress and amplifying the overall burden. Addressing total pain requires a comprehensive and multidisciplinary approach that considers the diverse needs of patients and their families. By drawing on the expertise of various professions, including the domains of nursing, medical, psychological, and spiritual care, holistic care can be provided to alleviate total pain and improve overall well-being.

• Saunders, D. C. (2006). Hospice: Its philosophy and movement (Okamura, A., Trans. Ed.). Mica Shobo.
• Tsunefuji, A. (1999). Latest palliative medicine. Shinsai Igakusha.