A theory of nonphysical suffering and trust in hospice patients.

Suffering is a complex, dynamic experience that overarches life experiences and includes physical, social, spiritual, and emotional domains. The purpose of this grounded theory study was to uncover participants' experiences of nonphysical suffering and what was helpful during this time. Eighteen patients who were chronically ill participated in this grounded theory study. Trust was uncovered as a central issue within nonphysical suffering, whereas meaning was the vehicle that enabled the individual to move within the suffering. Participants acknowledged suffering through the identification of various meanings of a situation within their constructed reality and belief system. During individuals' suffering, time was altered and the experience occurred within an expanded present. The individual created an emotional space apart from the meaning of loss within suffering. Trust included the categories of dynamic experience, losing trust, and dealing to regain trust. Participants identified nurse trustworthiness as important for decreasing energy expenditures associated with suffering.