Understanding, measuring, and mitigating pain-related suffering is a key challenge for both clinical care and pain research. However, there is no consensus on what exactly the concept of pain-related suffering includes, and it is often not precisely operationalized in empirical studies. Here, we (1) systematically review the conceptualization of pain-related suffering in the existing literature, (2) develop a definition and a conceptual framework, and (3) use machine learning to cross-validate the results. We identified 111 articles in a systematic search of Web of Science, PubMed, PsychINFO, and PhilPapers for peer-reviewed articles containing conceptual contributions about the experience of pain-related suffering. We developed a new procedure for extracting and synthesizing study information based on the cross-validation of qualitative analysis with an artificial intelligence-based approach grounded in large language models and topic modeling. We derived a definition from the literature that is representative of current theoretical views and describes pain-related suffering as a severely negative, complex, and dynamic experience in response to a perceived threat to an individual's integrity as a self and identity as a person. We also offer a conceptual framework of pain-related suffering distinguishing 8 dimensions: social, physical, personal, spiritual, existential, cultural, cognitive, and affective. Our data show that pain-related suffering is a multidimensional phenomenon that is closely related to but distinct from pain itself. The present analysis provides a roadmap for further theoretical and empirical development.

中文翻译：

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定义痛苦中的痛苦。使用自然语言处理对与疼痛相关的痛苦进行系统评价。

了解、测量和减轻与疼痛相关的痛苦是临床护理和疼痛研究的一个关键挑战。然而，对于与疼痛相关的痛苦的概念到底包括什么，目前还没有达成共识，而且在实证研究中往往没有得到精确的操作。在这里，我们（1）系统地回顾了现有文献中与疼痛相关的痛苦的概念化，（2）制定了定义和概念框架，以及（3）使用机器学习来交叉验证结果。我们在 Web of Science、PubMed、PsychINFO 和 PhilPapers 的系统搜索中确定了 111 篇文章，其中包含有关疼痛相关痛苦经历的概念性贡献的同行评审文章。我们开发了一种新的程序，用于提取和综合研究信息，该程序基于定性分析的交叉验证与基于大语言模型和主题建模的人工智能方法。我们从代表当前理论观点的文献中得出了一个定义，并将与疼痛相关的痛苦描述为一种严重消极、复杂和动态的体验，以应对个人作为自我的完整性和作为一个人的身份所受到的威胁。我们还提供了与疼痛相关的痛苦的概念框架，区分了 8 个维度：社会、身体、个人、精神、存在、文化、认知和情感。我们的数据表明，与疼痛相关的痛苦是一种多维现象，与疼痛本身密切相关但又有区别。本分析为进一步的理论和实证发展提供了路线图。