OP-3 The limits of care: patient, provider and systemic barriers to addressing nonphysical suffering

Introduction The prevention and relief of suffering, both physical and nonphysical, is a primary aim of palliative care globally. Research has been very limited on palliative care providers’ experiences working with patients’ nonphysical suffering: suffering that is psychological, emotional, social, spiritual and/or existential in nature. This study helps to fill this research gap. Aims To identify what discourses exist within how palliative care providers talk about their experiences working with patients’ nonphysical suffering, and how these discourses may affect palliative care clinicians and Impact clinical care. Methods Grounded in a poststructural discourse analysis, and following ethics approval and informed consent, 24 participants (physicians, nurses, social workers, music therapists, occupational therapist) working with adult patients across diverse settings (e.g., home care, long term care, outpatient and in-patient units) participated in phone interviews in 2020. Interviews explored participants’ experiences working with patients’ nonphysical suffering; transcripts were analyzed for the presence of discourses. Results Study findings revealed multiple, intersecting barriers to nonphysical suffering’s relief at the patient, clinician and systemic levels. For example, patients are reluctant to share their nonphysical suffering with providers; providers lack skills specific to their work with patients’ nonphysical suffering; and some care settings have less capacity to respond to patients’ nonphysical suffering. Providers reported experiencing helplessness and inadequacy in their work specific to patients’ nonphysical suffering and can avoid patients whose nonphysical suffering they cannot relieve. Conclusion Palliative care has long ascribed nonphysical suffering’s relief to the ability of a patient to transcend their own suffering, or a provider to facilitate/support that transcendence. Findings call into question and expand this long-standing discourse by pushing the field to consider how multi-level barriers limit palliative care’s call for the relief of nonphysical suffering. Impact Findings have implications for palliative care practice, and interdisciplinary training, education and support. Reference Rattner M, Cait C-A. ‘It’s hard not to feel like somehow I fell short’: a discourse analysis of palliative care providers’ experiences with patients’ nonphysical suffering. Palliative Care and Social Practice 2025;19. doi:10.1177/26323524251379910