Table A1.

Domains of Suffering in the Patient Vignette

AxisDomainThreat or Loss
BiomedicalSymptomsNight sweats, brain fog, fatigue, joint pain, pruritis, vaginal dryness, decreased libido, weight gain
FunctionsInsomnia, not running due to joint pain
SocioculturalRolesHard to perform at work due to brain fog and fatigue
RelationshipsSexual relationship with partner affected due to decreased libido, fatigue, and dyspareunia
PsychobehavioralEmotionsFear, sadness
ThoughtsAnxious thoughts about teenage children and ailing father
ExistentialNarrativeRealizing that a significant part of her identity has been defined by her sexuality, attractiveness, and reproduction, she wonders who will she be as she becomes a post-menopausal woman?
WorldviewEntering a later stage of life, she asks herself: What is her life all about? Where does it fit in the life of her family and the big picture of why she is on the planet?