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Qualitative Health Research
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Identifying Signals of Suffering by Linking Verbal and Facial Cues

Janice M. Morse

International Institute for Qualitative Methodology, University of Alberta, Edmonton, Canada

Melanie A. Beres

International Institute for Qualitative Methodology, University of Alberta, Edmonton

Judith A. Spiers

University of Alberta, Edmonton

Maria Mayan

International Institute for Qualitative Methodology, University of Alberta, Edmonton

Karin Olson

University of Alberta, International Institute for Qualitative Methodology, Edmonton

Here, the authors describe microanalytically the two main behavioral states in suffering (enduring and emotional suffering) so that in subsequent research, appropriate comforting responses to ease and relieve suffering can be identified for each behavioral state. Their objectives were to describe the facial expressions of enduring and emotional suffering, and to link them with verbal narrative and thus develop a microanalytic description of each behavioral state. Using Ekman's modified EMFACS, they videotaped interviews with 19 participants and coded co-occurring verbal text and expressions. They also documented differences between each behavioral state and the transitions from enduring to emotional suffering. Enduring and emotional suffering are distinct and identifiable behaviors. These formerly implicit behavioral cues can be used in clinical assessment and research.

Key Words: suffering • facial expression • enduring

Qualitative Health Research, Vol. 13, No. 8, 1063-1077 (2003)
DOI: 10.1177/1049732303256401
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