Measuring Pain 1. 1. Sensory - intensity, duration, threshold, tolerance, location, etc
2. 2. Neurophysiological - brainwave activity, heart rate, etc
3. 3. Emotional and motivational - anxiety, anger, depression, resentment, etc
4. 4. Behavioural - avoidance of exercise, pain complaints, etc
5. 5. Impact on lifestyle - marital distress, changes in sexual behaviour
6. 6. Information processing - problem solving skills, coping styles, health beliefs
Techniques used to collect data. --------------------------------
1. 1. interviews - advantage - it can cover Karoly's 6 points
2. 2. behavioural
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One way to assess pain behaviours is to observe them in a clinical setting (although pain is also assessed in a natural setting as the patient goes about his or her everyday activities). Keefe and Williams (1992) have identified five elements that need to be considered when preparing to assess any form of behaviour through this type of observation.
• A rationale for observation: it is important for clinicians to know why they are observing pain behaviours. One reason is to identify ‘problem’ behaviours that the patient may be reluctant to report, such as pain when swallowing, so that treatment can be given. Another is to monitor the progress of a course of treatment.
• A method for sampling pain behaviour techniques for sampling and recording behaviour include continuous observation, measuring duration (how long the patient takes to complete a task), frequency counts (the number of times a target behaviour occurs) and time sampling (for example, observing the patient for five minutes every hour).
• Definitions of the behaviour: observers need to be completely clear as to what behaviours they are looking for.
• Observer training: in most clinical situations, there will be different observers at different times and it is important that they are consistent.
• Reliability and validity: the most useful
Research has shown that there are several organizations and active advocates who are working on pain management problems to face this public health issue. The following establishments involve: The American Academy of Pain Medicine, Institute of Medicine, and American Pain Society and many for-profit and nonprofit organizations are also working at different level towards pain management. Most specifically, the IOM has been devoted to studying pain and its consequences on individuals, the healthcare system, as well as on government (IOM, 2011).
Pain is one of the most common reason patient seek out help. The concept of pain can affect every person is some form or way. Pain can stand alone as a theory or fix with other theories like Comfort, Self- care, and more. As a surgical nurse I need to have a higher understanding of the patients I care for to ensure they receive the best care. Concept analysis is a form of research that allows a person to explore a theory/ concept to the fullest degree in an organized way. This concept analysis will take Walker & Avant’s steps to form a better understanding into pain.
“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,
No evidence exists to suggest that older individuals perceive pain to a lesser degree or that sensitivity is diminished. Although pain is a common experience among individuals 65 years of age and older, it is not a normal process of aging. Pain indicates pathology or injury. Pain should never be considered something to tolerate or accept in one's later years.
Gender do plays a major key role in how patient respond, but we were subjective to believe that the female norm is: emotional, weak, passive, resistant, sensitive and that male are supposed to represent masculinity, strength, tough, and non-emotional. Be that as it may, we would assume in most cases that female response to pain will be higher on the pain rating--meaning it constitute a lower threshold in pain tolerance which it equate for their gender, and vice versa with male. For this reason, in a case study in “Gender, coping and the perception of pain”, by Keogh and Herdenfeldt stated “research consistently indicates that gender differences exist in pain perception, with females typically reporting more negative responses to pain than males” (Keogh, p. 195). Even describing how male and female coping strategies are different “it also seems as if males and females use and benefit from different coping strategies when under stress; females seem to prefer emotion-focused coping, whereas males prefer sensory-focused coping” (Keogh, p. 195). So, I had to include gender difference of pain perception into my project with the respect of cultural influences of pain. Two paradox that is needed to be observe is self serving and mindful, but I was up to the
During the monitoring period treatments and outcomes should be measured to determine the effectiveness and adherence of protocols.
“Pain is a complex, multidimensional experience that can cause suffering. [While] pain is inevitable, suffering is optional” (Kinder, 2014, p. 114). The control of pain is, as Kinder puts it very complex, without appropriate measures it can be easily side stepped especially in the elderly. To ensure patient center care it is important that all aspect of one’s quality of life is address, this is emphasizing by pain being a component of vital signs. Being a vulnerable population the elderly is often under assessed as they minimized their problems so as not to be a burden in addition to the fact that they may believe that their pain is a normal part of aging.
Six steps in pain assessment of is history of pain such as surgery, fracture and injury. Verbal indicators such are as pain scale assessment, describe the pain. Nonverbal indicators are such as restless movement,
They check and see what clients they have scheduled for the afternoon and the goals each patient should achieve during their session. Upon arrival, most patients are usually evaluated on their current condition such as their pain level, area of pain, and how the treatments are helping the afflicted area. Once evaluated, the patients are ran through a series of exercises and stretches to help the area of pain or affliction. After a long day of treating patient after patient, the trainer gathers up his materials and clocks out. These therapist are able to walk away each day knowing that their work is helping make a difference in someone's
Multimodal intervention along with attentive care and patient participation is necessary to achieve a balance between analgesia and side effects. Assumptions to the conceptual framework must be identified to understand the specific relevance of the theory to pain
Brain metastasis had left ‘Mr Brown’ with significant cognitive, personality, and behavioural changes- he was able to communicate single words/phrases in order to make his needs known e.g. “water”, “toilet”, and “help me”, however he was no longer able to understand and therefore answer questions, even those which required a yes/no answer.
‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.
Research design: Descriptive quantitative analysis was carried out so as to ascertain the degree of knowledge acquired by patients regarding pain agreement. 28 questions were designed so as to analyze the situation in detail (Przybelinski & Ball, 2015).
The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.