Assessing Pain: A Case Study

“Playing with Pain,” by Michelle Crouch in December, 2016, teaches us that focusing too much on one sport is not very good. Studies show that specializing in one sport actually has the opposite effect of what people think or say about it. Crouch write in the article about the experiences of Kellen Sillanpaa, a young athlete. The central idea is that if a person specializes in only one sport, there could be consequences. Some of the consequences are having pains, not being able to play a sport or do normal activities, and having a lower chance of success later in life.

What is the point in measuring something that is unique to every individual? In “The Pain Scale,” the author, Eula Biss, attempts to convey her pain to the reader. She tells the reader how she has tried to describe and measure her pain. There is a system set up for doing so, but it leaves much up to individual interpretation. The arbitrary process by which we are supposed to evaluate the level of pain we are experiencing doesn’t seem to accomplish much. Throughout the essay, Biss uses unique ways of comparing the suggested levels of pain to other “scales.” This raises the question, why can the scale, itself, doesn’t do adequate job of helping people understand pain.

The proposed pain assessment system consists of two main stages: 1) face detection and preprocessing and 2) pain expression recognition. We describe each stage in detail below.

In conclusion it can be seen that early and regular pain assessment on par with other vital parameters along with appropriate treatment by all healthcare providers will lead to improved patient outcomes and satisfaction. This can be achieved by education, use of departmental guidelines and protocols,regular audit of practice and feedback to the professional involved.

Outcome: Consistent pain monitoring and reevaluating. Pain management through opioid medication and non-medication methods. We attempted to use ice packs as pain relief. Patient was unreceptive to the use of pain medication because it did not help his pain. Opioid medication relieved pain for this patient, however pain was consistently rated as 8.

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.

JM is a 32 years old female who was admitted on 02/09/2016 for a planned C-section. As we entered the room, she was lying on her bed talking with her husband in Spanish about her incision pain. Also, she was talking in Spanish with two of her kids that were visiting and sitting on her bed. When the nurse approached her bed, JM preferred to speak in English with her nurse. While I was doing the interview, she spoke to me in Spanish. This patient dominates both languages perfectly. She is Mexican, but grew up in this country.

Furthermore, it is very important to take the patient condition into account when deciding which pain assessment method to be used. This is to ensure that the pain assessment method is suitable and understandable by the specific patient. There are various types of patients suffering from arthritis. The health care providers or the researchers may find some obstacles when dealing with different kinds of patients. Some may have cognitive issues, particularly the elderly; some may have communication problems, for instance, the neonates; some may have limited educational level such as children. Hence, it is necessary to select and modify the pain assessment method to suit the ability of different kind of

Policies and resources are important tools to use for guidance on developing a plan of care for pediatric pain management. Nurses must look at their hospital policies to determine the appropriate actions to take. The Doernbecher Children’s Hospital in Oregon developed a policy using a multi-modal approach for the staff to follow. A multi-modal approach is where pain management is provided before, during, and after all procedures that may cause pain and/or anxiety for the child (Oregon Health & Sciences University, 2012). Team huddles are used before procedures to discuss the appropriate pain management approach that will be used based on the child. The nurse’s report and assessment on the child’s past perceptions of pain, any current symptoms the child is facing, and cultural background are important for other members of the healthcare team to create a proper plan during huddle. If the child’s nurse feels that the child needs more pain interventions, the nurse may stop the procedure to provide the child with additional comfort measures (Oregon Health & Sciences University, 2012). The policy in place at Doernbecher Children’s Hospital is developed in order to provide the child with compassionate care while alleviating pain and anxiety that will decrease any physical or psychological effects caused by untreated pain. All hospitals must have a pain policy in place for guidance on how to provide quality care.

Assessing pain in the younger population with special needs it could be very daunting. For cognitive challenged children we typically start asking questions to the parents (who are actually reporting the child is having pain) re: how do they suspect pain is present. It is important to mention that pain in non-verbal and /or cognitive compromised children is many times under estimated. Following those questions, we proceed with behavioral observations during the examination/palpation stage looking for signs that help us identify the pain origin and determine needed pain management interventions including proper referrals if the suspected cause is out of our scope of practice. With our cognitive able children, we pursue self -report via questionnaires,

Accurate assessment of pain is a major prerequisite for the adequate pain control (positive) to assess the potential effects of the analgesic drug effect. Assessment of pain in patients with dementia is generally a particularly challenging to loss symptomology inherent communication capabilities of the condition to limit the subjective reports of pain is expected to be due to that the healthy adult. Maintenance and inspection of pain causal factors leading to pain, may be a somatic cell or psychological, or to investigate the interaction of the two. The Mechanism of the result of the test is therefore the source or pain, etc. (i. e., Musculoskeletal), internal (i.e., internal), neuropathy (e.g., diabetic neuropathy), functions, or mental (that

Mr. Anderson continues to report subjective pain levels that reach an 8 now instead of the over 10 he did have. The decrease in his pain level was with spinal cord stimulator and with the slight decrease of pain medications. He continues to treat for a nonrelated cervical issue and now has added knee pain. He has had 2 prior knee replacements. Mr. Anderson has stopped mentioning a return o work. Dr. Shah has placed him at MMI from a surgical standpoint. He will now solely treat with the pain clinic. Dr. Rampersaud is now planning on changing the pain medication to Nucynta. I have concerns about the medication in regards to Mr. Anderson’s Barrett Disease, and how accurately the medication is monitored and also if there is still a plan to

The gold standard for determination of the absence and presence of pain has long been self-report. However, for patients with major cognitive or communicative impairments, it would be better if clinicians could quantify pain without having to rely on the patient’s self-description. Here, we present a newly pain intensity measurement method based on multiple physiological signals, including blood volume pulse (BVP), electrocardiogram (ECG) and skin conductance (SC), all of which are induced by external electrical stimulation. The proposed pain prediction system consists of signal acquisition and preprocessing, feature extraction, feature selection and feature reduction, and three types of pattern classifiers. Feature extraction phase is devised

Estimating the intensity of the detected pain might provide better pain assessment and lead to better pain management. Several pain recognition methods were extended to include pain intensity estimation. For example, Gholami et al. \cite{5415598} presented a method to estimate infants’ pain intensity using RVM, which is an extension of SVM (See Table II, 3rd row). RVM is a sparse Bayesian model that provides posterior probabilities (i.e., uncertainty) for class memberships through Bayesian inference. Unlike SVM, RVM classifier outputs the probabilities of the class memberships or labels. Gholami et al. used RVM uncertainty for each class membership to estimate infants’ pain intensity. For validation, RVM posterior probabilities were compared with the results of estimating pain intensity by experts and non-expert observers. The agreement between RVM and human observers, measured using kappa coefficient, was 0.48 for experts and 0.52 for non-experts.

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).