Concept Analysis : Pain Management

1. It is important that we take into consideration, areas other than physical pain and have an holistic approach. Pain is whatever the person who is suffering it feels it to be. Physical pain can be experienced as a result of disease or injury, or some other form of bodily distress. For example childbirth. Although not associated with injury or disease, but can be an extremely painful experience. Pain can also be social, emotional and spiritual as well as just physical.

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

There are many concepts in nursing theory that need further clarification. A concept analysis can provide a thorough explanation of a term in nursing theory that will help healthcare professionals better communicate. The Walker and Avant approach to perform a concept analysis was specifically formulated with nurses in mind (McEwen & Wills, 2014). Walker and Avant proposed a concept analysis be used to further understand the meaning of a term or concept in anticipation that those using the term would have the same understanding (McEwen & Wills, 2014). When a term or concept is in question or needs further questioning in any field of nursing, a concept analysis is indicated (McEwen & Wills, 2014). Walker and Avant’s concept analysis is comprised of eight steps; select a concept, determine the aim of the concept, list all possible uses of concept, defining attributes, model case, alterative case (borderline, related, contrary, invented, and illegitimate), list antecedents and consequences, and lastly list empirical referents (McEwen & Wills, 2014). The defining attributes are deemed most beneficial in obtaining comprehension due to the fact that these attributes show which show up in regularity when relating to the concept (Linda & Judith, 2011). Using the Walker and Avant concept analysis model a formal concept analysis will be performed on the term “pain”. Middle range nursing theory gave the example of pain as one of many concepts used in nursing (McEwen & Wills, 2014).

Conceptual analysis is integral in understanding nursing theory. According to Walker and Avant (1995), concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. It can be used to evaluate a nursing theory and allows for examination of concepts for relevance and fit within the theory. The phenomena of pain will be discussed in this paper and how it relates to the comfort theory.

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

What is pain? If you ask someone to tell you the definition of pain they will typically state something that hurts. Registered nurses should know the definition of pain and how it can be identified on their patients. However, Abdalrahim, Majali, Stomberg, and Bergbom (2010) propose that nurses did not receive adequate education in pain management and suggest the lack of knowledge hinders their ability to adequate control their patients’ pain. Therefore, the unethical treatment of pain can be traced back nurses.

This paper will examine the the nurses and pain assessment in the hospitalized patient. The paper will focus on pain and pain management and the need to assess pain. How much percentage of the population in the U.S. are experienced pain, and how much of the population abuse the pain medications. There are many barriers which hinder nurses from perform accurate pain assessment. These barriers are nurses experience, competence, perception and manipulation. Pain is subjective, but pain assessment tools and nurses’ perception may contraindicate with what the patients stated. Thus, the paper will try to find solution to accurate pain assessment during hospitalization, especially with abuse of opioid.

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations

Pain is different for everyone, because the brain “…[creates] its own selective picture; a picture largely determined by what is important for the survival and reproduction of the species” (Axel 234). In addition, because “[o]ur perceptions are not direct recordings of the world around us, rather, they are constructed internally according to innate rules” (Axel 234), classifying and treating pain for a large group of individuals is problematic. When attempting to address this issue, the question must be presented: is there a particular type of therapy which hospitals can use to reduce pain perception of patients, thus improving (or upholding) their physical

This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.

In the physical realm of patient-centered care pain, comfort, sleep, and rest are important aspects of the fourth dimension of patient-centered care. Patient-centered care is the complete focus of the medical team on providing respectful care to meet patient needs, preferences and values guide decisions on each individual patient care. To understand the subjective view of the patient, these four aspects are at the forefront of their needs within the hospital setting to provide the best patient outcome. Nurses provide good patient-centered care by actively partnering with patients to determine care priorities and plans to tailor their level of involvement, according to their preferences, and being flexible by changing the care plan as the situation changes including providing smooth transitions between care goals. By doing this, nurses can assist patients with all pain by providing comfort and assuring the patient that there will be no deficiency of their quality of sleep.

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

‘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’.

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).