Pain and Tool Development
Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (International Association for the Study of Pain (IASP), 1986). However twentieth century theories support the rationale that “Pain is a multidimensional phenomenon and includes the patient’s emotions, behaviours and functionality both physically and mentally in response to the pain” (Osborn et al, 2009 Pg.335). The World Health Organisation (WHO) confirmed its belief in the importance of pain control by making its 2004 motto ‘the relief of pain should be a human right’ (www.who.int, 2004)
A fundamental requirement of diagnosing and treating any patient’s
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Since then variations of the VAS have been used with an array of different descriptions for example “worst pain imaginable” and “pain free” (Waterfield and Sim, 1996), however the method remains the same (Williamson et al, 2005).
The VAS has often been considered to be one of the leading methods of pain assessment (Scott et al, 1976). It provides a continuous scale and so is preferred over discontinuous methods such as numerical and verbal rating scales (Carlsson, 1983). However it has been claimed that the VAS is difficult to complete for many patients and consequently may impact negatively on the validity of the tool (Kremer et al 1981 cited in Carlsson, 1983)
Validity can be defined as ‘truthfulness: does the test measure what it intends to measure?’ (Mehrens et al, 1987). When measurements are made they must be representative, suitable for purpose and applicable to the setting in which they are used (Brooker et al, 2007). The intention of the VAS is to assess the intensity or severity of a patient’s pain. It is based on the assumption that the scale is completed by the patient, as scores taken from staff and/or family have been proven to be inaccurate (Stannard, 2004). “Pain is what the patient says it is” (McCaffery, 1983), ‘The foundation of pain assessment is the patient’s self report’ (Jacox et al, 1994). It is hard
2. One of the important factors that you need to establish is how much pain the person is feeling. This can be difficult as we all have different pain levels. Several methods have been developed to measure pain but the most common one is to ask the person to describe it on a scale 1 to 10, with 1 being the mildest to 10 being the worst pain they have ever felt. It is about individual experience and you need to react to the level at which that person describes their pain as one persons pain thresholds may be different to another.
Patients are asked to rate their symptom for each question for a period of two weeks. The patient is the one who rates himself, therefore, this instrument’s results are subjective. The sum total is the calculated, and interpreted to
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.
“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,
The ratings for this scale vary from no pain, a zero, to the worst pain one could possibly endure, a ten ('Misha' Backonja & Farrar, 2015). This type of tool used for measuring pain is considered a self-assessment. Meaning, the individual rates his/her pain on the provided scale. All individuals who have received medical treatment, whether for a serious injury or a yearly physical, has been asked, “What would you rate your pain today, on a scale of one to ten?”. This pain assessment tool is considered a fully ordered variable due to the individual having a wide range to rate his/her
Pain is a condition that is determined and described by the person reporting it. There are several components to pain including the emotional, psychological, and physical aspects. Many health professionals struggle to understand this phenomenon and thereby insert their own perspectives into the pain assessment of patient reporting pain. The Affordable Care Act (ACA) (2010), also titled the Patient Protection and Affordable Care Act H.R. 3590, was passed by Congress and signed into law on March 23, 2010 (U.S. Department of Health and Human Services (DHHS), 2013). Hospital value based purchasing programs (VBP) were developed to align patient quality care and outcomes to the support initiatives from the ACA. A component of the VBP includes patient satisfaction. Patient satisfaction is a self-reported response to questionnaire administered by a third party. Many hospitals utilize Press Ganey to administer the survey for the inpatient and outpatient patients. One component the survey includes patient’s self-reporting how well their pain was managed during their hospitalization. This measure of satisfaction can have an adverse effect on patient outcomes and increase opioid use in this setting. Patient satisfaction and pain management are both subjective however pain management while within scope of healthcare professionals should not be included in the patient satisfaction survey.
Pain is one of the most influential symptoms that leads individuals to reach out to health care professionals to seek relief. Pain is subjective and unique to each person. Some individuals may have a higher pain tolerance than others. According to Frandsen (2014), “Pain is an unpleasant, sensory, emotional sensation associated with actual or potential tissue injury” (p. 889). Pain may be caused by a variety of elements, such as tissue or nerve damage and surgery. There are three main categories that pain is classified by, which are origin, duration, and cause. The main focus of this paper is on acute pain, chronic pain, and phantom pain. It is crucial to know how to assess each type of pain, as well as how to enhance it, or decrease the pain.
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
The staff add a score to each assigned behaviour observed for a total score. A total score, ranges from zero to ten based on score of zero for five items and a higher score designates severe pain. (Hadjistavropoulos et al, 2014; Paulson et al., 2014). After each use the staff need to compare to previous score and one- two hours after a pain intervention to evaluate effectiveness of pain intervention (Hadjistavropoulos et al, 2014; Paulson et al., 2014). Also, staff need to use the associated user guide that shows instructions, items definitions and should be reviewed before using PAINAD (Herr et al,
The major concepts of this theory are defined theoretically since the use of these definitions is from a broader theoretic concept. Therefore, an operational concept could be developed from them. There is consistency in the use of these concepts throughout the theory of acute pain management with examples given using the same language as well as maintaining the integrity of the concepts.
‘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’.
This is a patient questionnaire that uses a score of 0-4 to assess subjective neuropathic symptoms (Functional Assessment of Chronic Illness Therapy, 2007).
Pain is something that connects all of us. From birth to death we can identify with each other the idea and arguably the perception of it. We all know we experience it, but what is more important is how we all perceive it. It is known that there are people out there with a ‘high’ pain tolerance and there are also ones out there with a ‘low’ pain tolerance, but what is different between them? We also know that pain is an objective response to certain stimuli, there are neurons that sense and feel pain and there are nerve impulses that send these “painful” messages to the brain. What we don’t know is where the pain
Pain cannot be measured by anyone other than the patient that is having the experience. This is why pain is sometime not understood and misevaluated by healthcare workers. Pain is measured by the Visual analog scale (VAS) of 1-10. One being the least amount of pain and ten being the worst possible. This test is done every four hours and reviewed 30 minutes after a medication administration for pain control. This non-invasive test gives the healthcare worker a measurable idea of the intensity of the pain the patient is experiencing. This also gives the health care worker a perceptive of how well the patient responds to pain after medication administration. Pain is not always seen it can be an eternal feeling.
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.