Scoliosis Is Defined As An Individual 's Self Image And The Presence Of Pain Essay

After a quick x-ray I wait for the doctor for what seems like hours, when she finally enters the room she looks in my eyes and says the exact word I was praying not to hear... “unfortunately”. My heart drops, she continues, “The x-rays showed a significant change in your curve.” I sit there, staring at the doctor, pale faced and in shock. When you have scoliosis, your spinal curve is measured in degrees, at around a 20 degree curve you would be

Psychological factors are known to contribute to how people experience and cope with pain. However, as people age, they experience normative age-related changes in psychological functioning. Thus, much of what is known about psychology and pain may not necessarily apply to older adults, unless it has specifically been tested in older populations. This is a particularly important point, because pain remains a major problem for millions of older adults. Furthermore, it is expected that the populations of older adults in America will increase significantly in the coming years, as people are living longer now that at any other point in history. Given that psychology changes across the lifespan, and that pain is a problem in older populations, this

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,

There are three different types of musculoskeletal disorders that effect the spinal column: Lordosis, Kyphosis, and Scoliosis. Scoliosis effects the largest amount of people and also effects the widest range of ages. There are three different types of scoliosis and they are categorized by the age at which the deformity developed. Infantile scoliosis develops from birth to 4 years old, juvenile scoliosis develops from 4 to 9 years old, and adolescent scoliosis develops from 10 to 18 years. Scoliosis is most commonly developed in the adolescent stage, it compromises approximately 80 percent of all scoliosis cases (Baaj, 2017). Any

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

‘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’.

Introduction I. What is idiopathic scoliosis? II. Idiopathic scoliosis is the most common type of spinal deformity confronting orthopedic surgeons. III.

Scoliosis is an abnormal lateral curvature of the spine. Surgery and braces for scoliosis normally expensive. Spinal manipulation can help with AIS. The treatment of the teen goes to 18 months two times a week. In the before the treatment, Manipulative procedures was done on her using mechanical assist and mobilizing the spine. After the pretreatment, The regular treatment was the same, but it used a brace to possibly help stop the spine curve progression. Her treatment consisted of a 15-minute session of deep tissue therapy, two visits a week for six weeks and once a week visit for six weeks. The goal was to improve her spine and reduce her pain and symptoms, The girl reported of have problems that her defecation is less than two times a week. “at least, some severe and progressive cases of scoliosis, including spinal manipulation may decrease the need for surgery”(Chen, Chiu 749 web). After surgery for scoliosis, Complications might start. Blood loss, infection, and equipment failure where rods break, screws and hooks get lodged. On rare times, paraplegia will start to occur losing all feeling in the legs due to a spinal injury. She had a fear of surgical complications and went towards more conservative treatment. For the first three months, her progression stopped at a 34°. Her bowel movements were starting to improve. Spinal manipulation is relatively safe, but there is some association with disk herniation. After 18 months of treatment, 34° from a 30° spine angle and slowed or stopped curve progression. This shows the effectiveness of the treatment. Compared to surgery, Spinal manipulation is more effectiveness with much less complication. If the brace was only used as a treatment it could be more effective than spinal manipulation. However, in some cases, it shows that braces do not indeed slow or reduce the chance of surgery if worn.

The goal of using Harrington rods is to allow continued growth while correcting the curve. Either one or two rods are used, with the surgery needing to be repeated every 6 to 8 month to ensure the rods are at the same length as the spinal column allowing correct growth. These rods are attached to the spine above and below the curve, which straightens and supports the spine and bones within. The use of the biomodel gave clear depiction of what length and width each rod needed to be for this particular surgery. Bone grafts are inserted to hold the spine in the correct position to keep it from curving again, with the rods inserted shortly after. In order to insert these Rods and Bone grafts, the surgeon made one surgical through the child’s back, known as a posterior approach. The surgeon then moved her muscles aside in order to remove the curved joints between the different vertebrae. Bone grafts replace these in order to reshape the spine. This is followed by the insertion of the two Harrington rods used to hold the spine together causing the bone grafts to attach and heal. This surgery took several hours to complete (refer to figure

Scoliosis is a common medical condition wherein there is a sideway curve of the spine or backbone. The curve is often shaped as S or C. In most of the cases, the reason for this is not known. It can affect all age groups. However, the most type is idiopathic in children aged between 10-12 years. It can also run in families. So, therefore, a child who has a parent or sibling with this condition must have regular check-ups. Now the treatment of Scoliosis is possible with the use corrective brace.

Depending on the severity of the curvature, different treatment methods are implemented to attack this abnormality of the spine. Although the effectiveness of using plastic back braces to deter the curvature is still to be determined, doctors still generally use this method for smaller curves. In recent years, doctors have been employing a minimally invasive surgical approach for larger curves, one that requires surgeons to only make a few small incisions along the spine, rather than the traditional two-foot incision along the spine. This technique is by far the most radical treatment since the first scoliosis surgery took place in the early 1900s.

Scoliosis is a complex deformity or curvature of the spine and entire torso and has been recognized clinically for centuries (Asher, Marc A.). “For a few of the patients an underlying cause can be determined, including congenital changes, secondary changes related to neuropathic or myopathic conditions, or later in life from degenerative spondylosis. However, the cause of most scoliosis is not known and since about 1922 such patients have been diagnosed as having idiopathic scoliosis (Asher, Marc A.).”

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 first study under critique is titled “Postoperative pain management experiences among school-aged children: a qualitative study” (Sng et al., 2013). The purpose of their study is to explore postoperative pain experiences among school-aged children in Singapore, where they are a culturally diverse population. They used a phenomenology design in which to explore there lived experiences. Their research sample included children who were the age of six to twelve, could verbally communicate in English or mandarin, and was post-op for at least twenty four hours. This excluded children with disabilities or chronic pain. Ethics and trustworthiness was taken into consideration and stated in their research. Limitations were stated. Multiple sub-themes emerged that discussed the different ways to relieve pain and a few methods were using cognitive-behavioral methods, pain medication, using physical methods such as massaging and repositioning, emotional support from family and nurses, and using distraction techniques such as video games. These sub-themes all fall under the main themes stated in the method section and the results of this study stated pharmacological methods were the common ones (Sng et al., 2013). For a further in-depth framework refer to appendix A.