Theories Of Assessing And Treating Pain

Pain is not only defined as a sensation or a physical awareness, but also entails perception. Moreover, pain is an unpleasant and an uncomfortable emotion that is transferred to the brain by sensory neurons. There are various kinds of pain and how one perceives them is varied as well. Certain parts of the brain also play a key role in how one feels pain such as the parietal lobe, which is involved in interpreting pain while the hypothalamus is responsible for the response to pain one has. Although some believe pain is just a physical awareness and is in the body, pain is all in one’s mind because the perception of pain and the emotion that controls its intensity differs in individuals and when pain itself is administered to the body, the brain determines the emotions one attaches to each painful experience.

The middle range theories consist of two more concepts, and these concepts are concrete and operationally explained. The hypothesis from middle range theories is testable. These theories are specific to the problem (McEwen, &. Wills, 2014). The middle range theory of Acute Pain Management by Good and Moore established in1996 used in the management of acute and chronic pain.

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).

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.

“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,

     How the patients feel they are being treated by the Doctors and nurses  SCD patients feel that many providers don’t believe their reports of pain unless their distress was visible.   Presumptions of drug seeking and addiction were pervasive among healthcare providers …… (Haywood, 2013).     SCD patients are asking the healthcare professionals (HCP) to treat their pain without being judgmental or

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.

Although there have been many improvements in health care, pain in this subpopulation is often undertreated and at times it is not addressed at all. Behavioral expressions of untreated pain in this subpopulation are common and the inappropriate prescription of psychotropic medication to mask the behavioral manifestations of pain instead of addressing the pain causing the behavioral symptoms is the norm (Achterberg et. al., 2013, p. 1479).

According to John Hopkins Medicine (n.d.), pain is an uncomfortable feeling that tells you something may be wrong. It can be fixed, throbbing, stabbing, aching, pinching, or described in many other ways. Pain is categorized as either acute or chronic. Acute pain is usually severe and brief, and is often a signal that your body has been injured. Chronic pain can vary from mild to severe and is there for long periods of time (John Hopkins Medicine, n.d). This paper will discuss a scenario that entails which person is experiencing the most pain, how two people can have the same procedure experience different levels of pain, factors that contribute to each person’s pain level, and two complementary/alternative methods of pain control.

‘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’.

Practitioners feel they do not have enough options regarding treatment when considering the balance of pain relief and safety. Patient-Physician interaction time was also an issue resulting in not getting enough medical history because of time restraints. Trialing included four phases. Phase one discussed finding the right practitioner to treat the pain. Phase two was initiating the pain treatment trial. Phase three included adjusting pain treatments. Phase four included continuing to adjust treatments as patients take control over their

Assessment of chronic pain first begins with understanding what chronic pain is. Chronic pain is any pain with or without obvious injury that lasts longer than the expected healing period. Like many chronic diseases, it has periods of remission, an absence of symptoms, and exacerbation, an increase in the severity of the symptoms. A recent study suggested that chronic pain affects about 80% of elders in nursing homes. (Pateinakis, 2013) Proper treatment of chronic pain begins with gathering subjective and objective data about the client’s pain.

Pain is a complicated idea defined by the American Pain Society as “whatever the experiencing person says it is, existing whenever the experiencing person says it does.” Nearly 100 million Americans experience chronic pain, not including children or acute pain sufferers. Pain dictates lives, and it dominates paychecks too. It is a significant health problem that yields around $560-$635 billion every year. While these numbers may seem controversial, the real problem begins when those experiencing pain visit the hospital seeking treatment.

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.