Essay on Kids' Pain Misunderstood: Assessing Difficulties in Diagnosing Pains in Children

Introduction

There is a difference in interpretation of pain between children and adults. One of the most misunderstood, least treated or diagnosed pains is that of children. It is always hard for medical providers to know the right pain a child is experiencing since they cannot be able to express themselves as compared to adults (Vink, Eskes, Lindeboom, van den Munckhof & Vermeulen, 2014). Therefore how pain is assessed in children is always linked to their level of development. Naturally, children of the same age vary in the way they view and tolerate pain. Some may be able to accurately state their symptoms, while others would need a pediatrician to intervene to be accurate.

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Children interpret pain as something that always affects their normal play and causes them discomfort. If the pain in children is left untreated, they could grow to chronic pain, which could lead to complications in their lives. In adults, pain is interpreted as an emotional and cognitive factor which has various intensities among different individuals. Adults interpret pain as an indicator of unusual happening in their body (Vink et al., 2014). The first step that they might take is to look for short measures to counter the pain, such as taking painkillers while others might opt to visit a doctor if the pain persists.

Adults compared to children can correctly interpret pain as compared to children. This makes it easy for the doctor to treat the adult and also prevent misdiagnosis. The other difference is the response time immediate as compared to children who would behave in a different way than the normal, making it hard for the quick response (Vink et al., 2014). Adults might also research more on the pain as compared to children who have little knowledge of interpretation.

Characteristics of pain

Pain has different characteristics depending on the parts that the pain affects. Normal pain causes the damages of tissues prompting a pinching, stabbing, throbbing, pinching, and aching. Another person cannot experience the pain experienced by a person; hence, the person experiencing it can adequately explain. Their different types of pain. First is acute pain. In this type of pain, the pinching or stabbing effect is short-lived. They are usually cured by the use of pain killers to relieve the pain. It usually occurs to notify a person that he is either hurt or is experiencing some danger. The pain often lessens as the person starts to heal. The most common drugs that are usually administered in this type of pain is the anti-inflammatory and narcotics.

The other type of pain is chronic pain. This type of pain can last for months or even years. Just as acute pain, it can either be neuropathic or nociceptive. Chronic pain usually results to change in the nervous system (Vink et al., 2014). This thus causes the pain to last longer. The causes of chronic pain are hard to identify since it might occur without the person being physically injured. The most common type of medication administered to people with such pain is mind-body techniques and physical therapies. The other type of pain is the breakthrough pain, which normally comes all of a sudden during treatment of a disease (Vink et al., 2014). It is usually common in cancer patients. This type of pain is characterized by sharp, persistent pain that can last for a longer period as compared to acute pain.

Three peer-reviewed journal articles on how nurses assess pain

According to Varndell Fry & Elliott, many patients usually experience moderate to severe pains that are mostly left undetected, or they are not treated. This is usually common among ill patients. The authors argue that acute pain patients do not mean that they get their pain from physical injuries or illness but can get the pain through delivering care when the patient is stabilizing (Varndell, Fry & Elliott, 2017). The emergency nurses are usually tasked with the responsibility of ensuring the safety of these critically ill patients. The main objective of this article was to find out how emergency nurses manage acuter pain on critically ill patients. According to their findings, it is clear that most nurses are not always well informed about the various methods they could use in accessing the acute pain in those patients. Some end up creating chronic pain among the patients due to their misdiagnosis.

Deldar, Froutan & Ebadi (2018) discuss the challenges that nurses usually undergo while assessing pain in patients. Nurses are human beings and are prone to a lot of risks while performing their duties. The authors highlight various areas that could make a nurse even misdiagnose a patient due to lack of proper explanation from the patient. In non-verbal patient, the most common method in assessing their pain is through the use of pain assessment scale.

The objective of the study was to focus on people who could not be able to communicate, making it hard for nurses to interpret (Deldar, Froutan & Ebadi, 2018). The research was conducted using a random sample. Experienced nurses were used as samples for data collection. Each nurse had his or her own experience dealing with people with pain but could not talk. The results indicated that using pain assessment scales could time lead to misdiagnosis because patients can't communicate.

This article by Lichtner et al. (2016) gives an overview of how nurses asses pain in patients with dementia. In most cases, patients with dementia are usually not given proper attention and treatment when it comes to acute pain treatment (Lichtner et al., 2016). The authors give an overview of the various methods the nurses' use in assessing the pain in a hospital setting. According to the article, it is evident that there is little knowledge of how these dementia patients are treated with pain. In the research, they used a qualitative method in data collection.

Data was collected in hospitals in Scotland and England (Lichtner et al., 2016). In the results obtained, it was clear that the assessment of pain depended upon the information provided by the patient (Lichtner et al., 2016). Due to the difficulty of communication by dementia patients, it was difficult to get the right pain information. The other thing that hindered was the time frames of the staff interaction made it had for the patients to share their information.

Acute and Chronic Pain Comparison

In acute pain, it is usually caused by the damage of the tissues or the disease process. In chronic pain, it is triggered by initial pain and usually lasts longer as compared to acute pain, which may last hours or a maximum of days. It is believed that acute pain has a purpose for you to be able to do something (Vink, Eskes, Lindeboom, van den Munckhof & Vermeulen, 2014). For example, the pain may occur to give assign that someone might have been injured and need quick actions to prevent the pain. While chronic pain does not have an absolute cause. Chronic pain times might give a signal that the pain is increasing and needs quick medical attention. Though chronic pain may also be managed and treated.

Pharmacological and non-pharmacological treatment of pain

The first line to the pharmacological treatment of pain, which could be either mild to moderate is the use of a nonsteroidal anti-inflammatory drug or acetaminophen. The choice of these drugs depends on many factors. Some of the factors include the type of pain and the risks associated with the drugs (Vink, Eskes, Lindeboom, van den Munckhof & Vermeulen, 2014). In case the first line agents do not work, the combination of acetaminophen/opioid may be the best option to treat the mild to moderate pain. Potent opioids are used to treat severe acute pain. (Vink et al., 2014).There is minimal evidence that a single opioid is better for controlling pain. With increase misuse of opioids, it is usually crucial for those prescribing it to do it in caution.

Their many ways in which pain can be managed without the need for medication. It is always recommendable for a person to let the body fight the pain on its own before seeking medical attention because it will always ensure that the body is not addicted to drugs. The first method is relaxation therapy. Some pain might be caused by fatigue. It is, therefore, essential if one could take a rest to help the body heal. The other is physical therapy; this is common to people who have pains such as back pain. They could be encouraged to do physical activities.

The other non-pharmacological treatment of pain is through the use of psychological therapy. In this method, the patient can visit a psychologist who will be able to assist him or her in the recovery process. Some of the past experiences might make someone feel pain, and the best way is through counseling (Vink et al., 2014). This can significantly help since the person might get a permanent solution instead of continually taking medicines that might have side effects.

References

Deldar, K., Froutan, R., & Ebadi, A. (2018). Challenges faced by nurses in using pain assessment scale in patients unable to communicate: a qualitative study. BMC Nursing, 17(1). doi: 10.1186/s12912-018-0281-3

Lichtner, V., Dowding, D., Allcock, N., Keady, J., Sampson, E., & Briggs, M. et al. (2016). The assessment and management of pain in patients with dementia in hospital settings: a multi-case exploratory study from a decision making perspective. BMC Health Services Research, 16(1). doi: 10.1186/s12913-016-1690-1

Nelson, D., & Zelman, D. (2013). Older adults' perceptions of pain medications. The Journal Of Pain, 14(4), S20. doi: 10.1016/j.jpain.2013.01.090

Varndell, W., Fry, M., & Elliott, D. (2017). Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study. Scandinavian Journal Of Trauma, Resuscitation And Emergency Medicine, 25(1). doi: 10.1186/s13049-017-0421-x

Vink, P., Eskes, A., Lindeboom, R., van den Munckhof, P., & Vermeulen, H. (2014). Nurses Assessing Pain with the Nociception Coma Scale: Interrater Reliability and Validity. Pain Management Nursing, 15(4), 881-887. doi: 10.1016/j.pmn.2014.01.004