Pain: A Multidimensional and Complex Phenomenon - Essay Sample

Introduction

In the contemporary world, pain is the most common problem of patients and the most frequent diagnosis in the nursing setting. However, it is a multidimensional and complex phenomenon and unique to different people. Since it is hardly measurable, pain is difficult to explain. However, according to Cheng, Foster, and Huang (2003), most nursing professionals agree that pain is what the patient explains it to be. Other scholars describe e pain as an uncomfortable, distressful, and unpleasant feeling. According to Farrell (1995), unrelieved pain can cause physical and emotional distress, affect the quality of life together with increasing the cost of healthcare for the victim and the community. Thus, the purpose of the paper is to provide a detailed analysis of the concept of pain. The research will identify the antecedents which influence the concept, explain its attributes, and the potential consequences of pain.

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Modern-day studies suggest that pain cannot be wholly controlled even with the modernized technology (Kotzer & Foster, 2000). Additionally, in research done by Beyer (2000), who interviewed more than 700 children with sickle cell anemia, most of the children suggested that they had moderate-severe pain. In the study, all the effort to reduce the children's pain seemed futile. One of the main reasons for this gap is the lack of knowledge of pain management by most health care providers. Another reason for this gap maybe be the concept has a broad pool of definitions, making it unclear. Montes-Sandoval (1999) and Mahon (1994) employed Avant and Walkers' theory of concept analysis, which entails defining the critical attributes of the concept. The two concepts have various similarities, such as; pain is a personal experience f distress, discomfort resulting in uncomfortable and unwanted experiences. A literature review of the concept is important in the bid to explain pain and the health care definitions used to describe it. Initially, pain was explained as a fine, penalty, punishment, suffering, or loss inflicted for an offense. It is now evident that pain does not have deep relations with crime or punishment but rather discomfort and suffering. Pain is always subjective in the sense that it can also be used as a warning sign for trauma. In the nursing setting, pain is described as the scenario when an individual experiences and reports an uncomfortable sensation.

Uses of the Concept

Use of the Concept in Sociology

According to Zborowski (1969), the pain experience involves not only the sensation and the response but also other associated feelings (Zborowski, 1969). He feels that the cultural and social patterns of the victim have a huge influence on the experience. In his study, Zborowski used pain acceptance and expectancy to show people's attitude towards pain. These attitudes are generally inherited from siblings, parents, and friends in an individual society as each person is often entitled to conform to certain attitudes. The author instills that pain is more of a response than a reaction and that these responses are behavioral and emotional. On the other hand, response to pain also depends on the cultural background and social situation of the victim.

Use of the Concept in Professional Fields

The International Association for Study of Pain defines pain as what the victim says it is. This implies that pain can serve as a warning sign for impending complicated situations such as trauma. Even though the pain sensation is generally related to the physical stimulus, the concept of pain seems to be more associated with social and cultural aspects. Merskey and Spear (1967) described the other emotionally laden events such as depression, isolation, anxiety, and fear, or the effective negative response to pain. Therefore, this implies that pain induces suffering, even though not all types of pain would do that. Similarly, Freynhagen Et al... (2019) feel that suffering is the state discomfort or distress, which is caused by loss of intactness of an individual from its cause. This means that suffering is a unique experience for every victim.

Defining Attributes of the Concept

Defining attributes generally involves listing characteristics that are related to the concept. Even though every concept analysis entails more than one defining attribute, it is important to identify attributes that fit in with the concept. Thus, the most significant aspect of the concept of pain are:

• Pain is a feeling that emanates from distressful and unpleasant experiences from physical sensation
• It is also an individual human experience
• A feeling with behavioral, emotional and sensation components
• Some of its functions include warning signs and protection
• They are emotional and physical responses to stimuli
• The responses are learned an influenced by society, culture, emotions, environment, and personality.

Antecedents and Consequences

To begin with, according to Walker and Avant (1995), consequences are events that take place as a result of certain actions, in this case, pain. As discussed above, its repercussions are hugely related to pain responses and the victim's definition of pain. As such, pain reaction is likened to pain behavior, which is subdivided into voluntary and involuntary responses. The main difference between these responses is that voluntary responses need motor activity and consciousness, while involuntary responses are the vice versa. Voluntary responses also have verbal and non-verbal reactions such as moaning (verbal) or rubbing the painful spot (non-verbal). Baron and Binder (2004) also suggest that voluntary responses can be incorporated into active or passive coping (Baron & Binder, 2004). Another consequence of pain is that the victim may create a meaning for the pain. According to Farrell (1995), there are three processes of finding the meaning of pain; immediate cause, immediate effects, and ultimate causes. As people show their pain reactions, the pain may increase, decrease, or stay the same depending on how people react to their pain.

Alternatively, antecedents are which occur before the existing concept. Walker and Avant (1995) suggest that the main antecedents of the concept of pain include cultural, personal, and environmental values and are interrelated. For instance, the environment is connected to the incident that causes pain since the victim's body and mind may be affected by the event. The victim's attitude and knowledge of the pain also plays a vital role since it often affects how the person expects and accepts the pain. The personal aspect entails how the person's economic class, gender, personality, and the current emotional and physical condition. As such, people who have positive attitude towards pain often employ positive methods to deal with it. In regard to culture, Merskey and Spear (1967) posits that culture determines how an individual receives and interprets pain. These attitudes are learned from family and friends from the victim's society.

Theoretical Perspectives

The theoretical perspectives of pain take four significant theories that describe pain; they include pattern theory, specificity theory, behavioral/ psychological theory, and gate control theory. The most commonly used approach in the professional world is the gate control theory and is believed to be formulated from the patterns and the specificity theory. The psychological Fordyce (1990) was significant in the process.

Another theoretical view of pain in nursing, as proposed by GCT, describes the perception of pain involved in three major interactive psychological processes that happen within the human body. They include cognitive evaluation dimensions, sensory discriminative, and motivational capability (Melzack & Wall, 1997). Initially, when describing the commonly described perspective on pain, the sensory discriminative aspects of pain refers to the transmission of pain from the nerves transporting pain sensation from the periphery through the spinal cord to the brain. In the brain, the neospinothalamic projecting mechanisms work to process the information on the pain. It processes the intensity, location, and duration of the stimulus (Fordyce, 1990). On another dimensional view, the concept of pain can be described in the motivational - affective dimension that refers to the condition of the brainstem reticular setup and the limbic system that makes one experience the motivational and the development of the aversive drive. The above describes the psychological impact of pain sensation on motivation. Finally, the cognitive evaluation dimension is used to describe the aspect of pain is used to describe the mental activities aspect of pain. The respective values include issues like anxiety, cultural values, and attention in the process. The dimension involves an analysis of the multimodal data, previous experiences, and the different response methods used. This dimension has a critical impact on the above two dimensions of the concept. In this aspect view, two significant authors on the idea, Melzack, and wall describe pain as multiple sensation systems to pain and other processes. In this aspect, it is described as a process that needs a series of responses by the brain action system (Melzack & Wall, 1997). The process begins with reflex responses in the series and the ongoing action systems with elaborate strategies to terminate the pain experience.

Significance of the Concept in Nursing Practice

the behavior theory of pain sets more emphasis on the dimensions of knowledge and each of the subsequent learning processes, the cognitive, cultural, emotional, psychological, and the environmental conditions influencing the process. Nonetheless, according to Melzack, and Wall (1997), he described the pain as a process of learning from respondent and operant conditions (Melzack & Wall, 1997). When viewed in the respondent dimension, pain in the body can be felt from an antecedent stimulus like the nociception. In this operation condition, pain response mechanisms to the cues in the respective environment, an aspect that elevates the consequences. In this dimensional view, when the environment triggering pain is increased, the painful pain behavior will be significantly increased and increased chances of pain persistence. Further, Fordyce identified the primary learning responses to the clinical pain condition and described examples that include; superstitious learning, avoidance learning, and the contingent elevation of the painful behavior and condition (Vaismoradi Et .al.., 2016).

The theoretical perspectives of pain involve a clear discussion on the psychological stimulus involved in the situation of pain and the psychological stimulus involved in the process. However, it is important to understand that the availability of psychological stimulus in the condition of pain is not a determinant of the behavior. In this aspect view for a compete for a view of the process, there is a need to focus on the cultural, cognitive evaluation, emotional, environmental and the cultural perspectives of pain should be put in close consideration to understand the complete pain process.

More often, the theoretical description of pain is confused with other related concepts. In a complete view, it is important to anticipate that some of the attributes of pain may overlap those that can be used in the description of related concepts like suffering and discomfort. One notable factor is that the process all involve both positive and negative responses to ongoing events (Butler, Gifford &, 1997). In this description of the theoretical perspectives, the major difference is based on the phenomena that pain involves both psychological and physical concepts being explained in the process. Further, despite the existence of psychol...