The Concept of Pain in Nursing - Paper Example

Introduction

Most patients seek clinical help due to the unwavering pain they experience. Thus, pain is one of the concepts that is frequently given diagnosis by nursing experts. Pain gets described as the undesirable and distressful sensation that causes mild discomfort. Notably, pain interferes with the quality of life of patients, causes emotional and physical impacts as well as increasing health care, individual and societal costs. For instance, for the last three decades, the nursing researchers have examined the pain in children especially the experiences, measurements and the aftermath. However, reports show that health care providers cannot manage pain completely hence increase in suffering among the affected.

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According to Walker and Avant method of concept analysis which is found on the CINAHL, pain is described as an unpleasant, personal experience, distressful, undesirable and an annoying experience (Walker & Avant, 2011). Nevertheless, Mahon and Montes-Sandoval who used the concepts did not dwell on the meaning of pain, role, state of feeling and responses and consequences. Therefore, it is important for nursing professionals to define the pain before they proceed to try and relieve it. One way through which pain can get defined via the application of concept analysis. Concept analysis grants nursing scholars a chance to study properties of a concept in order to differentiate defining and irrelevant characteristics. Therefore, the paper will focus on the concept chosen, the major aims of the concept as well as identify all uses of the concept. In addition, the article will focus on defining attributes, constructing different cases, identifying antecedents and consequences as well as the empirical referents in a concept.

Defining of the Concept of Pain in Nursing Theory

Pain has been defined differently across different materials. According to the Oxford English Dictionary, pain gets defined as an emotion felt in body and mind when the one gets hurt. Secondly, explains pain as the contrary of pleasure, anguish, and discomfort. Moreover, it refers pain as the mental and bodily suffering, grief trouble and sorrow. Lastly, the OED definition of suffering is that it is trouble that ids are given for achievement of something different. In the Encyclopedia and the dictionary of Medicine Nursing and Allied Health (Guaadaoui et al., 2014), pain is described as an emotion of misery, affliction, and disappointment facilitated by simulation of the various nerve endings.

Philosophers have contributed a great deal to the concept of pain throughout their works. For example, Plato regarded pain as something that came about not only from nerve simulation but that it associates with emotional struggles within the soul. According to Aristotle's perception, pain is an emotional, state and quality of the soul which is a total reverse of pleasure (Corcilius and Gregoric, 2013). On the other hand, Descartes associates pain with both the body and mind an approach that has been contradicted by other theorists. Generally, the philosophical viewpoint affiliates pain with perceptions of soul and mind defining pain as unpleasant, gross and an emotional feeling that is stimulated within the nerves.

Literature Review

The literature review will focus on the theories that have tried to explain the concept of pain in different scenarios. The main perspectives that discuss pain include: specificity theory, pattern theory, Gate Control Theory and Psychological or behavioral theory. Notably, GTC is created from the other two theories. According to Melzack and Wall on the GCT, pain is defined through a process of cerebral interaction which includes motivational affection, sensory discrimination as well as the cognitive-assessment approaches (Keskinbora & Keskinbora, 2016). The sensory-discrimination gets defined as the nervous transportation across the central nervous system. Brain's neospinothalamic systems act as the sensory organ that segregates critical information about intensity, location and stimulus in case the pain is inflicted. The motivation-affective gets described as the limbic system which initiates encouragement and aversive drive to stimuli.

On the other hand, cognitive-evaluation is associated with cognitive activities like anxiety, attention and cultural values. Therefore, Melzack and Wall came to the conclusion that pain is an ongoing process as it incorporates many sensations and the response system in the body. Their perception is that pain involves several responses starting from reflex responses to complex strategies in order to be able to terminate all the pain (Keskinbora & Keskinbora, 2016). A behavioral theory of pain relies on personality, learning, subjective, and environmental agents as the main things that can determine the pain. Pain is seen from the perspective responds and driver situations where the pain is exhibited by antecedent motives while in the operant, pain gets attributed to the environmental factors which bring about implications.

The sociological perspective regards to pain in the context of cultural inheritance. According to Zborowsk (Gaspa & Pinna, 2013), social and cultural patterns of people are significant control over how pain gets experienced. His approach involved utilization of pain expectations and acceptance to mirror the individual towards pain and recovery while relying more on pain responses. Indeed, pain responses lens towards emotions and the behavior of people. Moreover, McCaffery theory perceives pain as what a person says they are experiencing and it only in existence if the person confesses to it. Also, the International Association of the Study of Pain (IASP) refers pain as unbearable emotions of understandings which relates to potential tissues damages in the human body.

Defining Attributes

Attributes are the characteristics and features that get associated with a concept. In this case, the paper focuses on the attributes of pain in the concept analysis in Nursing as discussed by Walker and Avant. The leading attributes of the pain concept include;

Unpleasant Experience

A research carried out by Bain (2013) showed that unpleasant behaviors experienced by individuals can result in behaviors like crying, grieving, fast breathing. The actions motivate patients to approach medications like pain relievers to ease the feeling.

Dominating Force

A research was carried out to study the experiences and how patients can manage chronic pains through interviewing thirty-four patients (Ojala et al., 2014). The findings concluded that the chronic pain led to a severe psychosocial life of patients by inflicting pain and taking control of their thoughts.

Personal Experience

Clark's study (2015) on the application of medication based on genetics to ease the pain suggested that there is a high possibility that genetic factors contribute to pain management due to the facts that individuals reacted differently to the same type of experience. Furthermore, Belfer et al., (2014) show that indeed pain varies according to individual experiences as they exhibit variability in terms of sensitivity in the stimuli, perception of acute and chronic pain and difference when it comes to responses.

Antecedence

Antecedents were described by Walker and Avant (2011) as the situations that take place before a certain concept occurs. In the case of pain, trauma is the major antecedents. A study carried out by Trevino et al., (2012) in trauma patients at four months displayed that the chronic pain was experienced amongst 79.2% of patients. Other antecedent factors include personal, environmental and cultural values.

Consequence

Consequence refers to activities occurring as a result of the concept. According to Monsen et al., (2015), the consequences contribute to a decline in the quality of life. The scholars describe a quality life as one which portrays mobility, involves self-care, normal activities, pain, and anxiety. Therefore, the greater the extent of chronic pain, the higher the chances of interference with the quality of life.

Empirical Referents

Pain relief is necessitated by appropriate assessment and measurement of by nursing professional. Reports show that the move by patients to report the pain they feel is the best way through which experts can evaluate pain (Guo et al., 2015). The main measurements tools include; numeric, verbal, facial and self-report tools. The Numeric Pain Rating Scale is used to range the suffering capacity in adults by making patients chose numbers from 0-10 that represents their level of suffering. On the other hand, the Non-verbal Pain Assessment Tool (NPAT) is used to assess the level of those patients who are critically affected by the pain. The main domains in the approach are movement, emotion, facial cues, verbal and positioning. The scale of scores ranges from 0-10 where a high number indicated the severity of the pain in the patient.

Model Case

My patient Tasha was crying, gnashing and grinding her teeth. By application of NPAT, I discovered that Tasha was experiencing a lot of pain. After a few questions, Tasha told me about the pain she was feeling scoring 8/10 (personal experience attribute) on the numeric pain rating scale. Moreover, Tasha revealed that she as experiencing severe back pains she has never had before (Trauma) which forced her to grasp on something or grind as a way to let go of the pain (unpleasant experience) numbing and restricting her to one place (dominance force). The patient confessed that she had followed all the instructions from her doctor but with no satisfying results. I resorted to describing 2mg of morphine to the patient who later recorded 2/10 NPRS

Borderline Case

Mrs. Maria has been diagnosed with Breast cancer and set to have a radiotherapy. Maria asked for Tylenol for her severe headaches and rate 8/10 (personal experience) on the NPRS (referent). Maria claims that he often gets headaches when he does not get enough sleep (antecedence) and because of her condition, the pain was becoming antagonizing (unpleasant experience). Therefore, the Tylenol would help her at any point if the headaches recur. Dominant Force attribute was not available in this case.

Contrary Case

Sue is a 5year old girl who was brought to the hospital get an immunization. However, at the first glance of the Nurses, Sue was terrified and started crying. When the nurse started talking to her, the baby said she never was afraid of a syringe and she wanted to go back home. In the end, Sue ran out of the hospital facility leaving the mother and the nurses. The case lacks all the attributed.

Theoretical Application of the Concept

Pain brings both the negative and positive experiences. Application of the concept is understood from the basic facts experiencing the pain. According to Ross and Ross (Tam et al.,2013), pain is a vital sign for trauma-related cases as well as diagnosis and treatment of certain ailments. This helps in avoiding and preventing serious diseases like cancer and stroke. Notably, nursing diagnosis defines pain as experiences of a patient who communicates the availability of uncomfortable feeling.

Conclusion

Clearly, pain gets defined severally from dictionaries to various theoretical concepts and perspectives. There exist different categories of pain as well as measurement and assessment methods. Typically, personal experience, dominating force, and unpleasant feeling are among some of the characteristics of pain. The main antecedence of pain is trauma and it can bring about decreased quality of life. Moreover, the paper outlines NPRS and NPAT as some of the empirical referents that help nursing professionals to determine the pain in patients. Generally, the paper discusses the concept analysis thereby giving a deeper understanding...