Theory of Acute Pain Management Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept. Good, 1998, related that there was a balance between analgesia and side effects in which two outcomes can be deduced: (1) a decrease in pain, and (2) a decrease in side effects. These outcomes can be studied further or more detailed concepts can be deduced from them. Major Concepts The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects. Potent pain medication contains the aspects of utilizing medications such as morphine or demerol, how the medications are dispensed, and t... ... middle of paper ... ...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day. Each of these steps taken are to achieve a balance between analgesia and side effects in the management of pain. It is a continuous process and if a patient’s pain level falls out of the set range scale then intervention is necessary to bring the patient’s pain level back under control.
Pain is neither objective nor seen or felt by anybody other than the person that is experiencing it. Pain is subjective, therefore there is no way to distinguish whether or not someone is hurting and the only and best measurement of pain is that what the patient says it is. In settings such as end of life care, patients present with many different disease processes and ultimately are there because they have an average of six months to live. Along with this stage in their lives, palliative care patients can encounter a myriad of symptoms, which can result in these patients experiencing tremendous physical and psychological suffering (Creedon & O’Regan, 2010, p. [ 257]). For patients requiring palliative care, pain is the most incapacitating of symptoms and in return unrelieved pain is the primary symptom that is feared most by these patients. So why has pain management not become the top priority when it comes to end of life care, considering this area is growing at an extraordinary rate as a result of an increasingly ageing population?
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Chung, Y., Tsou, M., Chen, H., Lin, J., & Yeh, M. (2014). Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: A sham-controlled study. International Journal of Nursing Studies, 51(3), 370-378. doi:10.1016/j.ijnurstu.2013.06.007
This was a two-site level three study which determined that a systemic approach of “Personalized pain treatment and sedation” proved to “improve the patient’s comfort and raise the tolerance threshold for ICU treatment” (Woien, et al., 2012, p. 1552). This study complemented the results and design of the Mansouri, et al. study (2013), and supported the findings of a systematic, methodical, and organized approach to pain and sedation management. This method not only improves HCAHPS scores through increased patient satisfaction, but also gives healthcare providers and medical professionals better capabilities to care for their patients, as well as, use data to support the courses of treatment regarding any changes made to pain management (Woien, et al.
"The philosophy that you have to learn to live with pain is one that I will never understand or advocate," says Dr. W. David Leak, Chairman & CEO of Pain Net, Inc. (1). Indeed, the notion that pain is an essential element of life, and that one must endure pain to achieve something positive (as conveyed in the omnipresent athletic mantra "no pain, no gain") has informed our sense as a society of how pain is to be dealt with. Only recently, with increasing awareness in the health care community that managing a patient's pain is a complex, yet crucial aspect of their care, has society's view of pain and its management begun to change. "Pain Management" is itself a ne...
In 1931, the French medical missionary Dr. Albert Schweitzer wrote, "Pain is a more terrible lord of mankind than even death itself." Today, pain has become the universal disorder, a serious and costly public health issue, and a challenge for family, friends, and health care providers who must give support to the individual suffering from the physical as well as the emotional consequences of pain (1).
In addition, to keep a patient comfortable, pain control promotes recovery and may reduce risk of developing certain complications after surgery. Through the use of guided imagery and other pain management strategies, the patients can achieve better pain control and improved functioning and will enjoy a better quality of life (Dobson & Byrne, 2014). Also, the inability to escape from pain may create a sense of helplessness and even hopelessness, which may predispose the patient to a more chronic depression. According to Wells, Pasero, and McCarffery (2008), around the clock dosing is recommended during this early post-surgical period to prevent severe pain and control continuous pain.
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
The discovery of morphine, which occurred in 1803, transformed the medical treatment of pain and chronic diseases (Levinthal, 2005). Morphine, a narcotic or opioid, is widely used in the medical field today and is specifically used therapeutically to treat moderate to severe pain in individuals. The most common routes of administration for morphine are oral and intravenous administration (Angel, Gould, Carey, 1998). Morphine acts by binding to opioid receptors in the brain and thus reduces the perception of pain and emotional responses to pain (Weil and Winifred, 2004). The paper will focus on the therapeutic uses of morphine for individuals. Morphine is used in the treatment of pain with individuals suffering from cancer and acute myocardial infarction. Morphine is also administered to patients after surgery to decrease pain and is even thought to decrease the chances of developing posttraumatic stress disorder (Busse, 2006; Herlitz, Hjalmarson, and Waagstein, 1989; Levin, 2010).
In medical school/pharmacology school, medical professionals are taught to treat severe pain with opioids. However, opioids should be prescribed with the possibility of future dependency in mind. Physicians often struggle with whether they should prescribe opioids or seek alternative methodologies. This ethical impasse has led may medical professionals to prescribe opioids out of sympathy, without regard for the possibility of addiction (Clarke). As previously stated, a way to address this is use alternative methods so that physicians will become more acquainted to not not treating pain by means of opioid
Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983
Pain is universal and personal to those who are experiencing it. It is subjectively measured on a scale of 0-10 with zero being no pain and 10 being the worst pain ever. This can be problematic for patients and doctors because this score can be understated or overstated. Doctors will make quick decisions based on this score. Patients might feel not believed because only they can feel the pain. However, untreated pain symptoms may be associated with impaired activities of daily life and decreased quality of life. Pain is defined in our textbook, “as an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Ignatavicius & Workman, 2016, p 25). Actual pain is understood by most because there is an
To provide the best care for their elderly patients, nurses must incorporate pain assessment into their daily care of patients. Pain assessment is a key aspect of the nurse’s role. There are many factors to consider when assessing patients’ pain such as if they are verbal or non-verbal, what language they speak, their age and their cultural background. There are many tools that a nurse can use to assess a patient’s pain but one of the most common tools is the 0-10 scale. This tool can be asked verbally by asking what their pain level is on a scale of 0 to 10 with 0 being no pain and 10 being the worst pain they have ever had. You may also use this tool in a visual manner with faces that correlate to the numbers. 0 being a happy face and 10 being a very sad face. Elderly patients from diverse cultural backgrounds are increasing in long term care facilities so it is important to have a 0 – 10 pain scale written in their native language. Some patients are stoic and do not express their pain as much as other people so it is important to understand that a 0 – 10 pain scale might not always be sufficient and could be combined with observing any physical signs that the patient might be in pain such as facial expressions and guarding. Nurses must have a good base of knowledge and attitude towards pain and always take what the patient reports their pain scale to be as truth. If the patient does report pain it would be important to treat the pain or if it is a new occurrence to follow this assessment up with another val...
...c regimen, prolonged hospitalization, cost, workload on medical team, mortality rate. Moreover, unproductive assessment tool existence leads us to look for other evaluation criteria for pain. This study will aid in adding original information about the presented pain assessment tools and will demonstrate their effectiveness and ability to assess the level of pain in non-communicative patients comparing to The Critical-Care Pain Observation Tool (CPOT)
The talk about prescription painkillers prescribed by doctors are starting to be widely debated whether they’re doing more good than harm. The debate on whether painkillers are good for the human health has came into a mild and somewhat highly discussed topic within the last decade. At first prescribed painkillers were thought to be good, but these prescribed painkillers have always been like a double edge sword usually doing better than bad. The side effects from the painkillers used to be very minimal; for example the common side effects were drowsiness, nausea and vomiting, but since the world is a constantly developing place new painkillers are constantly being developed and so are their side effects” ("Types of Pain Medications on RxList.com." RxList. N.p., n.d. Web. 2 May 2014.’). Not only are the side effects becoming worst, but people are becoming severely addicted to them and in some cases their addiction is lethal and not only kills them, but it can also tear a family apart or put a family in great financial debt because of one person addiction. Now when something that been created to do good starts to be questioned whether it’s actually still good or not is major problem majority of the time.