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...
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...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.
Almost one hundred years ago, prescription drugs like morphine were available at almost any general store. Women carried bottles of very addictive potent opiate based pain killers in their purse. Many individuals like Edgar Allen Poe died from such addictions. Since that time through various federal, state and local laws, drugs like morphine are now prescription drugs; however, this has not stopped the addiction to opiate based pain killers. Today’s society combats an ever increasing number of very deadly addictive drugs from designer drugs to narcotics to the less potent but equally destructive alcohol and marijuana. With all of these new and old drugs going in and out of vogue with addicts, it appears that the increase of misuse and abuse is founded greater in the prescription opiate based painkillers.
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Institute of Medicine Report from the Committee on Advancing Pain Research, Care and Education. (2011). Relieving Pain in America A Blueprint for Transforming Prevention, Care, Education and Research. Retrieved from http://books.nap.edu/openbook.php?records_13172
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...
E. (2013). When will acupuncture become a first-line treatment for acute pain management?. Military Medicine, 178(8), 827-828. doi:10.7205/MILMED-D-13-00119
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
Pain is often overlooked and disregarded as an unimportant health issue by health care providers. However, according to the National Institutes of Health, pain affects more Americans than diabetes, heart disease, and cancer combined. It is the most common reason people seek health care, the leading cause of disability, and a major contributor to health care cost (National Institutes of Health [NIH], 2013). By managing pain, patient outcomes improve and health cost decreases because the patient is more likely to participate in activities such as mobilization and deep-breathing exercises, leading to fewer complications and earlier discharge. Organizations such as the American Society for Pain Management Nursing, the American Pain Society, and
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...
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.
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).
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
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
...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)
Management of pain is very important when it comes to palliative care patients, considering that 55-95% of this patient population requires analgesia for pain relief (Creedon & O’Regan, 2010, p. [ 257]). But what is considered pain management? And why does pain continue to be inadequately treated? According to the article on chronic non-cancer pain in older people: evidence for prescribing, in the past few decades significant improvements have been made to the management of pain in palliative care. However, it is universally acknowledged that pain on a global scale remains inadequately treated because of cultural, attitudinal, educational, legal, and systemic reasons (Creedon & O’Regan, 2010, p. ...