Usefulness of the Concept of Pain - Research Paper Example

Concept Analysis – Concept of Pain of Affiliation Introduction Pain is an unfriendly sensory and emotional experience that is associated with potential or actual damage of the tissue (Merskey, 1986). Pain is the harmful stimulation of tissue that is in danger or that which is actually damaged. This concept was derived from Descartes and has led to the successes of the biomedical revolution. However, pain has proved to be more than a response from a damaged tissue. The link between injury on a tissue and reported pain is so loose that the Cartesian model is of no value. Aim or purpose of the concept The concept of pain is very useful because it determines the questions that patients are asked by medical experts, the tests to be conducted as well as the treatment to be offered. Pain is the most recurrent diagnosis used in nursing as well as the most common problem through which patients seek help in a clinical setting. Unrelieved pain has an effect on the quality of life of an individual. It affects a person both physically and emotionally, impacts his family as well as the individual and the entire society (Ferrel, 1995). Pain is therefore a vital problem in the health care system. Literature review Pain is discussed by four major theories namely; specificity theory, gate control theory, pattern theory and psychological/ behavioral theory. The Gate Control Theory (GCT) is the most commonly used theory in the professional field. The insight of involves three interactive cerebral processes; motivational-effective, sensory discriminative and cognitive-evaluation (Melzack and Wall, 1965). Sensory-discriminative dimension speaks of the nerve transmission to the brain from the periphery through the spinal cord. This neospinothalamic projection system that is found in the brain serves to develop information that is sensory discriminative about duration, location and intensity to the stimulus. The limbic system and the formation of the brain brainstem reticular, which provoke the aversive and motivational drive are referred to as the motivational-affective dimension. Cognitive activities are referred to in the cognitive-evaluation dimension. These cognitive activities include attention, anxiety and cultural values. The cognitive-evaluation dimension places its basis on the analysis of multi-modal information, response strategies and past experience. This dimension also has effects on the other dimensions. According to Melzack and Wall, pain is a continuing process and not a sole sensation and response procedure. Pain includes a series of responses by a system of actions that start with reflex responses and continues with complicated strategies that eliminate the pain (Bonica, 1990) The role of psychological, environmental, emotional and cognitive factors as well as learning, culture and personality are emphasized in the psychological/behavior theory of pain. Pain is the process of learning from respondent to operant conditions (Fordyce, 1990). Pain is produced by a predecessor stimulus in the respondent condition while in the operant condition, it occurs to signs that reinforce consequences in the environment. If the environment is reinforced, pain is likely to be reinforced and likely to be persistent (Fordyce, 1990). Superstitious learning and avoidance learning are some of the responses to clinical pain. Pain is defined by the involvement of psychological stimulus but the stimulus does not determine the ensuing pain behavior. So as to view pain as a complete concept, cognitive evaluation and psychological, environmental, cultural and emotional factors must be considered. Uses of the concept of pain Pain in cultural inheritance is emphasized by the perspective of sociology. The experience of pain does not only include the sensation of pain but also an automatic response to the pain. Cultural and social patterns of an individual has an important influence on pain (Zborowski, 1969). The expectancy and acceptance of pain is used to express an individual attitude towards pain. Such attitudes are in part learnt from parents, peers and siblings. Pain responses are more on behavioral and emotional levels. An individual’s response to pain also depend on a specific situation as well as on culture background. Everyone learns the application of the word pain through his or her experience which relates to an injury in his or her early life. Pain serves both negative and positive functions (Ross and Ross, 1988). Pain acts as a treatment and diagnosis aid as well as a sign that warns of a tissue trauma. Pain is described as an individual’s experience and is used to report on the presence of discomfort as well as an uncomfortable sensation during a nursing diagnosis. The feeling of pain depends additionally on the physical stimuli. The perception and expression of pain emphasize a more pyscho-socio-cultural aspect. Professional as well as sociology fields consider pain to contain both negative and positive functions. Defining attributes Defining attributes are those characteristics that are associated with a certain concept. One needs to establish those attributes that are appropriate in exploring a concept (Walker and Avant, 1995). Defining attributes of the concept of pain include an experience that is distressful and unpleasant, which comes from an experience that is distressful and unpleasant and has both negative and positive meaning to an individual. A pain is negative if it cause is an injury on a tissue. However, pain is considered to be positive if it comes as a warning sign. Another defining attribute of pain is that a pain response is learned and influenced by environment, culture, personality and emotions. Pain is always associated by an early experience. Model case A model case includes all the defining attributes and is a paradigmatic example. This model case illustrates the defining attributes of the concept of pain (Walker and Avant, 1995) Mrs. She in a 54 year old female and was diagnosed with breast cancer. Her tumor has enlarged and the doctor wants her to have surgery as soon as possible. Monica is a nurse assigned to take care of her. Monica went to She’s bedside and found her lying on her stomach. She looked pale and tired. She’s blood pressure and heart beat rate had slightly increased. She told Monica that she was in pain and Monica gave her medication. She later told Monica that she had a lump on her breast a few years ago and that she feared that she could suffer from breast cancer. She also told Monica that her family has bad genes since her mother had been diagnosed with breast cancer too. This cases illustrates the attributes of pain. Pain is distressful and unpleasant. This attribute is illustrated both verbally and behaviorally in the case when Mrs. She is found lying on her stomach. Behaviorally, Mrs. She is found lying on her stomach and verbally, she tells her nurse Monica that she is in pain. Pain is a response that is learned and influenced by environment, culture, personality and emotions. In this case, Mrs. She learned pain from her mother who had also been diagnosed with breast cancer. Culture also influences pain in that Mrs. She seems to believe that her family has bad genes because her mother had also been diagnosed with breast cancer. The defining attributes of the concept of pain can clearly be identified in this case. Alternative case An alternative case is a case that does not present the concept. People can easily recognize an alternative concept and not the main concept (Walker and Avant, 1995) John is a 10-year-old boy whose father brought him to the clinic for a hepatitis A immunization last week. His father brought him to clinic again for a routine well-child check. When John arrived at the clinic and saw the nurses, he held his father very tightly with his eyes closed and would not let his father put him down. When the nurses talked to him, he began to cry and said, that he did not want to be in the clinic and that he wanted to go home. The nurse explained to him what he was going to do during the visit that day. However, John seemed not to pay attention to the nurse and kept crying and saying that he wanted to go home. The defining attributes of the concept of painare absent in this case. Antecedents and Consequences Antecedents are events that happen prior the existing concept (Walker and Avant, 1995). In the concept of pain, cultural, environmental ans personal values are the antecedents aned are interelated. Environment and the events that trigger pain are interelated. Both the person’s mind and body are are affected by the event, which cause potential or actual damage on the tissue. The person’s attitude and knokwledge also play a very crucial role and relate to the event. The individual,s attitude and knowledge may affect the person’s expectations and and acceptance which later influences how the person copes with pain. Consequences are incidents or events that result from the concept (Walker and Avant, 1995). Pain consequences relate to pain reactionand the person’s personal interpreatation of what pain means. The reaction of pain has a biologicl and physical focus. How to cope with pain is a psychologiacl focus amd refers to the individual’s perception of pain. Reaction of pain may be a voluntary or involutnatry response. Involuntary response is that response that is not under direct concious of the individual experiencing the pain. This response will focus on non-verbal responses that are evoked in the automatic nervoue system sush as reflex actions. Voluntary responses are carried out conciously by motor activity. These resposes include both non-verbal as well as verbal reactions. Empirical references This are representations of how concepts are measured or the reality that should be on observations from a phenomenon. Empirical references are a presentation of how the attributes of the concept of pain exist in reality. This enables concept analysis to be used as a developmet instrument. The most reliable indicators of pain should be the victims verbalizations. This is because pain is distressful, uncomfortable and unpleasant. However, verbalizations cannot be relied on all the time because some patients have restricted verbal capabilities. In this case, other methods of pain evaluation need to be used. Measuring pain includes intensity, quality and locating the pain. Patient’s pain is assessed using behavioral cues. Conclusion This concept was chosen because pain is a serious problem experienced the patients as well as by providers of health care. If pain is unrelieved, it could lead to dire consequences. This analysis seeks to benefit nurses and other providers of health care by providing a better understanding into the concept of pain. It also seeks to provide appropriate nursing activities that would help relieve pain. References Bonica, J. (1990). The management of pain (1st ed.). Philadelphia: Lea & Febiger. Ferrell, B. (1995). the impact of pain on quality of life. Nursing Clinics Of North America. Fordyce, W. (1990). learned pain. Pain As Behavior. Melzack, R. (1975). The McGill pain questionnaire. Major Properties And Scoring Methods. Merskey, H. (1986). Classification of chronic pain (1st ed.). Amsterdam: Elsevier Science Publishers. Ross, D., & Ross, S. (1988). childhood pain. Current Issues, Research And Management. Walker, L., & Avant, K. (1995). Strategies for theory construction in nursing (1st ed.). Norwalk, CT: Appleton & Lange. Zborowski, M. (1969). People in pain (1st ed.). San Francisco: Jossey-Bass. Read More