Introduction
A concept analysis is involved in defining notions in the nursing sector to bring clarity by defining and simplifying them. The following concept analysis of pain will define pain, the performance of a literature review, and attributes definition. Consequently, the paper will determine the consequences and antecedents of pain and review a case where the concepts are defined. A reflection will also be provided concerning how the concept will apply in the nursing practice.
Pain as Defined by Nursing Theory
The term pain is a biological experience characterized by physical discomforts, such as prickling, throbbing, or anguish, which is linked to evasive action. Most of the time, people go to the doctor because they are suffering from some pain, whether in the abdomen, chest or legs, or any other form of pain they may experience. It would be challenging for healthcare specialists to treat a problem that does not have a description, and pain assists in describing the patient’s ailment. In addition, a person’s interactions with their surroundings can be significantly impacted by their perception of pain, which is both a sensory and an emotional experience. For example, an individual may feel pain when the body is trying to tell them there’s a problem with their equilibrium or that they are in danger of further injury. The subjective nature of pain means that assessing and quantifying it can be quite difficult.
Medical professionals commonly employ the Numeric Rating Scale (NRS) when assessing the intensity of a patient’s discomfort. Pain is a profoundly personal experience, with each person defining mild, moderate, and severe pain in a distinctly different manner. The threshold for light pain ranges from five or less, six to seven for moderate pain, and eight or more for severe pain. However, the individual rating of pain may be influenced by personal biases. Thus, pain treatment may either be insufficient or inadequate for the patient.
Literature Review
As much as pain scales measure pain levels, pain is subjective and can vary for different people, even when using the pain scale. For example, a study conducted by Roidi et al. (2019) showed that children of Rett syndrome (RTT) have difficulty communicating their discomfort when tested for pain levels (2019). However, by using numerous pain measures, such as the Discomfort and Discomfort Scale (PADS), researchers discovered that 89 percent of the patients reported pain (Roidi et al., 2019). Furthermore, researchers observed that RTT Children expressed pain through interactions and mood changes in addition to verbal and facial expressions.
In modern medicine, pharmacological analgesia is the most frequent pain control strategy. While there are many therapeutic advantages to this approach, it contributes to the rise in opioid abuse. Opioid medications were responsible for about 15,000 deaths in 2008, according to the Center for Disease Control (CDC) (Hoffman et al., 2020). The use of analgesics should continue, but other treatment methods need to be investigated and considered for relieving pain. Studies have shown that non-pharmacological methods of treating pregnancy-related pain are ineffective in relieving the mother’s suffering. However, complementary and holistic treatment methods were significant in recovering from traumatic events. Researchers used the GCQ to discover that these interventions raised comfort levels from 17.5 to 30, and the pain scores decreased from 5.8 to 3.5 (Eklund et al., 2022). This study supports Kolcaba’s claim that nurses should approach pain holistically.
Music therapy helps reduce anxiety and pain by allowing muscles to relax. A study by Fu et al. (2020) showed that music therapy was effective as a treatment option for pain control. One hundred and fourteen inpatients in a local hospital’s Pain and Palliative Medicine Unit underwent an investigation. Some patients were given 20 minutes of music therapy, while others were asked to participate in the conversation (Fu et al., 2020). Music therapy was proven to be more effective at reducing pain than talking to patients. According to Kolcaba’s comfort theory, the physical surroundings of patients have an impact on their well-being.
Kolcaba’s concept of comfort influences the impact of the environment on cardiac patients. As a reassuring intervention, the researchers in this study used a time of silence (Coelho et al., 2018). Because it reduced stress, quiet time was thought to be helpful in the healing process of the patient. In addition, patients at ease are more satisfied with their care, which benefits the nurses and the facility.
Defining Attributes for the Concepts
Defining attributes is the art of stating characteristics related to the analyzed concept. In this context, there are several attributes related to the concept of pain. The most significant attributes of the concept of pain are as follows. The first attribute of pain is distress and an unpleasant experience that comes from the physical sensation that an individual faces (Stilwell et al., 2021). The second attribute is a state where one feels emotion, sensation, and behavioral components. The third attribute involves an individual experience for each human. The fourth attribute of the concept is the psychological and physiological responses to a stimulus. The fifth attribute entails the pain functions, including warning and protective signs. Finally, the sixth attribute is that responses to pain are learned and influenced by the environment, personality, culture, emotion, and society.
Antecedent and Consequence
The word antecedent defines attributes or traits that must exist before a prevailing concept. First, a person must be aware of the presence of the problem to begin the process of correcting it. Pain antecedence is its causative factor, and examples include acute or chronic illness, disease-related or trauma. For example, the development of chronic pain can lead to anxiety, insomnia, melancholy, and poor coping abilities if pain treatment is ignored (Davydov et al., 2021). As with a traumatic injury, the body’s stress reaction to extreme pain might include several consequences. The consequences of pain include decreased insulin sensitivity, increased cardiac output and metabolism, fluid retention, and increased cortisol production, increasing the risk for myocardial infarction and thrombosis.
Model Case
Manuel, a 49-year-old construction worker, fell from a one-story building and landed on his back. On a scale of one to 10 the pain levels, Manuel’s pain was rated at eight during the nurse’s assessment and examination. Analgesic morphine 4 mg IV was given to Manuel to alleviate his discomfort. The nurse exits the room after turning on the television for him to watch and turning off the lights for the patient. Manuel’s pain persists despite being hospitalized, and he cannot function effectively at work for three months. As he makes his way up the ladder, his grip becomes increasingly shaky, and he starts to sweat. As a result, Manuel can no longer work in the building sector.
Manuel experiences anxiety and seems nervous and uncomfortable when ascending story structures. He may be experiencing mental distress due to his inability to work. Manuel is currently experiencing excruciating discomfort and pain. This incident is noteworthy since it exemplifies all three of the pain attributes discussed earlier. Manuel suffers from a physiological reaction: pain after falling from the one-story building. The fact that he was hurt and the injuries he succumbed to during the fall are the antecedents that caused him pain. Since the accident, Manuel has been in constant discomfort for three months. This incident has significantly influenced his quality of life. A decline in his ability to perform at his peak may have impacted his day-to-day routines.
To determine Manuel s’ level of discomfort, the nurse, in this case, uses the NRS measure. The nurse administers analgesics precisely after assessing his level of discomfort and determining what he needs. In addition, while experimenting with non-pharmacological pain treatment methods, the nurse uses the television as a source of distraction (Yous et al., 2020). Kolcaba’s theory of comfort is based on these coordinated efforts and approaches to alleviate the patient’s discomfort.
Conclusion
Any concept analysis in nursing entails defining related terms and providing detailed information to create an understanding of the model. Pain, as defined in nursing, is a biological experience characterized by physical discomforts, such as prickling, throbbing, or anguish, which is linked to evasive action. Attributes in this context include anxiety, stress, and suffering. Antecedents of pain are the causative agents of the pain, while consequences are the results that come after the pain. Reflecting on the knowledge gained from the concept, I will apply it as a nurse practitioner by critically analyzing my patient’s pain and response to it. The pain assessment of the patient enables an effective diagnosis. I will use pain concepts to identify the difficult terms to describe and equip other practitioners with knowledge. The analysis has impacted me with more understanding and knowledge about pain and will allow me to care for my patients more effectively.
References
Coelho, A., Parola, V., Sandgren, A., Fernandes, O., Kolcaba, K., & Apóstolo, J. (2018). The effects of guided imagery on comfort in palliative care. Journal of Hospice & Palliative Nursing, 20(4), 392-399.
Davydov, D. M., Galvez-Sánchez, C. M., Montoro, C. I., de Guevara, C. M. L., & Reyes del Paso, G. A. (2021). Personalized behavior management as a replacement for medications for pain control and mood regulation. Scientific reports, 11(1), 1-15.
Eklund, R., Eisma, M. C., Boelen, P. A., Arnberg, F. K., & Sveen, J. (2022). My Grief App for Prolonged Grief in Bereaved Parents: A Pilot Study. Frontiers in psychiatry, 757.
Fu, V. X., Oomens, P., Klimek, M., Verhofstad, M. H., & Jeekel, J. (2020). The effect of perioperative music on medication requirement and hospital length of stay: a meta-analysis. Annals of surgery, 272(6), 961.
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Li, L., Pan, Q., Xu, L., Lin, R., Dai, J., Chen, X., & Chen, Z. (2019). Comparison of analgesic and anxiolytic effects of nitrous oxide in burn wound treatment: A single-blind prospective randomized controlled trial. Medicine, 98(51).
Roidi, M. L. R., Isaias, I. U., Cozzi, F., Grange, F., Scotti, F. M., Gestra, V. F & Ripamonti, E. (2019). A new scale to evaluate motor function in Rett syndrome: validation and psychometric properties. Pediatric neurology, 100, 80-86.
Stilwell, P., Hudon, A., Meldrum, K., Pagé, M. G., & Wideman, T. H. (2021). What is pain-related suffering? Conceptual critiques, key attributes, and outstanding questions. The journal of pain.
Yous, M. L., Martin, L. S., Kaasalainen, S., & Ploeg, J. (2020). Low investment non-pharmacological approaches implemented for older people experiencing responsive behaviours of dementia. SAGE Open Nursing, 6, 2377960820964620.