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Concept Analysis

4216 words - 17 pages

Management Focusing on Acute Pain: A Multidisciplinary Concept Analysis
The concept of managing acute pain is extremely significant to nursing as pain is one of the most common problems for which patients seek out health care resources. Pain is a complex and abstract concept that encompasses sensory, emotional, psychological, social, and spiritual perceptions of pain that may occur in combination with physical pain. Pain is difficult to describe and often hard to measure; although, most healthcare providers agree that pain is subjective and is to be measured qualitatively and quantitatively as the patient perceives its intensity. Pain can affect the quality of life of the individual by ...view middle of the document...

Most notably Mosby (2001) defines acute pain as “severe pain, as may follow surgery or trauma or accompany myocardial infarction or other conditions and diseases. Acute pain occurring in the first 24 to 48 hours after surgery is often difficult to relieve, even with drugs”. Chronic pain is defined as “pain that continues or recurs over a prolonged period, caused by various diseases or abnormal conditions” (Mosby, 2001). Mosby also defines pain management as “a nursing intervention from the Nursing Interventions Classification (NIC) defined as the alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient” (2001).
Psychology Discipline
Ehde, Dillworth, and Turner (2014) discussed cognitive behavioral therapy (CBT) as a mainstream treatment for managing pain in conjunction with other medical treatments. Turner and Romano (2001) stated “the goals of CBT for pain are to reduce pain, psychological distress, and improve physical function’ (as cited in Ehde et al., 2014, p.154). The efficacy of CBT for managing pain has been evaluated in multiple reviews. CBT had a small effect on pain. Most notably CBT showed the most improvement in the mood of individuals with chronic pain. Ehde et al. concluded that not only the biological causes of pain should be treated but also the psychological and social causes and consequences.
In 1965 Melzack and Wall the developed the Gate Control Theory of Pain (GCT) a framework in which pain management was viewed from a broad perspective. Kugelmann (1997) discusses the change in the perspective of medicine in treating the totality of the patient; thus, changing the definition of the patient. Prior to the 1950’s Kugelmann states that the disease was treated causing a dehumanization of the patient. The GCT was introduced within a new field of bio-psychosocial medicine. With this evolution in medicine the subjective nature of pain along with its psychotherapeutic treatment became the focus. Bonica (1952) stated “pain involves the perception of noxious impulses, and a reaction thereto” (as cited in Kugelmann, 1997, p.45). Kugelmann concluded that in the GCT “pain only occurs as a complex interaction of afferent and efferent signals in the nervous system, all converging on the gate control mechanisms in the spinal cord”. Pain is described as a process instead of a sensation. Pain can be influenced by decreasing sensory inputs, and changing behavioral-cognitive factors. It was no longer necessary to differentiate between organic and psychogenic pain. GCT is to be utilized as a multidisciplinary approach in pain management along with CBT and pharmacological interventions. Defining pain from a psychological perspective, it can be agreed that pain involves a physiological stimulus. The presence of a physiological stimulus cannot determine the pain behavior. The impact of an individual’s mood, cognition, culture, social, and environmental influences need to be considered to view the...

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