Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Standard view
Full view
of .
Save to My Library
Look up keyword
Like this
0 of .
Results for:
No results containing your search query
P. 1
pain management

pain management

Ratings: (0)|Views: 677|Likes:
An essay for the 2011 Undergraduate Awards Competition by chizua okoye. Originally submitted for ns277 at Dublin City University, with lecturer shelagh wright in the category of Nursing & Midwifery
An essay for the 2011 Undergraduate Awards Competition by chizua okoye. Originally submitted for ns277 at Dublin City University, with lecturer shelagh wright in the category of Nursing & Midwifery

More info:

Published by: Undergraduate Awards on Aug 29, 2012
Copyright:Attribution Non-commercial


Read on Scribd mobile: iPhone, iPad and Android.
See more
See less


Pain is a personal experience that cannot be shared by other people. The experience of painpenetrates the world of every living soul .It can cause anguish, suffering and does notdiscriminate across age or class. This essay will discuss the issues relevant to the principles of best practice in pain management.In order to have a good knowledge of the concept of pain, it is vital to consider the nature andthe definition of pain.Pain has been defined as
sensory and emotional experience associated withactual or potential tissue damage or de
scribe in terms of such damage”
(MaCaffery andPasero 1999 p 16).This definition does not highlight the psychological, social andenvironment impact of pain on patient. It only emphasises on physiological aspect of pain.A great pioneer in pain management is Dame Cicely Saunders (1918-2005).Saundersoriginated a movement that intended to provide a holistic approach to those who suffer pain,taking into consideration their social, physical, psychological and social needs (Clark 2002).Saunders idea agrees with the concept of total pain which appropriately takes intoconsideration the multifaceted nature of pain.In terms
of clinical practice, pain can be defined as “
whatever the experiencing person says it
is and existing whenever he says it does”
(MaCaffery 1968).This definition clearlyemphasises that a patient self- report of pain is the golden standard and therefore, healthcareteam must respond to the report of the patient.What cause pain can be chemical or mechanical stimuli and transduction begins in theperiphery when the stimulus sends an impulse across the nerve fibre developing an actionpotential (Hawthorn and Redmond 1998).When cellular damage occurs, it results in the
release of neurotransmitter such as neuropeptides and histamine which cause inflammatoryresponse (ibid).The fibres that relay information from a painful input consist of two types; they are themyelinated C fibres and the unmyelinated A- delta fibres. The A fibres send signals while theC fibres send impulses that are not strongly localised (Berger 2007).There are several models of pain. The medical (bio) model indicates that when a person isexperiencing pain, it is caused by a background biological organic disorder which can becorrected through medical intervention (Wright 2008).This model does not totally account forevery experience of pain.The biopsychosocial model of pain concentrate on the biological, psychological and socialaspects of pain and takes into consideration the physical dysfunction, distress, copingstrategies, beliefs, illness behaviour and social interactions of the patient (Waddell1998).Perhaps good example that suits this model is one applied by (ibid) that a pat
beliefs about back pain will influence on how the pain will impact on him. Examples of thesebeliefs include fear of hurt, beliefs about the damage that is generating pain and beliefs andoutcomes about treatment. Moreover, pain causes a lot of anxi
ety and a patient’s beliefs,
emotions and coping mechanisms will determine illness behaviour (ibid).Pain can also affect
a patient’s social life and this often leads to inability to interact with
others and function effectively in the society.The concept
 behind the “gate control theory” was first opined in 1965 by psychologist
Ronald Melzack and anatomist Patrick Wall. Gate control theory proposes that theexperiences of pain results from the opening and closing of gate mechanisms in the nervoussystem. The theory is based on the fact that pain impulses are normally carried to the spinal
cord from the peripheries in small nerve fibres. Activity in the pain fibres causes transmissionT cell to send signals to the brain and open gate. Activity in sensory nerves not directly linkedto pain causes larger diameter nerves to carry information about harmless and sensation e.g.touching, rubbing and scratching .This activities close the gate and reduce the likehood of thepain experience message from the brain itself can close or open the gate (Ibid). These gatingmechanisms are located in the thalamus, limbic system and in the substantia gelatinosa in thedorsal horn of the spinal cord. Melzack and Wall (1965) suggest that excitement or anxietycan have different effects on the gate mechanisms and distracting, relaxation and positiveemotions can cause the pain to close thereby decreasing pain.There are different types of pain. Neuropathic pain occurs as a result from damage to theperipheral or central nervous system. Neuropathic pain is commonly continous rather thanintermittent. It may be accompanied by paresthesis sensation or heat (Hardy 1997).According to McCaffery and Pasero (1999) nociceptive pains are associated with the tissueinjury due to trauma, surgery and arising from activation of nociceptors that undergo fourprocesses: transduction, perception, transmission and modulation. Examples of nonciceptivepain are cancer pain and post operative pain. Pain can be also be classified by the duration(e.g. acute and chronic pain) or by pathology pain e.g. cancer pain (Ibid).Chronic pain is pain which persists beyond the usual phase of a disease process or trauma.Chronic pain can be malignant and non-malignant. Examples of non-malignant pain includefibromyalgia and low back pain (Ibid).Acute pain is protective, short lived and has limited tissue damage. Example of acute painincludes chest pain with myocardial infraction or limb pain after a fracture (Greenstein 2004).

Activity (8)

You've already reviewed this. Edit your review.
1 hundred reads
ckc_21 liked this
Jozi Saudia liked this
Ninin Erniawati liked this
Julieta Klein liked this
Zx Ax liked this
Alice Renacco liked this

You're Reading a Free Preview

/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->