Chamberlain College of Nursing
NR501: Theoretical Basis for Advanced Nursing
Spring Session B 2013
Concept Analysis: Pain
Pain is one of the most common reason patient seek out help. The concept of pain can affect every person is some form or way. Pain can stand alone as a theory or fix with other theories like Comfort, Self- care, and more. As a surgical nurse I need to have a higher understanding of the patients I care for to ensure they receive the best care. Concept analysis is a form of research that allows a person to explore a theory/ concept to the fullest degree in an organized way. This concept analysis will take Walker & Avant’s steps to form a better understanding into pain. The steps include: selection on concept (pain), Aims or purposes, literature on the pain, concept uses, determine defining attributes, model cases, alternative cases, identify antecedents and consequences, and empirical referents. Aims or Purposes of Pain Analysis
Patient occurs in every person in some form. An understanding of what pain is and how to treat and assess it will allow the patients and nurses to achieve a better outcome. With an understanding of the concept of pain and how it affects the care nurses give then the better the patients’ outcomes. Working on a surgical unit I am faced with pain daily and learning how to assess it allows me to understand each patient’s views of pain. I can be faced with two patients with the same surgery, but the pain scale totally different. “All pain is Real and Pain is what the patient says it is” (McCaffery, 2002). The Purpose of this analysis of pain is to take the Walker & Avant steps to unfold what pain is. Literature On Pain
First one needs to define pain. Pain is as (a) the sensation which one feels when hurt (in body or mind); (b) suffering, distress, the opposite of pleasure; (c) in specifically physical and psychical senses: bodily suffering; mental suffering, trouble, grief, sorrow: (d) trouble as taken for the accomplishment of something difficult according to the Oxford English Dictionary (2013). Pain can breakdown into four theories: specificity theory, pattern theory, gate control theory, and psychological/ behavioral theory. Specificity theory” proposed that injury activates specific pain receptors and fibres that, in turn, project pain impulses through a spinal pain pathway to a pain centre in the brain” (Melzach, 1996, p130). With the specificity theory many chronic back pain patient were diagnosis as psychologically disturbed not with pain. Out of the testing the specificity theory come the pattern theory which had multiple theories which mostly lead to the Gate control theory. One of the pattern theories looked at all ‘cutaneous qualities are produced by spatiotemporal patterns of the nerve impulses rather than by separate modality-specific transmission” (Melzach & Wall, 1965, p973). Next came the Gateway control theory. The Gateway Control theory is a stimulation of the skin evokes nerve impulses that are transmitted to three spinal cord: cells in the substantia gelatinosa, dorsal-column fibers, and central transmission cells (Melzach & Wall, 1965, p974). This theory explains how pain can increase to a person. If one of the three areas is triggered than the response aka pain increases. Finally we have the psychological/ behavioral theory. This theory looks at pain being a result of emotions, feelings, and mental behavioral no physical injury needed ( Turk & Okifuji, 2002). In this theory explains how pain can be expressed by feelings. There need not be injury, but looks at how someone thinking.
Reviewing all the different literature, there is a clear point that I can make. It is that pain can be one or two: physical or psychological. The other subtopics of pain like environment, social get fix into one of the top two. I feel that pain is felt different in each patient, and their bodies have...