Journal of Advanced Nursing, 1999, 29(4), 935±941
Nursing theory and concept development or analysis
An analysis of the concept of pain
Lucy Montes-Sandoval RN MSN
College Assistant Professor, Department of Nursing,
New Mexico State University, New Mexico
Accepted for publication 13 April 1998
Journal of Advanced Nursing 29(4), 935±941
An analysis of the concept of pain
This paper presents a conceptual analysis of the phenomenon of pain. The strategic process of developing a conceptual analysis is a cognitive exercise of critical thinking applied to a very common, but complex and poorly understood, experience. Within the classic framework developed by Walker & Avant (1995), pain is analysed and critical attributes are distilled. A model case, a related case and a contrary case are constructed in the course of creating conceptual clarity. Empirical referents that exemplify the concept of pain are identi®ed. The concept analysis provides a forum for dialectics, offering one defensible interpretation of a complex human occurrence. Nursing implications are discussed in the conclusion.
MONTESMONTES-SANDOVAL L. (1999)
Keywords: concept analysis, pain, noxious stimuli, anguish, critical thinking, conceptual clarity, nursing
Pain is a universal factor and a common human experience. Yet, despite its universality, pain is a very complex concept to de®ne and understand. In nursing practice,
pain is probably one of the most widely experienced and
expressed phenomena. Its magnitude and application
suggest that nurses have an adequate understanding of
its meaning. However, Zalon (1995) suggests that nurses
lack basic knowledge about pain and its management.
Poor relief of pain is well-recorded and has been noted
in nursing literature for over 20 years (Zalon 1995). This is both thought-provoking and troublesome, as it re¯ects the
incompleteness of the nursing process. Suffering pain
needlessly raises ethical concerns and is a barrier to
nursing's goal of enhancing an individual's quality of
living. Pain cannot be assessed adequately if it remains
vague, ambiguous and arbitrarily de®ned. Conceptual
clarity of pain is important as the nursing profession
continues to establish itself as a distinguished discipline.
A concept analysis is a useful technique to promote
conceptual clarity. An analysis is a `formal linguistic
exercise' to examine critical attributes of a particular
concept (Walker & Avant 1995). A careful analysis of pain
and distillation of its attributes will enhance understanding and result in an operational de®nition that can be assessed empirically (Chinn & Kramer 1995, Walker & Avant 1995).
The purpose of this paper is to engage in this cognitive
exercise of critical thinking to examine the concept of pain and to re¯ect on its meaning, rather than to draw a solitary conclusion. Ironically, the only assured outcome of this
exercise is ambiguity that leads to continued exploration.
This concept analysis is intended to provide a workable
approximation from which the nursing profession can
draw and expand the conceptual clari®cation of pain.
Such analysis is part of an evolutionary process to develop
and strengthen the substantive knowledge that guides our
practice. This being the case, the analysis of the concept of pain is conducted within the classic framework developed
by Walker & Avant (1995).
Correspondence: Lucy Montes-Sandoval, College Assistant Professor,
CONCEPT USAGE AND DEFINITIONS
Department of Nursing, MSC 3185, New Mexico State University, PO Box 30001, Las Cruces, NM 88003-8001, New Mexico.
Tel.: (505) 646 3812; Fax: (505) 646 2167.
Ó 1999 Blackwell Science Ltd
To clarify the meaning of the concept of pain it is
important to identify as many uses of the term as possible.
The ®ndings allow for richer meaning and are used to
validate the selection of de®ning attributes (Walker &
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