Estimating Pain Intensity Analysis

Pain is a multidimensional concept which encompasses evolutionarily developed body responses to algesic factors. Impeding individuals’ health, quality of life, and well-being, pain accompanies a wide range of medical conditions. Depending on the etiopathogenesis, all pain syndromes are divided into nociceptive, neuropathic, and psychogenic pain. Factors that cause pain sense modalities are defined as algogenic or nociceptive. Being directed towards eliminating these factors, pain mobilizes a variety of functional systems to protect the body and triggers such psychophysiological components as consciousness, sensation, memory, motivation, emotions, and vegetative, somatic, and behavioral reactions. However, a plethora of theories did not exhaustively explain mechanisms underlying pain sense modalities until 1965 when Ronald Melzack and Charles Patrick Wall suggested the Gate Control Theory of Pain. This theory was the first attempt to unite physiological and psychological factors and develop an integrative model of pain. Today, the Gate Control Theory of Pain is utilized in medical practice and clinical activities to control acute and chronic pain. This paper will explore recent scientific research and current implementation of this theory in clinical practice by reviewing pertinent academic publications.

“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,

To most people, pain is a nuisance. But to others, pain controls their life. The feeling discomforts us in ways that can sometimes seem almost imaginable. These feelings can lead to many different side effects if not dealt with or diagnosed. These effects can include depression, anxiety, and incredible amounts of stress. The truth about pain is that it is vital to our existence. Without the nervous system responding to pain, we would have no idea if we were touching a hot stove, being stuck by a porcupine's needles, or something else that could leave a lasting effect upon our bodies without us even knowing anything about it. This warning system helps to alert us when there is

The ratings for this scale vary from no pain, a zero, to the worst pain one could possibly endure, a ten ('Misha' Backonja & Farrar, 2015).  This type of tool used for measuring pain is considered a self-assessment.  Meaning, the individual rates his/her pain on the provided scale.  All individuals who have received medical treatment, whether for a serious injury or a yearly physical, has been asked, “What would you rate your pain today, on a scale of one to ten?”.  This pain assessment tool is considered a fully ordered variable due to the individual having a wide range to rate his/her

Self-report pain assessments are either one-dimensional (Appendix C) or multi-dimensional and more comprehensive (Appendix D), depending on the patient’s ability to communicate and tolerate lengthy questionnaires, and are regarded as the gold standard of pain assessment measurement as they provide the most valid measure of pain (Wood,

Numerous tools have been developed to help identify pain within health populations. Each tool used is specific to the population that the nurse is trying to conduct a pain assessment on. In neonates and infants, it can often be difficult to assess their pain when they are not yet able to speak or express their pain appropriately. Several pain scales exist to help nurses pick the best scale to use on their individual patient. It is important for the nurse to know what tools and scales are available because each patient is different, whereas one scale might work better for one patient compared to another. Cong et al. (2014) indicated that recognizing pain in neonates is often undertreated. This journal examines the deficits and barriers within

Assessing infants’ pain manually using the common pediatric scales has three main limitations. First, caregivers assess pain at different time intervals and are not able to provide continuous assessment of pain. Continuous monitoring is important because infants might experience pain when they are left unattended. This is especially true for postoperative pain since it requires continuous intensive care and prompts pain detection and intervention. Second, caregivers’ assessment of pain is highly biased and is affected by several idiosyncratic factors, such as the observer's cognitive bias, identity \cite{pillai2004parental,samolsky2016medical}, background and culture \cite{pillai2004parental,pillai2006judgments,pillai2008understanding}, and

In addition, it is hard to draw conclusions about the interaction of pain perception and age because, as seen in previous studies, findings about pain and age are often a side note and not part of the original purpose. There are many cross-sectional studies, but few longitudinal studies. Also, there are few studies that observe changes in both pain sensitivity and pain threshold, and none that observe these constructs while utilizing the cold pressor

What I have learned from the Pain Log is that it wants to know more about an individual internally and externally. It is based on a scale of 0 (highest) to 10 (lowest) on what an individual do, and how he or she feels. The Pain Log is something new to me, and should be in doctor offices, and hospitals. Even though there is a simple overall pain log of what level of pain currently experiencing; however, this pain log is different, by including other important questions about an individuals well being.

To qualify for the study, participants had to be between 18 and 70 years of age, have moderate to severe chronic low back pain, had low daily opioid use at the time of enrollment, and were declared as candidates for opioid therapy – as determined by their physician. Patients were excluded if they had a history of substance abuse, unstable psychiatric disease, and women who tested positive for pregnancy. This study took place for 14 months, patients were assessed on 2 different occasions, once beforehand and again 1 month after starting the opioid therapy. During each assessment, pain sensitivity was determined by using the cold pressor pain test and a model of experimental heat pain. This testing is known as quantitative sensory testing, patients were trained in the testing, and a test-retest variability of less than 20% was required before the formal pain testing began. The cold pressor test consisted of patients immersing their hand up to the wrist into ice water. The patients were asked to indicate when it first started to feel painful, and then remove their hand when the pain became intolerable. The threshold, which was the time to feel pain, was recorded, along with the tolerance, which was the withdrawal of the hand. The heat pain test used a thermal sensory analyzer (TSA). The TSA put out a heat stimuli via a thermode in contact of skin on the forearm of a patient, the temperature was raised at a rate of 1οC/second until the patient pushed the button to indicate that it had become painful. This process was repeated 4 times and the median value from the 4 trials was deemed the heat pain threshold. The measurement of hyperalgesia was deduced from a decrease of the experimental pain threshold and pain tolerance when comparing the measurements taken before and 1 month after. The only significant finding of hyperalgesia was in the cold

Pain is a sensory and affective state that can be experienced by the self, and perceived in others (Jackson, Meltzoff & Decety, 2005). Such psychophysiological state signals potential threats to the body, initiating a behavioural response that ensures survival (Novembre, Zanon & Silani, 2014). Neuroimaging studies have identified a range of brain areas associated with processing physical pain (PP); typically referred to as the ‘pain matrix’ (Iannetti and Mouraux, 2010). This consists of an affective-motivational component of the painful experience (negative feelings) and the sensory-discriminative component of the pain stimulus (duration and intensity). While the former is primarily associated with the anterior insula (aINS) and

Pain cannot be measured by anyone other than the patient that is having the experience. This is why pain is sometime not understood and misevaluated by healthcare workers. Pain is measured by the Visual analog scale (VAS) of 1-10. One being the least amount of pain and ten being the worst possible. This test is done every four hours and reviewed 30 minutes after a medication administration for pain control. This non-invasive test gives the healthcare worker a measurable idea of the intensity of the pain the patient is experiencing. This also gives the health care worker a perceptive of how well the patient responds to pain after medication administration. Pain is not always seen it can be an eternal feeling.

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).

A significant part of the population is suffering from the ill effects of joint pain. This syndrome is not easy to detect as a little bit of back pain is common in all humans, after a certain age. According to orthopedic surgeons and orthopedic doctors in Delhi, joint pain causes are many. Thus, identifying the

The BPI also contains a section to record information on the patient’s use of pain medication, together with three numeric rating scales, one measuring pain intensity (scored from 0–10), one measuring pain relief (scored from 0–100%), and one measuring interference with daily activity (scored from 0–10). The use of BPI in a in large multicenter trials facilitates the identification of pain levels which represents clinical important cut-offs because of their interference with function. Upon reaching the level 5, the pain intensity begins to have a significant effect on life activities. This allows for an operational definition of “significant” pain when the level of intensity goes beyond 5 (De Conno & Caraceni. 1996). Items assessing the patient’s demographic characteristics are also included within this instrument.