Pain Scale Research Paper

What is the point in measuring something that is unique to every individual? In “The Pain Scale,” the author, Eula Biss, attempts to convey her pain to the reader. She tells the reader how she has tried to describe and measure her pain. There is a system set up for doing so, but it leaves much up to individual interpretation. The arbitrary process by which we are supposed to evaluate the level of pain we are experiencing doesn’t seem to accomplish much. Throughout the essay, Biss uses unique ways of comparing the suggested levels of pain to other “scales.” This raises the question, why can the scale, itself, doesn’t do adequate job of helping people understand pain.

In the article “The Pain Scale”, Biss is giving a proposal to definition of the pain scale. The author scaled the pain in a numeric values represented by a scale from zero to ten. First, is the zero scale. As Biss described herself as some one who generate question instead of answering them, she thinks that pain cannot be eliminated. Meaning, zero cannot explain a situation, just like its numerical value, we cannot apply some computational operations to it. Then, the author goes to explain how zero is interpreted in Celsius and Kelvin. To illustrate her point, she used the chicken as an example. The concept of the chicken example is that when we grab the chicken by its feet and the chicken is not complaining, that does not mean that the chicken is in no pain. The moral of zero pain is that either the pain cannot be expressed or it can not be felt. Second, the author started with the stories of how she was taught what is pain and who invented the scale of zero to ten pain scale. For example, Biss’s father told her that an itch is just a damaged tissue. Biss then asks a very complex question, she said “When does pain worth measuring? With poison ivy? With a hang nail?… A razor cut?” This shows how complex it is to judge where the pain begins. Even with a trained hospice nurses, not every pain can be identified. Biss conclude the scale one by assuming that zero and one are close to each other to the point where they might equal each other. Third, the scale number two starts

“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,

1. It is important that we take into consideration, areas other than physical pain and have an holistic approach. Pain is whatever the person who is suffering it feels it to be. Physical pain can be experienced as a result of disease or injury, or some other form of bodily distress. For example childbirth. Although not associated with injury or disease, but can be an extremely painful experience. Pain can also be social, emotional and spiritual as well as just physical.

Pain not only involves the physical reaction to damaged tissue, but also involves an emotional and cognitive response by the person experiencing the pain (Backer, 1994). A person's prior experience will influence how pain is managed. Pain is a signal that something is not

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 amount 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.

Pain can be categorized as acute or chronic pain. Chronic pain is described as pain that is both long-term and continuous, or is pain that persists after the expected healing time following an injury (British Pain Society, n.d.) Acute pain can provide a warning signal that an illness or injury has occurred. It is defined as pain that lasts less than three months and lessens with healing (Briggs, 2010). Acute pain can then be described in more detail by the following categories; somatic, visceral and neuropathic pain. Somatic pain is a localized pain described as sharp, burning, dull, aching or cramping. It is seen with incisional pain and orthopedic injuries or procedures. Visceral pain refers to an injury to the organs and linings of the body cavities. It produces diffuse pain and can be described as splitting, sharp or stabbing. This is pain that be described from patients with appendicitis, pancreatitis or intestinal injuries and illnesses. Injuries to the nerve fibers, spinal cord and central nervous system cause neuropathic pain. This pain can be described as shooting, burning, fiery, sharp, and as a painful numbness. This can be seen after an

Measuring Pain 1. 1. Sensory - intensity, duration, threshold, tolerance, location, etc 2. 2. Neurophysiological - brainwave activity, heart rate, etc 3. 3. Emotional and motivational - anxiety, anger, depression, resentment, etc 4. 4.

Aside from determining the type of pain suffered, the other major consideration in treating pain for cancer patients is to determine the level of pain. A significant proportion of patients experiencing pain would grade this as moderate to severe, but some may have only mild to moderate pain which may respond to lower risk treatment options (van den Beuken-van Everdingen et al., 2007, p.1437).

In 2002, the American Geriatrics Society established comprehensive guidelines for assessing behavioral indicators of pain.1 More recently, the American Society for Pain Management Nursing Task Force on Pain Assessment in the Nonverbal Patient (including persons with dementia) recommended a comprehensive, hierarchical approach that integrates selfreport and observations of pain behaviors.11 Recently, tools to measure pain in persons with dementia have proliferated. In 2006, a comprehensive stateof-the-science review of 14 observational pain measures was completed. The authors concluded that existing tools are still in the early stages of development and testing and that more psychometric work is needed before tools are recommended for broad adoption in clinical practice.12 Others, including an interdisciplinary expert consensus

The National Institute of Neurological Disorders and Stroke (NINDS) implies that acute pain, left untreated, can lead to chronic pain. Chronic pain affects more Americans than diabetes, heart disease and cancer combined and leads the cause of long-term disability in America.

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).

There are several assessment tools nurses use in in the field to assess geriatrics along with the rest of the population. Three most common assessment tools are, the pain scale, fall risk scale, and the depression scale.

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.