Patients Description Of Pain And Meaning

Accurate assessment of pain starts with deciphering the patient's pain report. Although the issues surrounding assessment are covered in depth in Chapter 2, they are worth some additional discussion here.

The location, temporal nature, description by the patient (e.g., whether it is sharp, dull, aching, stabbing, pulsating, buzzing, numb, burning, tingling, cramping), and activities that might be the cause of the pain can provide valuable clues that might eventually lead to the correct therapeutic regimen. Also, listen for key descriptions associated with depression, such as insomnia, loss of appetite, loss of hope, irritability, and short-tempered actions with loved ones.

Careful listening to the patient's complaints can help the clinician make the appropriate pain assessment (63-66). Assessing the patient's cognitive function also will help determine the approach to take for the patient's analgesic therapy. To succeed in pain management, the patient must be included as part of the therapeutic plans. A patient has to be made a partner in the pain management plan.

The clinician must also be aware of cultural differences. In some Asian cultures, for example, patients are afraid to complain of pain because they believe that pain is a punishment for a family's past wrongdoing. Therefore, they are afraid to discuss pain with the clinician when their family members are around. In this case, the clinician has to be sensitive and keen enough to use translators who are not family members. Often, patient education can improve the patient's understanding of the pain and enable them to take a more active role in their pain management. The more patients understand their pain condition, the more likely they will be compliant with therapy (67-75).

In addition, specific questioning of patients about the quality and location of the pain and activities that may alleviate or exacerbate it can often elicit its nature. The majority of patients frequently lack understanding of the concept of neurogenic pain because they expect pain to be associated with some form of pathology, and their complaints are often described in familiar terms such as pulled muscle, back strain, or painful knots. However, most patients will be able to describe their pain when specifically asked about the associated symptoms of neurogenic pain. Physical examination is also extremely helpful in patient identification and isolation of pain.

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