Principles and practice of managing pain: a guide for nurses and allied health professionals

217 Pages·2010·5.48 MB·English

by  Parsons

Principles and Practice of Principles and
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A Guide for Nurses and Allied Health Professionals ip ulty
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‘I enjoyed reading this book immensely. It is written in an easy to understand a g, Ch
style, has a logical progression and contains interesting 'real life' scenarios. Each n ian
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chapter encourages the reader to explore the background issues followed by d ma
useful information to assist in an understanding of the complexity surrounding P Pain i Univ
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pain and its effective management.’ ra rsity
Eileen Mann,Previously Nurse Consultant, Poole Hospital NHS Trust and c 5.6
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Lecturer, Bournemouth University, now retired. t .15
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This practical introductory text provides an accessible guide to pain and how it affects t [0
patients and care giving. It considers: o A Guide for 7/18
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● Different pain types including acute, chronic and palliative M Nurses and Allied Health Professionals ]. Co
● Assessing pain py
●● TCrheaaltlemnegnitn ga nsdit puhatairomnasc aonlodg dyi loefm pmaians control an right © M
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● Communicating with patients in pain a Gra
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● Ethical and legal aspects of treating pain gi -Hill G
The book also considers the experience of pain from the patients’ perspective, to help n lob
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health care students better understand the needs of patients who are in pain and how g l Ed
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they can improve the care they give. atio
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Case studies, tools for decision making, insights on patient experiences and reflective a oldin
exercises provide readers opportunities reflect upon their own practice and to develop i gs, L
problem-solving and critical thinking skills. n L
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Principles and Practice of Managing Painis ideal for students preparing to practice in a ot to
health care environment. P be
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Gareth Parsonsis a Senior Lecturer at the Faculty of Health, Sport and Science at the rson distribute
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University of Glamorgan, UK. He is the Award Leader for the BSc (Hons) Managing Pain & or m
degree and a member of the UK Pain Society and the Welsh Pain Society. P od
Wayne Preeceis Principal Lecturer (distance education development) at the Faculty of re ified
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Health, Sport and Science at the University of Glamorgan, UK. c an
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Contributor Maria Parry, Senior Lecturer Palliative Care, a
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University of Glamorgan, UK ith
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Gareth Parsons rm
Cover design Hybert Design (cid:129)www.hybertdesign.com issio
Wayne Preece n.
www.openup.co.uk
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Open University Press y
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McGraw-Hill Education a
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McGraw-Hill House lty
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Shoppenhangers Road f N
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Maidenhead rsin
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email: [email protected] rsity
world wide web: www.openup.co.uk 5.6
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and Two Penn Plaza, New York, NY 10121-2289, USA .8
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First published 2010 /16
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Copyright © Parsons and Preece 2010 yrig
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All rights reserved. Except for the quotation of short passages for the purpose of criticism and review, no part of this c
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publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, ra
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A catalogue record of this book is available from the British Library tio
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ISBN-13: 978-0-33-523599-5 (pb) ing
ISBN-10: 0335235999 (pb) s, L
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Typeset by RefineCatch Limited, Bungay, Suffolk istribu
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Printed in the UK by Bell & Bain Ltd, Glasgow d o
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Fictitious names of companies, products, people, characters and/or data that may be used herein (in case studies or in ifie
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examples) are not intended to represent any real individual, company, product or event. in
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For Ann, Becca, Tom, Rhodri and Mum lty
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For Sue, Aimee, Beth, Nia, Molly, Marc, James and Mam and Dad ian
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Praise for this book ed
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ªThe recent survey of undergraduate pain education in the UK for health professionals highlights the limited , C
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pain education that many receive and makes this a very timely and welcome text. The book is written by ian
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experienced pain educators and reflects their wide knowledge and understanding of the key issues in relation to a
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pain and its management which are addressed in the book. The use of a variety of reflective activities as well as n
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clear aims and summaries of the key learning points makes this an excellent resource for health care rsity
professionals aiming to become informed carers of those with pain.º 5
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Dr Nick Allcock, Associate Professor, University of Nottingham School of Nursing, .1
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Midwifery and Physiotherapy, UK .8
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ªI enjoyed reading this book immensely. It is written in an easy to understand style, has a logical progression 7/1
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and contains interesting `real life' scenarios. Each chapter encourages the reader to explore the background /16
issues followed by useful information to assist in an understanding of the complexity surrounding pain and its ]. C
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effective management.º yrig
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Eileen Mann, Previously Nurse Consultant, Poole Hospital NHS Trust and Lecturer, t ©
Bournemouth University, now retired. M
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Contents ed
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List of figures xi , C
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List of tables xii ian
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About the authors xiii a
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Acknowledgements xiv n
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Introduction xv rsity
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1. What is pain? 1 56
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Introduction 1 6] a
The importance of defining pain 2 t [0
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Classifications of pain 4 8
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Perspectives on pain 10 ]. C
Summary 17 op
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Reflective activity 17 righ
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References 17 M
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2. Dilemmas in pain management 19 raw
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Introduction 19 ill G
Principles 20 lo
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Moral and ethical principles 20 l E
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Effects of illness on moral behaviour 20 uc
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Morals and pain 22 tion
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Deontology 23 old
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Utilitarianism 25 g
Performing a moral calculus 25 s, LL
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Rights and duties 28 . N
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Bioethics 28 t to
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The best way to organize pain management 33 e re
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Considering the particular nature of pain in developing principles of managing pain 34 istrib
Summary 34 u
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Reflective activity 35 o
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References 35 o
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Further reading 36 ifie
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3. Communicating the experience of pain 37 y
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Introduction 37 ay
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Intrapersonal perspective of pain 38 ith
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Biopsychosocial model and communication 39 t p
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The intrapersonal nature of pain 40 rm
Detection and modulation 42 issio
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Cutaneous receptors 42
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Contents
Visceral receptors 43 D
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Inflammation and primary hyperalgesia 43 nlo
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Action potentials 43 de
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Sensory nerve communication 44 y
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The pain gate 44 a
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Ascending pathway 46 lty
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The brain 46 f N
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Differing pain experiences 48 rsin
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Interpersonal pain 52 , C
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Influences on pain responses 53 ian
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The pain experience 55 a
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Something lost in the translation 57 n
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Iatrogenic communication 57 rsity
Summary 58 5
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Reflective activity 58 .1
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References 59 .8
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4. Pain assessment 61 t [0
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Introduction 61 8
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Pain assessment 62 ]. C
Assessment as part of care planning 63 op
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Problems associated with pain assessment 63 righ
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The pain management process 64 M
Why assess acute pain? 68 cG
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Pain assessment tools 70 w-H
Pain assessment in children 73 ill G
The assessment of chronic pain 75 lob
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The character of pain 77 l E
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Psychosocial assessment 77 ca
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Functional assessment 78 n H
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Pain history assessment 78 ld
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Questionnaire methods 78 gs, L
Pain diaries and journals 81 LC
Chronic pain assessment in children 81 . No
Summary 82 t to b
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Reflective activity 82 re
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References 83 istrib
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Further reading 85 te
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5. The pharmacology of pain control 87 r m
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Introduction 87 ifie
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Mechanisms for drug action 88 in
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Choice of analgesia 88 y
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Drug effectiveness 89 ay
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Drug delivery 91 ith
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Routes of administration 93 t p
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Different routes 93 rm
Plasma concentration 95 issio
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Duration of action 96
viii
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