This can influence a positive pain management outcome. A health care professional's empathic understanding of the patient's pain experience and accompanying symptoms confirms that there is genuine interest in the patient as a person. This means listening empathically, believing and legitimizing the patient's pain, and understanding, to the best of his or her capability, what the patient may be experiencing. However, the quality and utility of any assessment tool is only as good as the clinician's ability to thoroughly focus on the patient. JCAHO surveyors routinely inquire about pain assessment and management practices and quality assurance activitiesin both inpatient and outpatient care areas.Īssessment of the patient experiencing pain is the cornerstone to optimal pain management. The development of practice guidelines and standards reflects the national trend in health care to assess quality of care in high-incidence patients by moni-toring selected patient outcomes, as well as the assessment and management of pain.
Recognition of the widespread inadequacy of pain management has prompted efforts to correct the problems by a wide variety of organizations, including the Agency for Health Care Policy and Research, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the American Pain Soci-ety, and the Oncology Nursing Society. Additionally, clinicians' personal belief systems, attitudes, and fears can directly influence the manner in which they and their patients respond to the varied dimensions ofpain management. Studies have found that two of the chief barriers for health care professionals are poor pain assessment and lack of knowledge about pain ( 15, 16). Yet reports documenting the inability of health care professionals to use this information continue to appear in the literature. Suboptimal pain management is not the result of lack of scientific information, considering the explosion of research on pain assessment and treatment. It has been estimated that 9% of the US adult population suffers from moderate to severe chronic nonmalignant pain ( 14).ĭespite the existence of evidence-based guidelines, acute pain is not adequately addressed by health care professionals ( 15). The Mayday Fund survey noted that pain is a part of life for many Americans, with 46% of respondents reporting pain at some time in their lives ( 13). Pain in persons with cancer also remains a significant problem, with studies suggesting that as many as 30% to 40% of cancer patients at diagnosis and 70% to 80% of cancer patients undergoing therapy or in the end stages of life have unrelieved pain ( 7– 12). In the USA, 23.3 million surgical procedures are performed each year, and most, if not all, result in some form of pain ( 3– 6). Chronic pain can also accompany an injury that has not resolved over time, such as reflex sympathetic dystrophy, low back pain, or phantom limb pain. It accompanies disease processes such as cancer, HIV/AIDS, arthritis, fibromyalgia, and diabetes. Chronic pain, in contrast, worsens and intensifies over time and persists for months, years, or a lifetime. Acute pain serves as a warning that something is wrong. Acute pain usually lasts hours, days, or weeks and is associated with tissue damage, inflammation, a surgical procedure, or a brief disease process. Pain is commonly categorized along a continuum of duration. Clinically, pain is whatever the person says he or she is experiencing whenever he or she says it occurs ( 2). 321–323 as well.Īccording to the International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience arising from actual or potential tissue damage ( 1). The quiz, evaluation form, and certification appear on pp. This page also provides important information on method of physician participation, estimated time to complete the educational activity, medium used for instruction, date of release, and expiration. She is co–principal investigator of a National Institutes of Health grant on palliative care and is on the speakers bureaus of Purdue Pharmaceuticals, Anestra Corporation, and Roxane Laboratories.īefore beginning this activity, please read the instructions for CME on p.
Fink has held positions as oncology and pain clinical nurse specialist. Regina Fink, RN, PhD, AOCN, is a research nurse scientist at the University of Colorado Hospital in Denver.
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