The Integration of Psychology in Pain Diagnosis and Treatment - Research Paper Example

? It is fundamental for patients, clinicians to understand the role of psychology in the assessment and treatment of pain otherwise, pain diagnosis, and treatment does not meet optimum results. Successful pain management can be achieved by addressing pain management from a biopsychosocial point view, which integrates multifaceted nature of pain. In fact, pain is addressed forma broader view as a complex experience materializing from a self-motivated interplay of a patient’s sociocultural influences, thoughts, behaviors, emotions and physiological state. In this paper I will expound on the integration of psychology in pain diagnosis and treatment through application of comprehensive pain management models in modern health approaches (Hamric, Sprouse, & Hanson 94). In the past when pain was entirely addressed from a biomedical perspective, the realm of psychology was not considered key in pain management. This model was inefficient in situations whereby a patient complained of pain that was beyond diagnosis through observable pathology. In fact, clinical observations are indicative of the shortcomings of the biomedical model in diagnosis and prediction of chronic pain. This “disconnect” is universal in cases of chronic pain conditions such as headache, back pain, headache and fibromyalgia. Consequently, it became known that there are other considerable factors, which heavily contribute to the pain experience as well as the outcome of treatment. In this scenario, the likely causes were social and psychological factors. The developments in comprehensive pain models being incorporated in a biopsychosocial approach has advanced over the decades. However, it is noteworthy that in recent times, more efficient models have been implemented to integrate multiple dimensions of pain management acknowledging the numerous factors that contribute to pain experience such as cognitions, beliefs, sociocultural variables, learning, emotional reactivity and personality that influence a patient’s perception of pain (Patricia, Benner, Victoria, Leonard & Molly Sutphen 124).. In essence, modern comprehensive pain management models are characterized of three dissimilar, but interrelated dimensions: 1. Discriminative/sensory, which recognizes the essential physical pathology and integrates nervous system pathways 2. Affective-emotional dimension that depicts emotional responses to pain 3. Cognitive evaluative dimension that addresses individual beliefs and attributes implication of pain experience Thus, treatment based on such biopsychocosocial angles not only address the biological basis of symptoms, but also incorporates the entire range of social and psychological factors, which affect a patient’s pain, disability and distress. Essentially, the role of psychology in pain management partially depends on the degree of a patient’s acceptance, adherence and commitment to a strictly biopsychosocial approach in pain management and conceptualization. Clearly, the psychologist an play a substantial role in working with clinician to assess, identify, examine and treat non-physiological aspects that contribute to a patient’s pain complaints. Therefore, pain treatment and management should involve cooperation between clinicians and psychologist. In addition, psychologists should not only be consulted in extreme cases where there role in treatment is viewed as “a last result” but also in the early stage of pain diagnosis. To emphasize the significance and role of psychology in pain management, I took keen interest in CNS competencies. Patients with cardiac problems can be treated either with a help of drug therapy, regular outpatient consultations, day-care, hospital admissions, pacemaker insertions, or, in extreme cases, both minor and major surgeries are used (Bethann, 2008). In most cases the cardiac field, ailments impose burdens to the family and society of the affected patients. The costs of managing and treating such diseases as well as the inability of such people to do all activities by themselves contribute to big sacrifices from the families of those affected hence psychological stress (Bethann, 128). In my research I found out that clinical experiences and collaboration in the cardiac field are dependent on skilful leadership for effective care giving since ethical conduct, and other professional peculiarities are observed. Leadership is demonstrated through initiation of consultation during, which I was able to gain and use consultation skills. Clinicians collaborate with fellow staff during treatment especially when sharing information. The main of exploring core competencies of CNS, demonstrates how biomedical models are inferior to compressive psychosocial models of pain diagnosis and management (Benner, Tanner & Chelsea 133). One of the CNS competencies developed is direct care competency where clinicians interact directly with patients suffering from cardiac problems and their families. In those situations, clinicians use various methods of developing the competency. First, most clinicians use advanced skills to communicate with the patients. These are skills within therapeutic relationships. Since most patients have multiple pain complaints, the application of advanced nursing therapies and schemes are performed. Through use of the signs and symptoms evident in every cardiac problem, different diagnostic procedures for each condition are noticeable. All these are based on direct clinical practice and professional ethical decisions. Thus, diagnosis and treatment of cardiac ailments are solely based on biomedical models that do not integrate psychological aspect of pain (Gautam & Bilal 78). Before diagnosing patients, clinicians study information about the disease and factors related to the disease. In this way they formulate plans of appropriate care that should be given to such patients (Bennet, et. al 119). Assessments are conducted using techniques that had previously been tested and have evidence of success. These practices not only helped me develop competency, but also allowed me to fulfill my goal of developing proper management strategies for cardiac patients. Evaluation of the effectiveness of addressing the above competency is done in three ways. First, clinical assessment is done by evaluating patient’s health condition. I would conclude that clinicians achieve biomedical success, but fail on the psychological treatment that pain impacts on cardiac problem patients. Although, in this case most of patients’ wellbeing improve, but they still suffer from psychological consequences of pain. Secondly, an evaluation of the treated patients indicate that their biological cardiac problems are solved, but their psychological suffering from pain goes unsolved hence it is absolutely necessary for a psychologist to be involved in this kind of treatment to encompass al dimension of pain in the treatment. The second CNS competency that I addressed is consultation competency. Here, I was expected to use interaction between patients and nurse staff in order to help my patient overcome his or her problem. While dealing with this issue, I initiated consultations. I ensured that all consultation information was passed to the necessary personnel. I also used records of previous and current consultations for the purpose of developing knowledge and making improvements. In CNS competencies, it is apparent that there is laudable achievement in collaboration competency (Thompson & Cathy, 2011). This is achieved in cooperation with caregivers and the entire fraternity in the treatment procedure: the patient, family, community and staff. In as much as I was interested in the treatment of cardiac disorders, I researched other aspects of pain management in this field that would incorporate psychology and upholds it role in pain perception since the clinician also discern pain differently depending on the value they assume psychology has in pain diagnosis and treatment. With consideration of such factors help of such collaborations I was also able to form a team the main aim of which was to improve the efficiency of the whole system. As stated above, this competency was developed using help of others mainly because in some cases assembling all the teams at the same time was almost impossible. The time I had to do my research was not enough for the full development of the competency. One of the factors affecting accuracy of information is the number of people who helped further develop my ability to facilitate communication among different departments. To demonstrate how the role psychology in treatment is downplayed, I incorporate reports by clinicians on scheduled practicum. For instance, below is a practical example of the care giving scenario by clinician on practicum. “Systems leadership competency was also addressed since I was able to use the knowledge I gained to empower others. This competency was not fully developed. However, I was able to perform assessments of the environment surroundings the patient, population age, the quality of health care delivery system and different practices used by the staff. I was also able to evaluate how these practices affect patients. Research and analysis of available data enabled me to determine the methods that had positive effects to the family and the patient. With the help of other staff members and available community, I was able to evaluate the impact of cardiovascular nursing system on both the patient and nurse. Being a nurse, I was able to use the knowledge I had gained to specify outcomes that could be expected. The challenging part of addressing this competency was when I was required to implement a system that would have a positive effect on patients and their families. During my practicum my proposal for using an interdisciplinary approach to achieve better results had to be reviewed by several people for approval. It was also difficult for me to come up with age- specific procedures for diagnosing patients with cardiac disorders. I was unable to obtain information about budgets and thus I had difficulties in making suggestions for system changes. To some extent, this competency was poorly accomplished due to inability to access information relating to budget. Coaching competency was part of the CNS competencies I was expected to show. To address this competency, I used my knowledge as a CNS nurse in advising families about the care of patients with cardiac problems. I was also in a position to use the knowledge I had gained to modify treatment strategies for patients with cardiac problems. After the realization that most of my patients and families were not well informed about their condition, I developed an educational program for the relevant people with cardiac disorders. In order to facilitate learning I also developed a program for students interested in cardiac nursing. In the future, I have plans of becoming a mentor for those interested in my field in order to fully accomplish this competency. As mentioned above, one of the clinical experiences was in ethical decision-making. This is a competency whereby I was expected to take action on ethical issues affecting the patient, system, family, health care provider, community, and family. This competency was accomplished by explaining to the patient and family members about their condition, how it can be managed, and the effects of each management system. Through collaboration with various councilors I was able to create a climate that allowed the provision of ethical care. I asked my peers and staff for evaluation by encouraging them to provide me with information on how I could improve myself. I can say that this competency was achieved due to what I was able to do during my practicum. The other competency is research competency where I was expected to do systematic inquiry and use evidence-based methods and strategies in my everyday work. The first step to develop this competency was to apply the practices and products that are evidenced to have positive effects on the patient. I was also able to come up with a program that could improve the system. Finally, I did some reading and any new information that I obtained was critically evaluated. The last thing I accomplished in this competency was the identification of a problematic area in which I plan to carry out further research. There is still a lot of work to be done in accomplishing this competency. I spent few weeks doing my practicum and some of the CNS competencies were not developed. Inefficient amount of time also made it difficult to achieve some of my goals. However, having enough time during my continued practicum, I intend to fulfill all my goals and develop all the competencies fully. My plan involves consulting advanced nurses about the practice. This will help me to better understand what is required of me in that field. With the information and experience I have gained from my practicum so far I will approach my patients more confidently. This will enable me to communicate more effectively with them. I realized that I was not able to do an extensive research during my practicum so this will also be a part of the future extended practicum. The research will be based on analysis of available data, use of evidence, analysis of the system and health personnel (Thompson & Nelson-Marten 234). I will identify an area of inquiry, use relevant tools to collect data while considering ethical principles in the process. Not only will this enable me to develop all CNS competencies, but will also help to achieve the goal of devising appropriate management strategies. One of my goals is to gain exhaustive knowledge on Acute Coronary Syndrome and this can only be accomplished through research. At this point, I would like to point out that my main plan is to accomplish my professional goals”. Conclusively, the role of psychology in treatment and management can only be achieved by incorporating comprehensive psychosocial treatment models. Works Cited Benner. P, Tanner, C & Chelsea, C. Expertise in Nursing Practice: Caring, Clinical Judgment and Ethics (2nd Ed). New York: Springer(2009). ISBN 978-0826125453. print Bethann, S. The Student Nurse Handbook E-Book. New York: Elsevier Health Sciences(2008). ISBN-9780702047916. print Gautam, M. & Bilal I.. Clinical Medicine for the MRCP PACES. Core Clinical Skills, Volume 1. New York: Oxford University Press. (2010). print Hamric. A, Sprouse, L & Hanson, C Advanced Nursing Practice: An Integrative Approach (4th Ed). Philadelphia: W.B. Saunders. (2009). ISBN: 978-4160-4392-8. print Patricia. E, Benner, Victoria, Leonard. & Molly Sutphen. Educating Nurses: A Call for Radical Transformation. New York: John Wiley and Sons. (2010) print Thompson, C. & Nelson-Marten, P.Clinical Nurse Specialist Education: Actualizing the Systems Leadership Competency. Journal of Advanced Nursing Practice, 25(3),133-139. . (2011). Read More