Patient-Centered Approaches to Pain Management - Essay Example

PATIENT-CENTERED APPROACHES TO PAIN MANAGEMENT College A large number of hospitalized persons suffer short-term or long-term pain. Prolonged pain could lead to disabilities (Temel, 2010). In this regard, nurses incorporate certain mechanisms of managing pain. Pain management is the use of medical, psychological and rehabilitation techniques on a patient to reduce or cope with pain and eventually aid the healing process (Brennan, 2007). Medical practitioners use certain pharmacological agents in pain management process. They incorporate comprehensive methods of patient care on patients of pain. Patient centered care takes into consideration differences in each patient during administration of pain management strategies. These differences vary in personal preferences in food and comfort. Patients require exclusive specialized attention (Gunningberg et al 2007). Patients are especially concerned with their health. Medical facility should ensure that the quality input to their service is high and appealing. Choice of food provided should reflect the concern of hospitalization (Chris et al 2004). Medical staff should ask questions of inquiry on the desired food and the level of comfort a patient receives. Nurses for example should constantly ask whether patients are comfortable and what they may have them do for those patients. They require Nurses and other medical practitioners in enhancing the quality of life and service, ensure that patient’s views are taken into account (Carinci, 2010). Patients should be treated with utmost respect and honor. Patients should also be informed fully on the actions to be to be taken regarding their health. They should be allowed to give consent concerning procedures to be carried out on them (Dihle et al 2006). Their contribution adds to the quality of service provided and should therefore be emphasized to avoid poor pain management. Patient centered care should address both physical and emotional needs along with other clinical aspects. Clinical facilities should make provisions for family and friends of the patient. This is useful in enhancing emotional relaxation on the patient’s part. Patients feel loved and cared for when their environment is rebuilt to suit their routine life structure. Patient care from family and family is useful in after discharge treatment. It allows for continuity of the treatment process to complete the healing process. This avoids situations where patients could fall back to anxiety and feel neglected after hospitalization. Clinical facilities ought to realize the importance of patients’ close counterparts in the end (Fondas, 1997). The role of clinical care is to provide assurance and confidence in patients’ health. Practitioners ensure they are available and within the reach of patients in the event that they are required. They enhance accessibility by providing emergency response systems like ambulance services and administration availability. Facilities should also prioritize emergency cases to attend to patients immediately without having to follow routine procedures. They ought to make life saving the only priority above other requirements during emergencies (Apfelbaum et al 2003). Facilities should be open and available around the clock for quality service. Clinical practitioners should as well avail themselves to personal attendances. This involves providing patient with care from their own home. Nurses for example and doctors ought to be available for such extensions as to treat patients from the comfort of their home. Medical and clinical faculty should further advise patients on treatment and requirements of equipment such as wheel chair and beds accordingly. They should extensively provide patients with information on their prognosis. Information should be provided adequately and honestly for decisions to be well informed. Person centered care goes as far as engaging other professionals like lawyers of the patient in his life process. Poor pain management is however rampant in institutions. It is challenged by lack of sufficient knowledge based on pain pathophysiology, appropriate dose titration, lack of enough comprehension on the utilization of multimodal treatment approach and fear of heinous effect to the patient (Munir, 2007).Consequently, healthcare providers need to develop competence and confidence needed to enhance the provision of quality care when managing patients with chronic pain. This facilitates integration of patient-centered pain alleviation approaches. Pain alleviation is not a non-aging concept. Despite the fact it’s only recently that different approaches have being developed to the management of pain as a symptom, pain has been treated constantly over ages (Chris & Chris 2004) In a clinical setting in Nigeria, on a male orthopedic ward there are about 43 patients and one nurse to care for about 3-4 patients with fractures. In this ward, the nurses deal with the prevention and treatment of orthopedic issues ranging from fractures or joint replacement which is more acute compared to the chronic ones such as osteosarcoma. Men are the dominant patients most of them from road traffic accidents (Nigeria Journal of orthopedics 2010). Procedures were mostly minor and intermediate. Accident and emergency beds were few. And the pain management process requires personalized care and treatment on patients. There is Pain assessment methodology in this setting (Aurbrun 2008). The first step is meeting the patient to recognize and quantify the issue; here the nurse is able to assess the intensity of the pain by conducting a brief pain inventory (B.P.I). This assessment was done once on the third day of admission. To the chronic cases strong opioids were given. For the acute cases weak opioids were instituted (Ogboli & Sule 2012). In government hospitals, there tends to be prevalence in under-treatment of pain. Despite the increased focus on patient-centered pain management programs coupled with the new standard for pain assessment, pain management is still a big concern for the patients (Nigeria journal of orthopedics). In the same vein, patient-centered pain-management constitutes a healthcare issue that mandates the knowledge on proper prescription and administration of drugs, assessing and reassessing pain coupled with a broad understanding of cultural and ethnic responses to pain and patient centered management. (Bracci,1993). Developments are however hindered by the inadequacy of resources and scarcity of training programs to address these requirments In the B.P.I assessment, severe pain recorded among surgery patients with a scale of over six. With an overwhelming number of patients, communications with the patient may be hampered by noise. Teamwork coordination is especially difficult from delayed surgeries due number. Unfortunately, elective surgery id the main cause for admission (Idvall 2009). Nurse-patient rotation allows pharmacological relief when it is required. Other strategies include physiotherapy, stimulation techniques, nerve blocks and psychological techniques (Hill, 2007). The drugs used were analgesics and opioids (mainly used for treatment of chronic pain) (Barret, 1986). To keep up with adequate monitoring of pain management, medical staff should determine levels of pain at least every morning, afternoon and evening (Dunn, 2010) Proper daily routines should be developed while establishing follow up assessments. Pain should be regularly treated by administering analgesics. It is also advisable to enlighten patients on the type of pain treatment to be received after surgery. The healthcare staff should also ensure that the patients get a comfortable position in bed to avoid any more pain (Layman, 2006). Other pain management techniques include peace and quiet in the room where the patient can have a good rest. Calmness aids in avoiding respiratory depression. To determine pain, assessment of patients’ movements and breathing process is useful. Assessment instruments aid in determining pain intensity (Brown, 2005). Acute pain management services (APMS) involve pain teams which make ready procedures, information and guidelines for workflow while enhancing patient knowledge in pain management. Standardized protocol for pain assessment should be employed throughout the medical facility. This ensures a streamlined flow of pain management and enhances communication (Eloise, 1997). Patients react differently to pain management. In a survey carried out, some adult patients refuse any pain alleviation method with the belief that pain should be tolerated. Others turn treatment down because from fear of side effects and prescribed addiction (Carr, 1997). High pain intensity and other dysfunctions could be indication of patient’s hesitation to report mild to moderate intensity pain( Kitchen, 2007). Opioids are especially used to treat non-malignant chronic pain. They have been reported to induce constipation. Opioid-induced constipation (OIC) is a side effect. Respondents with OIC reported significantly great overall activity impairment (Gordon et al 2002). These findings have created a reluctance to prescribe opioids. Research has shown that addiction, misuse, overuse, abuse and dependence have been related to Opioid use (Plowman, 1987). In person centered treatment care, facilities should outline clearly the prescriptions made on patients health ad aid them with contact information for further question after discharge (Giulani, 2002). Pain is subjective to patient’s personal experience and should therefore be addressed from the patient’s angle. Some patients assert that their pain is not assessed frequently enough and that they do not receive painkillers enough and a sizeable percentage feel that the analgesics administered do not help (Carina, 2010). Physicians focus on an objective assessment by using patient’s medical history and physical examination along with laboratory testing (Kehlet, 2004). Where relative strengths of the sensory components are known, pain alleviation medications can be tailored more accurately (Bracci, 1993). Patient-centered pain management entails guidelines aligned with patients’ needs. Pain management tactics may vary with patients. Patient centered approaches take in to consideration the age, sex, weight, personality of the patient coupled with information of any previous procedures. In addition medical professionals should consider the patient’s word when assessing pain rather than make assumptions of the situation. Patients should be substantially involved in the treatment procedure (Miller, 1976). Furthermore, medical professionals need to interpret non-verbal signals such as expressing agony through facial expressions. Cognitive tactic as this improves on the quality of patient-centered care (Oberle, 2009). To change and improve attitude of the healthcare providers towards patient-centeredness, further training in precaution during pain management is essential. Caution during administration of analgesic and addressing side effects is useful in patients’ level of satisfaction (McIntyre, 2007).Patients ability to understand treatment procedures and ascribe to treatment is aided by the quality provided by medical staff (Richard, 2000). Staff should have a positive attitude. They should reflect responsiveness and care in order to build stronger relationships with their patients (Franck, 2004). Overall cooperation from staff eases patient’s feelings of anxiety and helplessness (Colvin, 1991). Nurses should encourage the patients to ask questions and constantly assure them in order to benefit the care given and effective postoperative pain management. In this case, a combination of pharmacological and non-pharmacological methods of pain control probably yields the most effective pain relief for the patient (Idvall, 2005). Patient centered care also involves providing an emotional environment that is conducive to a caring and compassionate experience. A significant contribution to pain control is making the environment more cordial so as to maximize privacy and comfort from beginning to completion; this can be enhanced by the colors in the room, the lighting and cleanliness of the environment (Gargani, 2012). These help reduce the psychological responses to the illness like depression and anxiety (White, 2010). According to research, the most commonly guided patient centered methods are distraction, positive reinforcement, using non-invasive treatment procedures for pain, comforting, reassurance, positioning while still giving back-pain relief treatments and relaxation. Patients can be guided through breathing exercises, stretching so as to reduce discomfort (Karla, 2008). Consistent communication is essential. Statistics show that lack of communication can be palpably felt and may increase patient’s anxiety and vulnerability. Nurse’s background factors including age, nursing position, education, professional work experience, and experiences of earlier hospitalizations of other similar cases, significantly relate to their perceptions on performing non-pharmacological practices (Richards, 2000). Five promoting factors were nurse’s competence, versatile use of pain alleviation methods, patient’s age, patient’s ability to cooperate and the patient’s participation. There are however downsizing factors that hinder this. These factors include nurse’s workload, beliefs pertaining alleviation methods, a patient’s ability to express pain, limited use of pain alleviation methods and also patient turnover rate; all this influences the nurse’s use of pain alleviation methods. Another downsizing factor is reluctance among patients to report pain. Reluctance to reporting pain is a significant hindrance to pain control (Brown, 2005). For elderly patients, NRS is the most reliable method for pain assessment where patients do not suffer cognitive impairment. On the other hand, situations of communication problems adopt observations as basis for assessment to determine the severity of pain. This takes in to account physical behavior like difficulty in motion, restlessness, and tense muscles, groaning and grimacing. As far as gastric and renal effects are concerned elderly people are at greater risks. In this case titration is very vital in pain management (Moxham & Sokhumi, 2002). Non pharmacological methods used for pain can be applied by family on patients. Statistics show that most commonly used methods are emotional support strategies, helping with daily activities, distraction and imagery. Distraction is especially helpful before operations(Colvin, 2012). Care provided at my clinic can be more patient centered when preparations are made for the optimal exchange between my patient and by giving him/her full attention. Nurses should enhance an environment that helps the patient feel free to ask anything. By asking what they would wish to be addressed and sharing information about themselves all this in order to facilitate a smooth interaction and eventually quality treatment (Katz & Green, 1992). Pain relief is one of the most vital roles of health professionals. Pain that is ineffectively treated may impose physiological, social, economic and psychological effects and further place a york on the family and society of patients (Marmion & Auburn, 2007). In conclusion, post-operative pain helps improve the quality of life that of patients. Studies however still mirror inconsistency in patient centered pain management (Apfelbaun, 2003). Patient’s pain relief in hospitals is affected largely by personal characteristics of the nurse than the work related factors or the patient’s behavior. Person centered patient is therefore a matter of sensitivity. Advancement in pharmacological treatment has all in all advanced treatment by improvements in medication for pain conditions as they arise (Carr et al 1997). With these insights, physicians can prescribe drugs to treat moderate to severe pain in many angles of innovative drugs and pain management procedure. It must be regarded as unethical to let patients suffer from pain without making adequate efforts to facilitate high quality treatment. This asserts nurses awareness in that pain management as helpful. It is in little things that nurses and other persons surrounding patients do that greatly impact patient’s experience (Barret, 1986). If careful attention and honest efforts are directed towards pain management, it would be within the scope of medical facility to create provision of quality pain treatment. During medical training given to medical professionals ought to focus on proper assessment of pain. Medical experience should ensure further that side effects are well managed. Pain management should also focus on use of adjuvant medications (Gargani, 2012). A sizable population is impacted by pain. Pain is complex and hence the treatment options vary but after obtaining an objective and concise pain evaluation, treatment can be achieved. This is however dependent on the medical professional’s patient centered care. Quality pain relief improves conditions of health during treatment of other ailments. 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