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Findings showed that medication was the most common treatment, followed by physiotherapy and no treatment. The majority preferred physiotherapy and no surgery was the third most popular choice. Their preferences and choices evolved from previous experience. They did not perceive their pain as severe enough to require surgery. (Mitchell & Hurley).
A revised regimen for Sid consists of 10 parts. These are a record of his general medical history for a total and comprehensive picture; the use of the four assessment tools mentioned earlier in this paper; his complete and updated pain history; instruction on chronic pain, opioids and opiate therapy; information about non-pharmacological treatment options for chronic pain; continuation of interrupted physiotherapy treatment sessions; conduct of training on self-management and pain control; warning about the risks of smoking; counseling on depression; matching preferences with evidence-based guidelines recommended for chronic pain; and hiring caregivers for himself and his wife.
General Medical History
This may reveal prior conditions, which may have led to chronic pain and thus underlies or contributes to it. It also provides a total picture on which to base a comprehensive approach to treatment.
Pain Assessment Tools - These include the Brief Pain Inventory, the McGill Pain Questionnaire and the Short-form McGill Pain Questionnaire, the Massachusetts General Hospital Pain Center's Pain Assessment form, and Neuropathic Screening Tools, as discussed in an earlier part of this paper.
Pain History - This should identify the location of the pain, its intensity, description,, the temporal aspects and possible patho-physiological and etiological features of the pain. Other information includes what relieves or aggravates it, its effects on daily physical and social functions, pain treatments and their positive or negative effects, feelings of depression, worry over pain condition and overall health and possible involvement in litigation or compensation process (Brevik et al., 2008).
Information Intervention - Chronic osteoarthritic pain is a nociceptive musculo-skeletal pain with a more predictable than neuropathic pain (Benedict, 2008). It is often treated with non-steroidal anti-inflammatory drugs or NSAIDs until healing occurs and the pain disappears. Most healthcare providers prescribe opiates for this pain. The 10 universal precautions on pain medicine and the Share-the-Risk Model address the controversies concerning the mis-use and abuse of opioids.
Non-Pharmacological Treatment Options - These are physiotherapy or physical therapy, hydrotherapy, homeopathic remedies, Chronic Behavior Therapy or CBT, transcutaneous electrical nerve stimulation or TENS, alternative medicine, self-management of pain and psychological interventions. Homeopathic remedies include herbs. CBT includes biofeedback and relaxation strategies. Alternative medicine includes acupuncture, acupressure, reflexology and magnetic healing. Self-management of pain includes exercise, wearing appropriate and comfortable footwear, and weight control. Psychological interventions process one's perception of pain and change behavior towards it through relapse prevention techniques (Kroner-Herwig, 2009)These techniques have been reported to achieve long-term positive results (Kroner-Herwig).
Adherence to Evidence-Based Guidelines - Chronic pain patient treatment preferences have been found to mis-match these guidelines because of lack of resources and time pressure (Mitchell & Hurley, 2008). These recommend verbal and written information, self-management, physiotherapy and simple analgesics as first-line approach. These may be supplemented by opioids and NSAIDs if needed as second-line therapy. Surgery is resorted to only when these conservative treatments fail (Mitchell & Hurley).
Sid will resume physiotherapy sessions with a new schedule and program. He will be warned about the risks of smoking on his and his wife's overall health. They will receive counseling on depression. Caregivers and a live-out housekeeper will be assigned to help him in the care of his wife and of the house chores. #
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102). Christensen, a., & Jacobsen, N.S. (1996). Studying the effectiveness of psychotherapy: How well can clinical trials do the job? American Psychologist, 51(10), 1032. Authors emphasized that pain sufferers should not limit themselves to one approach, but should rather seek to identify a broad range of therapies that may result in appreciable gains for the healthcare consumer. Craig, K.D., & Hadjistavropoulos, T. (Eds.). Pain: Psychological perspectives. Mahwah, NJ: Lawrence Erlbaum Associates, 2004. Authors
Pain is the most famous member of bodily feelings including orgasms, tickles, itches and tingles among others. These feelings are normally attributed to the locations of the body and seem to have several features like duration, intensity and volume which are attributed to quantities or physical objects. For most patients seeking for clinical help, pain is often the most common problem and the most common nursing diagnosis. Generally, pain can
Perception of Pain Uses of Pain in nursing Definitions of Pain from Dictionaries Uses of Pain in psychology Defining attributes Model case Related Case Contrary Case Antecedents and Consequences CONCEPT ANALYSIS OF PERCEPTION OF PAIN The aim of this paper is to increase the understanding of the perception of pain. The researcher purpose to clarify describe the characteristics of pain and recognize antecedents that effect the idea of pain and the likely outcomes of pain by utilizing Avant's and
8). A number of alternative treatment modalities have been used in an effort to avoid these adverse side effects, including various mind-body and therapeutical techniques that may prove efficacious in some orthopedic patients, but many healthcare providers remain unaware or untrained in their use (Lukas, 2004). For instance, one orthopedic nurse reports that, "In today's fast-paced surgical environment, perioperative nurses face many challenges to meet the needs of outpatients
" (Giovacchini, 1996, pg. 2) According to Giovachinni research into the psychodynamics of individuals in their experience of current adjustments and symptom formation is "much more interesting and fulfilling than monitoring surface behavior. processes are innately fascinating and their study creates dimensions and viewpoints that expand our appreciation of the versatility of the psyche as our in-depth understanding is increased, in itself, an aesthetic experience." (Giovacchini, 1996, pg. 2) Unconscious motivation
On the other hand a diet that is high in fruit and vegetable intake has also been found to increase the absorption of antioxidants and vitamins that help to manage the symptoms of this disease. Pineapples have been found to be effective in the control of inflammation in arthritis, as they contain bromelain enzymes. ".... bromelain enzymes block the prostaglandins that play a part in swelling. These enzymes have
Nurses can frame a personalized clinical plan accordingly. The plan can empower the patient as well as his nurse. By using a family-centered model approach, the nurse can collaborate closely with the patient's family, who knows his temperament better (Ranger & Campbell-Yeo). Clinical Case 1: Sciatica Mrs. J. K, aged 42, has had stiffness and aching in the lumbar region when rising or sitting down for six now (Boger 1994). Her