Today our topic of discussion is Principles of Assessment and Management
Principles of Assessment and Management
Principles of Pain Assessment and Management
- Patients have the right to appropriate assessment and management of pain (JCAHO Standard). Pain (should be) is assessed in all patients.
- Pain is always subjective. Therefore, the patient’s self report of pain is the single most reliable indicator of pain. A clinician needs to accept and respect this self- report, absent clear reasons for doubt.
- Physiological and behavioral (objective) signs of pain (e.g. tachycardia, grimacing) are neither sensitive nor specific for pain. Such observations should not replace patient self-report unless the patient is unable to communicate.
- Assessment approaches, including tools, must be appropriate for the patient population. Special considerations are needed for patients with difficulty communicating. Family members should be included in the assessment process, when possible.
- Pain can exist even when no physical cause can be found. Thus, pain without an identifiable cause should not be routinely attributed to psychological causes. Different patients experience different levels of pain in response to comparable stimuli. That is, a uniform pain threshold does not exist.
- Pain tolerance varies among and within individuals depending on factors including heredity, energy level, coping skills, and prior experiences with pain.
- Patients with chronic pain may be more sensitive to pain and other stimuli. Unrelieved pain has adverse physical and psychological consequences. Therefore, clinicians should encourage the reporting of pain by patients who are reluctant to discuss pain, deny pain when it is likely present, or fail to follow through on prescribed treatments (JCAHO standard).
- Pain is an unpleasant sensory and emotional experience, so assessment should address physical and psychological aspects of pain.
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