Comfort Flashcards
What is Comfort?
•The immediate state of being strengthened by having the needs of relief, ease, and transcendence addressed in the four contexts of holistic human experience: physical, psychospiritual, sociocultural, and Environmental”
Defined by Katharine Kolcaba’s Comfort Theory
•Sources of discomfort
•Physical
•Emotional
•Psychospiritual
•Sociocultural
•Environmental
Health Promotion
Teaching patient lifestyle changes to decrease pain, depression, fatigue
•Sleep hygiene, psychosocial well-being, relaxation therapy
•Personal preferences
•Lifestyle habits
•Nutrition
•Smoking, alcohol use, illicit drug use
•Occupation
Assessment
Subjective: Symptoms patient is experiencing
Current problem
•Patient complaints related to discomfort
•Pain scale
•Duration, activities of daily living (ADLs), sleep, motivation
•Focus on onset, cause, length, relieving factors, factors that create more discomfort
•Patient history
•Lifestyle, occupation
Assessment
Objective: What you SEE
Physical examination
•Obvious signs of discomfort
•Guided by age, ethnicity, severity of discomfort
•Observation of posturing, gait, grimaces, verbal complaints, guarding
•Diagnostic tests for underlying cause
•X-ray
•Blood tests
What is Pain?
•International Association for the study of pain: An unpleasant sensory or emotional experience associated with tactual or potential tissue damage or described in term of such damage.
Etiology of Pain
Nociceptive pain
•Results from external stimuli on uninjured, fully functional nervous system
•Often magnified when neuropathic pain
•Neuropathic pain
•Caused by nerve malfunction or injuries resulting from trauma, disease, chemicals, infections, and tumors
Types of Pain:
Acute
Sudden onset – surgery, inflammation or traumatic injury
•Identifiable tissue injury
•Short duration (few minutes to 6 months)
•Initiates typical autonomic responses
•Increased heart rate, blood pressure, pallor and anxiety
•Three categories
•Somatic
•Visceral
•Referred pain
Types of Pain:
Chronic
•Prolonged pain (>6 months)
•Not always a known cause
•Ranges from mild to severe
•Autonomic responses decrease over time
•Three categories
•Chronic recurrent
•Chronic intractable benign
•Chronic progressive
Types of Pain:
Central pain
Caused by damage to nerves in central nervous system (CNS) due to stroke, multiple sclerosis (MS), Parkinson disease, or trauma
•May occur immediately or be delayed
•Constant pain along with pain paroxysms, evoked pain, or allodynia
•Described as burning, pins and needles, aching, or lacerating
Types of Pain:
Breakthrough pain
Transient exacerbation of pain that occurs spontaneously or in relation to a specific predictable or unpredictable trigger
•Three types
•Incident
•Idiopathic
•End-of-dose medication failure
Types of Pain:
Phantom pain
•Pain felt in amputated limb or body part
•Usually recurring versus constant
•Described as shooting, stabbing, squeezing, throbbing, or burning
•Associated with neurological activity in portions of brain once connected to amputated body part
Pathophysiology and Etiology: Risk Factors
Internal and external environment factors can make patients more susceptible to pain
•Include age, gender, genetic factors
•Barriers that prevent adequate pain relief
•Barriers from perspective of patient, family
•Barriers from perspective of healthcare providers
•Barriers from perspective of healthcare infrastructure
Prevention
•Safety precautions
•Healthy lifestyle
•Adequate pain relief
•Compliance with pain medication regimen
Culture Influences and Personal Beliefs
•Cultural and ethnic influences
•The meaning of pain
•Environmental and social support
•Previous experience with pain
