Palliative unit 1 Flashcards
Pain
an unpleasant sensory and emotional experience associated with actual and potential tissue damage, or
described in terms of such damage. It is always subjective
Dimensions of total pain
- Spiritual
- Physical
- Psychological
- Social
Physical
“Traditional
pain
Impaired
mobility
Require
analgesia
Other
physical
symptoms
Assessment for physical
Pain history (acronym SOCRATES SMM):
* Site
* Onset
* Characteristics (e.g. aching, sharp, pulling)
* Radiation – where the pain moves to
* Associated factors (e.g. systemic symptoms)
* Time – duration
* Exacerbating and relieving factors (e.g. medications,
movement, rest)
* Severity
Sleep/Function:
Mood
Meaning
Causes of pain
Nociceptive: Pain from tissue injury
Neuropathic: Pain from nerve injury
Nociceptive: Pain from tissue injury
Somatic
(e.g. tumour invasion of bone, joint, muscle or connective tissue)
Visceral
(e.g. bowel obstruction, liver infiltration or compression of vital organs)
Neuropathic: Pain from nerve injury
Peripheral
(e.g. tumour compression of peripheral nerves)
Central
(e.g. multiple sclerosis, stroke)
Description of nociceptive pain
Lacerating
Stinging
Heavy
Suffocating
Description of neuropathic pain
Numbness/Pins and needles
Burning
Aching
Throbbing
Pulling
Psychological
Anxiety/fear of worsening pain
Equating “pain” with “dying”
Equating pain relief (especially Morphine) with dying
Sense of inevitability of future severe pain
Reminder of ill health/limitation/sick role
Anger, despair and hopelessness
Social
Loss of role as earner, practical
person, or carer for another
person
Restricted social activities and
contacts
Understanding the patient’s
situation in his/her environment.
Interpersonal relationship and
family system, environment,
cultural context and social
system.
Spiritual
Loss of sense of purpose
- Loss of role(s) and identity
- Change of expected life
narrative or journey - Feeling of being punished
- Altered relationship
with/feelings about a “higher
authority” in whatever form
