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 (6)
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 (4)
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 (5)
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
