This chapter aims to provide you with the knowledge to be able to take an evidence-based approach to the nursing management of people who are experiencing pain. As a practising nurse, pain will be something that many of your patients will experience; however, one individual’s pain may be very different from another person’s. Pain can vary depending on the circumstances in which it is experienced and the individual characteristics of the person experiencing it. Understanding someone’s pain experience is therefore challenging because you cannot see someone’s pain or easily judge how bad it is, what it feels like, or how it affects him or her. This chapter provides you with knowledge and skills to recognize, assess, and manage the patient’s experience of pain effectively with evidence-based strategies. The variability of the experience of pain makes defining pain difficult. Pain is something that we have all experienced at some point in our lives and therefore, through these experiences, we have developed an understanding of what we consider to be pain. One of the most widely accepted definitions is that of the International Association for the Study of Pain (IASP), which defines pain as:…An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (Merskey and Bogduk,1994)…Although this definition is often quoted, the difficulty in defining pain is illustrated by the fact that the IASP added a note (go to http://www.iasp-pain.org/ and search for ‘pain definitions’) to highlight the individual nature of pain and the fact that pain is a sensory experience with an emotional component. The individual nature of pain is also highlighted by another commonly used definition:…Pain is whatever the experiencing person says it is and happens whenever he/she says it does. (McCaffery, 1972)…This definition highlights the fact that pain is an individual experience and that measuring pain objectively is difficult. Therefore asking the person and actively listening to the self-report of the experience is the best way in which to understand another person’s pain. A common criticism of McCaffery’s definition is that some people cannot say what they are experiencing.
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