1. Standard memberGrampy Bobby
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    18 Feb '13 22:48
    What's the Scientific Explation of Pain?

    The considerable scope and depth of the study in the following link strains my imagination.

    Does anyone have the requisite frame of reference and time to distill it to layman terms?

    http://plato.stanford.edu/entries/pain/

    Thank you.
    .
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    18 Feb '13 23:291 edit
    Originally posted by Grampy Bobby
    [b]What's the Scientific Explation of Pain?

    The considerable scope and depth of the study in the following link strains my imagination.

    Does anyone have the requisite frame of reference and time to distill it to layman terms?

    http://plato.stanford.edu/entries/pain/

    Thank you.
    .[/b]
    Well there are nerves throughout the body that send impulses to the brain. These impulses can be interpreted as a touch or feel sensation. When there are too many of the impulses from one area of the body or sent to one location of the brain it is interpreted as pain. An example of this is when you get your hands cold enough to start getting numb and they warm up they sting like hell. All of a sudden there are too many impulses going to the noodle. Another example is when you stubb your toe. If you gently touch the coffee table leg with your toe you feel it. If you kick the coffee table leg hard there are too many impulses and it hurts. I am not a clumsy person however I have stubbed my toe many times. Also I have delivered newspapers in the cold winter mornings as a kid. I do believe I posess the requisite frame of reference of the matter to instill this to you. In the case of swelling/inflamation I can only guess that there are impulses generated from tissue distortion at a rate the brain interprets as pain. I am no doctor but Bill Nye the Science Guy may be able to explain better.
  3. Standard memberGrampy Bobby
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    19 Feb '13 02:44
    Originally posted by joe beyser

    Well there are nerves throughout the body that send impulses to the brain. These impulses can be interpreted as a touch or feel sensation. When there are too many of the impulses from one area of the body or sent to one location of the brain it is interpreted as pain. An example of this is when you get your hands cold enough to start getting numb and they ...[text shortened]... brain interprets as pain. I am no doctor but Bill Nye the Science Guy may be able to explain better.
    "1.2 Second thread: pain as subjective experience

    That pain is a subjective experience seems to be a truism. Given our common-sense understanding of pain, this seems to be the more dominant thread: instead of treating pains as objects of perceptual experience, it treats them as experiences themselves. Indeed it is this thread that the official scientific definition of ‘pain’ picks up and emphasizes, which was first formulated in the 1980s by a committee organized by the International Association for the Study of Pain (IASP), and has been, since then, widely accepted by the scientific community:[1]

    Pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

    Note: Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life... Experiences which resemble pain, e.g., pricking, but are not unpleasant, should not be called pain. Unpleasant abnormal experiences (dysaesthesia) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain. Many people report pain in the absence of tissue damage or any likely pathological cause; usually this happens for psychological reasons. There is no way to distinguish their experience from that due to tissue damage if we take the subjective report. If they regard their experience as pain and if they report it in the same ways as pain caused by tissue damage, it should be accepted as pain. This definition avoids tying pain to the stimulus. Activity induced in the nociceptor and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state, even though we may well appreciate that pain most often has a proximate physical cause." (IASP 1986, p. 250; cf. IASP-Task-Force-On-Taxonomy 1994)

    Joe, so far so good. Please help me with "Pain is always subjective..."
    .
  4. Standard memberKepler
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    19 Feb '13 13:09
    Originally posted by Grampy Bobby
    "1.2 Second thread: pain as subjective experience

    That pain is a subjective experience seems to be a truism. Given our common-sense understanding of pain, this seems to be the more dominant thread: instead of treating pains as objects of perceptual experience, it treats them as experiences themselves. Indeed it is this thread that the official scien ...[text shortened]... Taxonomy 1994)

    Joe, so far so good. Please help me with "Pain is always subjective..."
    .
    Pain is subjective because there is no absolute way to measure it and it depends on personal interpretation and experience of the sensation.

    An example:

    My grandfather kept bees and had, to my way of thinking, a wholly unnatural tolerance for bee stings. He would get stung several times during the course of fiddling about in a hive and just shrug it off as an annoyance. To me, a bee sting was the most excruciating pain I had ever suffered. I was seven and had never suffered real nasty dental pain at that point. Now I know different.

    When doctors or some other bunch of clever people develop an accurate painometer then it will become objective but how the pain feels to you will always be subjective. My "Expletive deleted! That stings!" will still be your "That wasn't too bad" and vice versa.
  5. Wat?
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    19 Feb '13 13:19
    Originally posted by Grampy Bobby
    [b]What's the Scientific Explation of Pain?

    The considerable scope and depth of the study in the following link strains my imagination.

    Does anyone have the requisite frame of reference and time to distill it to layman terms?

    http://plato.stanford.edu/entries/pain/

    Thank you.
    .[/b]
    I think you should find this more layman specific. 😉

    https://www.edsers.com/uploads/Genetic_Basis_for_Pain.pdf

    -m.
  6. Joined
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    20 Feb '13 08:371 edit
    Originally posted by Grampy Bobby
    "1.2 Second thread: pain as subjective experience

    That pain is a subjective experience seems to be a truism. Given our common-sense understanding of pain, this seems to be the more dominant thread: instead of treating pains as objects of perceptual experience, it treats them as experiences themselves. Indeed it is this thread that the official scien Taxonomy 1994)

    Joe, so far so good. Please help me with "Pain is always subjective..."
    .
    Well- pain is subjective as a result of life experiences. The brain does not interpret a larger number of impulses to the brain as pain if it is something that is a normal part of life early on. A good example of this would be if you are riding on a buss and see someone pulling hairs out of their nose with needle nose vicegrips. A conversation something like this ensues. " Oh my god doesn't that hurt? " " Naw I am used to it. I been pickin my nose since I was knee high to a grasshopper. " So there you have it. Life experience seems to be able to set the threshold of pain for people.
  7. Standard memberGrampy Bobby
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    20 Feb '13 09:06
    Originally posted by mikelom

    I think you should find this more layman specific. 😉

    https://www.edsers.com/uploads/Genetic_Basis_for_Pain.pdf

    -m.
    Surely you jest. The scope and depth, narrative and graphic formula representations of this study presents an esoteric
    challenge far exceeding the opening link. Mike, I need a few paragraphs of paraphrase in your own words. Thanks.
    .
  8. Standard memberGrampy Bobby
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    20 Feb '13 09:12
    Originally posted by Kepler

    Pain is subjective because there is no absolute way to measure it and it depends on personal interpretation and experience of the sensation.

    An example:

    My grandfather kept bees and had, to my way of thinking, a wholly unnatural tolerance for bee stings. He would get stung several times during the course of fiddling about in a hive and just shrug it o ...[text shortened]... "Expletive deleted! That stings!" will still be your "That wasn't too bad" and vice versa.
    So, the source of serious "human pain" must be understood in subjective

    and relative terms, not objective realities and/or genetic predispositions?
    .
  9. Standard memberGrampy Bobby
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    20 Feb '13 09:29
    Originally posted by joe beyser

    Well- pain is subjective as a result of life experiences. The brain does not interpret a larger number of impulses to the brain as pain if it is something that is a normal part of life early on. A good example of this would be if you are riding on a buss and see someone pulling hairs out of their nose with needle nose vicegrips. A conversation something li ...[text shortened]... So there you have it. Life experience seems to be able to set the threshold of pain for people.
    If All Pain Thresholds are Individual-Specific (not generalized from collective human experience), how and why have 1-10 Type Tables been

    established for use by Medical Professionals? Also, are you familiar with the term "Obtunded State"? (my wife's own status prior to death)
    .
  10. Joined
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    20 Feb '13 09:43
    Originally posted by Grampy Bobby
    If All Pain Thresholds are Individual-Specific (not generalized from collective human experience), how and why have 1-10 Type Tables been

    established for use by Medical Professionals? Also, are you familiar with the term "Obtunded State"? (my wife's own status prior to death)
    .
    I am sorry Grampy Bobby. I am afraid my frame of reference is lacking in that department. I do beleive though tables could be set as life experiences for the masses is pretty similar for pain. I also believe pain threshold can be changed later in life as well. I suppose one could get some power tools out of the garage and do experimentation on peresonal pain threshold, but I am content with my own personal understanding of my pain. I will look up Obtunded after work. Is that where they don't feel pain?
  11. Standard memberGrampy Bobby
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    20 Feb '13 10:42
    Originally posted by joe beyser

    I am sorry Grampy Bobby. I am afraid my frame of reference is lacking in that department. I do beleive though tables could be set as life experiences for the masses is pretty similar for pain. I also believe pain threshold can be changed later in life as well. I suppose one could get some power tools out of the garage and do experimentation on peresonal pa ...[text shortened]... standing of my pain. I will look up Obtunded after work. Is that where they don't feel pain?
    Yes. This dark and unwholesome onomatopoetic word dates back to the 15th Century, I believe, and embraces the concept of being forcefully struck on the head with a blunt instrument. THUD... THUD! Her Pancreatic Cancer Condition was such that even the Heaviest Dosages of Morphine were to no avail. Final Medications which produced the Obtunded State were Dilaudid with an Ativan Booster (sp).
    .
  12. Standard memberKepler
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    20 Feb '13 13:25
    Originally posted by Grampy Bobby
    If All Pain Thresholds are Individual-Specific (not generalized from collective human experience), how and why have 1-10 Type Tables been

    established for use by Medical Professionals? Also, are you familiar with the term "Obtunded State"? (my wife's own status prior to death)
    .
    Good question on the pain tables. I recently had an injury that caused a great deal of pain and was asked on a daily basis how bad, on a scale of 1-10, my pain was. As I said at the time, how the hell would I know? The pain identifying bits of my brain aren't equipped with a digital display. Eventually I related it to the worst pain I had experienced so far, an abscess on a tooth root, as 10. Then one day the pain went to 11.
  13. Wat?
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    20 Feb '13 14:31
    Originally posted by Grampy Bobby
    Surely you jest. The scope and depth, narrative and graphic formula representations of this study presents an esoteric
    challenge far exceeding the opening link. Mike, I need a few paragraphs of paraphrase in your own words. Thanks.
    .
    The interplay of perceiving and managing pain among nurses at a surgical ward
    - a focus group study.

    Abstract

    Aim: To describe surgical ward nurses’ perceptions of pain, and pain management.

    Background: After abdominal surgery pain, as a cause of suffering, there are vital signs of physical illnesses and tissue injuries that bring people to hospital. A nurse is the person who plays a key role in the patient’s post-operative care, and therefore the one who usually has to intervene, manage, and relieve the pain that caused the patients to present themselves.

    Design: This was a focused group design. This study reports on topics that are important to nurses’ perceptions of pain, and pain management, on a surgical ward.

    Methods: This was a focused group design consisting of three focused group interviews, with 6 registered nurses (RNs) in each group. The interviews were conducted with a normal distribution sample of RNs at Nopparatrajathanee Hospital, Thailand.

    Results: The result shows that nurses’ perceptions of pain operate in two categories. The first is as two perceptions of pain, which include unpleasant feelings of discomfort and suffering for the patient that are harmful as undesirable. These include the disability and change of personality for the patient. The second category is the nurses’ perception of pain management in three themes comprising; managing patients’ pain by being assertive; using belief and expectations. These results are reflections based upon nurses’ perceived and experienced roles, being some of the primary and important roles of the nurse. In order that the improvements regarding pain management practice, as knowledge of pain management, which have been found to be fragmentarily related to each other, represent only one perspective. The themes described form understandings, or ways of thinking about, perceptions of pain and pain management which, in relation to perceptions of pain and pain management as a whole, are either atomistic or holistic in character.

    Conclusion: Findings point to the suggestion that nurses should demonstrate a holistic approach is usually applied on an individual basis; that can change, depending upon the patient, the situation, and the possibilities of approach; and also that how that approach might affect other patients, nurses, doctors, pharmacists, physiotherapists, and their relatives.
    Keywords: Nurses’ perceptions of pain, pain-management, post-abdominal surgery.

    Introduction

    Post-operative pain.
    It has been demonstrated that post-operative high levels of pain are experienced by 68% of patients, within the first 24 hours. Those levels of pain gradually decrease within 72 hours post-surgery (Vallano, et al. 1999; Apfelbaum, et al. 2003; IASP, 2011). According to previous research, it is shown that beliefs, attitudes, and cultures are important for nursing assessment, and the nursing care of post-operative pain (Edwards, et al. 2001; Sjöström, Owe Dahlgren & Haljamäe, 2000; Phengjard, Yousiri, & Petpichetchian, 2003).

    In Thailand, as well as internationally, there is a general culture of development for nurses to play key roles in the management of post-operative pain. Hence, there is a need to study, to grasp and to understand the complex assessments of the varying nursing roles regarding post- abdominal surgeries. The relationships between ‘perceptions’ of pain and ‘pain management’; their cultural perceptions; their values, their beliefs and their fundamental knowledge all entwined need to be further studied. Therefore, this study aims to describe a surgical ward nurse’s perception of pain and pain management.

    Background

    Definitions of pain, and pain management, after abdominal surgery.
    Pain is an individual, subjective experience and a multi-dimensional phenomenon, related to six dimensions which include; physiological, sensorial, effectual, cognitive, behavioral, and socio-cultural dimensioned (McCaffery, 1968; McGuire, 1992). In accordance with those definitions, the primary aim of post-operative care is to manage pain at the lowest possible levels, given different modules of attendance and care guidelines, to help improve post-operative experiences and to reduce the suffering and shorten the recovery period (Samaraee, et al. 2010; IASP, 2011).

    Abdominal pain, as a cause of suffering, is a vital sign of physical illness, and possible tissue injuries, that present patients to hospitals. Previous studies have shown that more than 50 % of people with abdominal pain require emergency abdominal surgery (Heading, 1999; Samaraee, et al. 2010).
    Nurses play an important role in post-operative pain management, especially between 24 and 72 hours after surgery (Vallano, et al., 1999; Apfelbaum, et al., 2003; IASP, 2011). Pain management activities include; giving information and advice, giving sufficient pain medication to reduce that pain and using appropriate nursing therapeutics. Such therapeutics may include; active listening, acknowledging and valuing the individual’s and/or family’s perspectives, being empathetic, applying physical strategies such as breathing exercises, turning and positioning, wound supports, therapeutic hot and cold touches and massages and psychological and behavioral strategies. The latter may include cognitive behavioral strategies, stress management, patient and family education, self-management counseling groups, and other collaborations within the multi-disciplinary teams of experts (Poomnikom, 2000; Richards & Hubbert, 2007; Rejeh, et al. 2008; Suwanraj, 2010; IASP, 2011).

    Perception is the organization, identification and interpretation of sensory information in order to represent and understand the environment. This perception involves signals in the nervous system, which in turn result from physical stimulation of the sense organs (Goldstein, 2009). Previous research studies by Back & Larrabee (1966) indicate that nurses’ perceptions should be positively correlated with patient perceptions. However, the studies found that there was a lack of correlation between these variables, suggesting four possible explanations for these. The suggestions included that: (i) The nurses may not have documented all nursing care given for treatment or prevention of pain; (ii) The lack of correlations may have been related to the tendency of patients to over-rate nursing and hospital care; (iii) It was possible that patients were unable to evaluate some aspects of their care; (iv) Nurses and patients do not always agree on a definition of quality nursing care.

    Nurses have typically defined ‘quality’ as a conformance to standards of care, and patients usually have an undefined quality of care. This study by Rejeh, et al. (2008) recommended the need of improved communication between nurses and patients that can lead to a mutual definition of quality care. Patient satisfaction is directly related to a patient’s intent to return for treatment, where it is known that they will receive the best quality of care. A patient’s intent to recommend a place of quality, in today’s performance criteria, is of very high fundamental importance in environments of strong economic and highly competitive markets.
    Additionally, previous studies by Sjöström (1995) and Cohen, et al (2009) revealed that the main factors resulting in insufficient pain management were related to both patients and healthcare providers, including physicians and nurses. Barriers found in patients included a fear of the side effects of pain medication and refusal to take medication (Rejeh, et al. 2008; Suwanraj, 2010).

    Nurses are sometimes cited as contributors to the problems of inadequate pain management (Richards & Hubbert, 2007). Knowledge deficits may causes nurses to hold negative beliefs and attitudes toward opioid analgesics, in the under-estimated assessment of post-operative pain (Edwards, et al. 2001; Sjöström, Owe Dahlgren & Haljamäe, 2000; Phengjard, Yousiri, & Petpichetchian, 2003). A survey study by Horbury, Henderson & Bromley (2005) of 886 nurses showed that 50 % of nurses had insufficient knowledge, and negative attitudes, about pain, mostly in post-operative patients.
    In Thailand, some descriptive research studies were carried out to explore the knowledge and practices of Thai nurses in pain management. Two studies showed that 58% and 54% of nurses had a fair level of pain management knowledge and practice respectively. (Yimyaem, et al. 2006; Charuluxananan, et al. 2009). The interesting finding of one study by Songkong, Petpichetchian, &Sae-Sia, in 2008, revealed that the clinical judgment of pain management within the nursing community was at a good level. However, the clinical judgment regarding the pain management of nurses was not significantly correlated with the actual pain management behavior of nurses. It can, therefore, be concluded that the situations that have surfaced and arisen from previous studies of insufficient pain management by Thai nurses are quite clearly not defined.
    Methods

    Design

    This was a focused group design. This study was based on focus group data with extracted themes stemming from the nurse members viewpoint about perception of pain and pain management after abdominal surgery on a surgical ward. They include an open question such as. “Can you talk about what you see in the nursing care and pain management for patients during abdominal surgery?” based on the participant's response to supplementary questions as asked (Baker, 1996; Sjöström, et al. 2000). The study that formed part of the focused group design consisted of three focused group interviews, with 6 registered nurses (RNs) in each group, in which the interviews conducted were a convenient normally distributed sample of RNs at Nopparatrajathanee Hospital, Thailand.

    Participants

    Subsequent to ethical approval forms within the relevant organizations, invitations to attend a discussion session upon the ...
  14. Wat?
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    20 Feb '13 14:32
    Originally posted by mikelom
    The interplay of perceiving and managing pain among nurses at a surgical ward
    - a focus group study.

    Abstract

    Aim: To describe surgical ward nurses’ perceptions of pain, and pain management.

    Background: After abdominal surgery pain, as a cause of suffering, there are vital signs of physical illnesses and tissue injuries that bring people to hosp ...[text shortened]... orms within the relevant organizations, invitations to attend a discussion session upon the ...
    Participants

    Subsequent to ethical approval forms within the relevant organizations, invitations to attend a discussion session upon the topic of pain management were posted on the notice boards of hospitals, at the Thailand (Code: 16/2555) , School of Health Care, and Social Welfare at Mälardalen University and the Ethical Review of Research Involving Humans (Code:2012/383), Sweden. A participant was voluntary, and anonymity was assured. In total, there were 18 participants: (Group 1:G1) six RNs as representatives at novice skill levels of practice; (Group 2-3:G2, G3) six RNs each with each group including at least advanced beginners, with competency, being proficient or expert nurses (Benner, Tanner, & Chesla, 2009). The participants were predominantly female (94.4 percent), and mean age was 40.44 years old (Rang 21-55). More than half (88.9 percent) held a bachelor nursing qualification, and more than half (72.2 percent) had not experienced surgical care related to pain management certification. On average, the nurses had been registered nurses for 16.73 years, had practiced surgical nursing care for 12.89 years, and had worked for periods of 51.39 hours per week (Rang 32-88).
    Data Collection
    The focused group interviews were conducted in a quiet room, within the organization, from which participants were recruited. The interviews were all approximately 45-60 minutes in duration, and with the participants’ permission. They were tape recorded to facilitate data analysis. Prior to the interviews, a question guide was issued to inform the participants of basic topics that would be covered, in consistency with the perception of pain, and pain management.

    C/O Mrs Lom. 😉
  15. Standard memberGrampy Bobby
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    20 Feb '13 19:43
    Originally posted by mikelom

    The interplay of perceiving and managing pain among nurses at a surgical ward
    - a focus group study.

    Abstract

    Aim: To describe surgical ward nurses’ perceptions of pain, and pain management.

    Background: After abdominal surgery pain, as a cause of suffering, there are vital signs of physical illnesses and tissue injuries that bring people to ho ...[text shortened]... orms within the relevant organizations, invitations to attend a discussion session upon the ...
    Got any details?
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