Chinn and kramer model

Concept Analysis: Caring – Outline I. II. Identification of Concept Aims of Analysis III. Definitions IV. Development of Cases A. Model Case B. Contrary Case C. Related Case D. Borderline Case V. Tentative Criteria VI. Overall Evaluation Concept Analysis of Pain Pain is a factor that is felt differently from person to person and from culture to culture. It is subjective in nature and as care providers we are taught not to question its existence rather to believe it exist through the eyes of the person feeling the pain. Pain is triggered in the nervous system. Pain may be intermittent or constant, dull or sharp. Pain can be acute as in the case of a cut or maybe chronic as in the case of back pain. According to Wells, Pasero, & Mcraffery (2008) thirty-five (35) million patients were discharged from U.S. hospitals in 2004; of these patients, forty-six (46) percent had a surgical procedure and sixteen (16) percent had one or more diagnostic procedures. They also asserted that pain is common, and expected, after surgery. Ted Further, Wells, Pasero; Mcraffery, 2008 inadequately managed pain can lead to adverse physical and psychological patient outcomes for patients and their families. Pain is also one of the most frequent cited nursing diagnoses. This makes pain a critical problem in healthcare. Nursing researchers have conducted many studies to identify and understand pain. According to Walker and Avant (1995) the purpose of concept analysis is to helps nursing scholars to identify the similarities and difference between concepts. Further it helps us identify the differences between irrelevant and defining attributes of a concept. Mahon (1994) and Montes-Sandoval (1999) used the Walker and Avant’s method of concept analysis to determine their similarities of pain. These are that pain is a personal experience, an unpleasant, distressful, unwanted, uncomfortable experience. Mahon added that pain is psychological and socio-cultural response to a noxious stimulation. The dictionary defines pain from the philosophical, theoretical and a sociological perspective. The Oxford English Dictionary defines pain as a sensation which one feels when hurt, suffering, distress and is specific to the physical and psychical sense. From a philosophical perspective dating back to Plato (427-347 BC) he proposed the idea of the soul, pain and pleasure. Aristotle (384-322 BC) viewed pain as an emotion, state of feeling. While Descartes (1596-1650) emphasized the relationship between mind and soul in relation to pain. There are four major theories that discuss pain form a theoretical perspective. These are: specificity theory, pattern theory, gate control theory, and psychological/behavioral theory. The concept of pain as it relates to sociology is seen through cultural views. According to Zborowski (1969) pain is believed to be a social and cultural pattern of the individual have significant influence. Further he assets that attitudes towards pain are learned from parents and society. Pain in professional fields is best explained by McCaffery (1977), as “whatever the experiencing person says it is, and exist whenever he says it does”. Presently this is what we teach in nursing schools. It is important to distinguish the concept of pain from other closely related concepts such as suffering and discomfort. According to Loeser and Egan (1989) suffering is defined as a negative affective response to pain or to other emotionally filled events, such as fear, anxiety, isolation or depression. Therefore, pain may induce suffering, however, not all pain will induce suffering. Person may suffer even in the absence of pain. Discomfort on the other hand is not defined in the nursing literature. (Cheng, Foster, & Huang, 2003, p. 23). Sheridan (1992) states that mild pain is referred to as discomfort. In the McGill pain questionnaire discomfort is used to state the intensity of pain.