Managing Pain in Chronic Patients (Research Paper Sample)

Managing Pain in Chronic Patients
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Managing Pain in Chronic Patients
Introduction:
The management of chronic pain is a challenge that nurses have to tackle on a daily basis. Many patients suffering from chronic diseases experience pain due to psychological, physical and emotional trauma. According to Park and Moon (2010), chronic pain presents with both physical and psychological symptoms, and it affects a fifth of the population in the developed countries. Various methods have been devised for the management of chronic pain, and advances have been made. However, chronic pain management remains a challenge in the health care settings. Since nurses are the group of the healthcare team that spends most of their time with the patients, it is important they keep up to date with the discovery of new knowledge, through research, to adopt the latest, effective methods of managing pain. Non-pharmacological methods have been employed in the management of chronic pain, in chronically ill patients. Non-pharmacological methods include psych education, music therapy, massage therapy and cognitive behavioral therapy. Determining the most effective method among the three is a pivotal milestone in tackling the challenge of chronic pain management in palliative care settings.
Current Practice/Background Information:
The target population for this paper are patients who suffer chronic pain. Park and Moon (2010) argue that both physical and psychological injuries are likely to result in chronic pain. Chronic diseases, like cancer, diabetes and hypertension also predispose the victims to prolonged, chronic pain. Currently, three major techniques are applied in the plan of care for the management of chronic pain. Thomas, Weiss and Sylvester (200) as well as Salvetti (2012) affirm that psych education has been found to be very effective in the management of chronic pain. On the other hand, Halford and Brown (2009) assert that, cognitive behavioral therapy is effective, not only in treating chronic pain, but also in managing mental disease in chronically ill patients. Additionally, Tsao (2007) champion for massage therapy in the management of chronic pain, although with a basis of support from available literature. Since the challenge of chronic pain management remains, it is important to champion continuous research in this area, to determine the extent in which the different strategies of management are effective.
Literature Search/ Interventions:
i). Psychoeducation:
Chronic pain does not discriminate against age or type of chronic disease. Whether child or adult, one is very predisposed to chronic pain if one is suffering from a chronic disease. Although with the inclusion of pharmacological interventions, the management of chronic pain depends greatly on the consideration of psychological variables. In this regard, the effective management of chronic patients has a high dependence on psychoeducation. Salvetti et al. (2012) conducted an eight-week study to determine the effectiveness of psychoeducation on chronic management. The researcher involved a total of seventy-nine patients, who had chronic pain of different etiologies. They found out that psychoeducation is effective in reducing depressive symptoms, which is directly related to pain reduction. The method is also effective in reducing disability and decreasing the intensity of pain. According the Thomas, Weiss and Sylvester (2000), psychotherapy is preferred because it empowers patients to participate actively in the pain management activities. Such activities contribute to the psychological wellness of the patients.
Although there are few studies that have been conducted in relation to psychoeducation, it has been found that patient psychoeducation is a major strategy that can be used to modify the attitudes of patients in regard to chronic pain management (Salvetti et al. 2010). Apart from its direct effect on reducing chronic pain, psychoeducation also contributes greatly in enhancing patient behavior in regard to medications and treatment plans. Many patients suffering from chronic diseases are likely to stop taking medications by the time they feel better. However, psychoeducation supports such patients and one they feel better, they are less likely to stop taking their medications. In addition, psychoeducation promotes personal responsibility in chronic pain management. In essence, thus, patients are able to handle side effects of the medications, as they anticipate them, and can initiate measures to prevent them. Thomas, Weiss and Sylvester (2000) argue that patients undergoing psychoeducation are less likely to worry about addiction and tolerance as compared to the patients under medications alone. Exploring psychoeducation in the management of pain is thus a very beneficial milestone in the management of chronic pain, and thus, treatment of chronically ill patients.
ii). Cognitive Behavioral Therapy:
Cognitive behavioral therapy is a very important theoretical model in the management of chronic pain. Halford and Brown (2009) argue that CBT is based on the thinking that behavior, mood and physical symptoms are very interrelated. Halford and Brown (2009) observe that the patients' cognitive appraisal of events serves to determine their response to treatment with CBT. Such observation may explain why CBT has been more directed to groups and individuals, rather than couples and families (Thomas, Weis and Sylvester, 2000). Due to the assumption of the mental, emotional and physical interrelations, the CBT perspective focuses on modifying the feelings, behaviors and thoughts that may lead to emotional and psychological disturbance. The preference of cognitive behavioral therapy, according to Halford and Brown (2009), is its use in, not only treating psychological pain in chronic ill patients, but also addressing negative beliefs, adjustment to illness and illness behaviors.
iii). Music Therapy for chronic pain
The value of music in the management of chronic pain cannot be under-estimated. According to Guetin (2012), music therapy is very effective in the management of chronic pain. Guetin et al. conducted a research with eighty seven patients with different types of pain, and established that music had a great therapeutic effect in all the patients that were complaining of pain. According to the researchers, music has an extra benefit as it is also helps in the management of anxiety and depression in the same patients. A call on nurses to apply music therapy in the management of chronic pain has not been very successful. Most healthcare facilities have not adopted music as part of the plan of care in their management of chronic pain. Since evidence shows that music has benefits in the management of pain in chronically ill patients, it is prudent that nurses be sensitized to apply this therapeutic measure in their plans of care, for the chronically ill patient.
iv). Massage Therapy
The existing current literature supports the effectiveness of massage therapy for the management of chronic pain (Tsao, 2007). Even though massage therapy has not been found to be very good in treating non-specific pain, it does not produce good results for specific pain, like shoulder pain. However, according to Tsao (2007), massage therapy has been found to do well in the treatment of some pains like mixed pains, non-specific low back pain, carpal tunnel syndrome and neck pains. Trained therapists have also championed the use of massage therapy in the management of chronic pain. Massage therapy works through manipulation of soft tissues, and, through this, it relieves chronic pain. An advanced application of massage therapy is using it through advanced machines, rather than human beings. Tsao (2007) observes that massage therapy is even more e...