Literature Review of Pain Assessment Tools

Literature Review of Pain Assessment Tools Introduction This essay will identify the issue of poorly addressed acute pain in hospitalized patients and critically compare and discusses a range of pain assessment tools referring to contemporary research literature and practice guidelines for patients who are able to self describe their pain and who are unable to self describe their pain due to verbal communication barriers, critical illness or delirium/dementia. Main Body According to the International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience arising from actual or potential tissue damage (1). Clinically, â€Å"Pain is whatever the experiencing person says it is, existing whenever he/she says it does† (McCaffery, 1968). The temporal profile classification is most commonly used to classify pain.This broad classification of pain duration is often used to better understand the biopsychosocial aspects that may be important when conducting assessment and treatment. For example, many times chronic pain is a result of unresolved acute pain episodes, resulting in accumulative biopsychosocial effects such as prolonged physical reconditioning, anxiety, and stress. It is obvious that this type of time categorization information can be extremely helpful in directing specific treatment approaches to the type of pain that is being evaluated (Gatchel Oordt, 2003). Acute pain is usually indicative of tissue damage and is characterized by momentary intense noxious sensations (i.e., nociception). It serves as an important biological signal of potential tissue/ physical harm. Some anxiety may initially be precipitated, but prolonged physical and emotional distress usually is not. Indeed, anxiety, if mild, can be quite adaptive in that it stimulates behaviors needed for recovery, such as the seeking of medical attention, rest, and removal from the potentially harmful situation. As the nociception decreases, acute pain usually subsides. Unlike acute pain, chronic pain persists. Chronic pain is traditionally defined as pain that lasts 6 months or longer, well past the normal healing period one would expect for its protective biological function. Arthritis, back injuries, and cancer can produce chronic-pain syndromes and, as the pain persists, it is often accompanied by emotional distress, such as depression, anger, and frustration. Such pain can also often significantly interfere with activities of daily living. There is much more health care utilization in an attempt to find some relief from the pain symptoms, and the pain has a tendency to become a preoccupation of an individuals everyday living. According to Buckley (2000) nurses are the primary group of health care professionals responsible for the ongoing assessment and monitoring of patients to ensure that pain is effectively and appropriately managed and that patients and families are informed of the consequences of acute pain. Assessment of pain can be a simple and straightforward task when dealing with acute pain and pain as a symptom of trauma or disease. Assessment of location and intensity of pain often sufà ¯Ã‚ ¬Ã‚ ces in clinical practice. However, other important aspects of acute pain, in addition to pain intensity at rest, need to be deà ¯Ã‚ ¬Ã‚ ned and measured when clinical trials of acute pain treatment are planned. If not, meaningless data and false conclusions may result. The 5 key components: Words, Intensity, Location, Duration, Aggravating factors pain assessment are incorporated into the process. Objective data are collected by using one of the pain assessment tools which are specià ¯Ã‚ ¬Ã‚ c to s pecial types of pain. The main issues in choosing the tool are its reliability and its validity. Moreover, the tool must be clear and, therefore, easily understood by the client, and require little effort from the client and the nurse. According to Husband (2001) to measure the pain severity or intensity, several scales can be used such as a numeric rating scale (NRS), the visual analog scale (VAS), observation scales with indicators of pain, and even creative depictions of pain intensity with scale using a pain thermometer. The numeric rating scale allows patients to rate their pain on and 11-point scale of 0 (no pain) to 10 (worst pain imaginable). The majority of patients, even older adults can use this scale. The thermometer scale may be useful in the elderly, according to Rakel and Herr (2004). It shows a picture of a thermometer arranged on a background with a vertical word scale. Finally categoric scales use verbal descriptors to quantify the level of pain and those scales have been validated and are considered to be reliable. Chronic pain has a major impact on physical, emotional, and cognitive function, on social and family life, and on the ability to work and secure an income. Meaningful assessment of long-lasting pain is therefore a more demanding task than assessing acute pain. This is true both in clinical practice and when conducting trials of management of long-lasting pain. A comprehensive assessment of any chronic complex pain condition requires documenting (i) pain history, (ii) physical examination, and (iii) specià ¯Ã‚ ¬Ã‚ c diagnostic tests. Chronic pain assessment tools are the Brief Pain Inventory (BPI), which assesses pain severity and the degree of interference with function, using 0 – 10 NRS, and the McGill Pain Questionnaire (MPQ) and the short-form MPQ (SF-MPQ) evaluate sensory, affective–emotional, evaluative, and temporal aspects of the patient’s pain condition. Pain assessment in older adults can be challenging and very difficult in some situations (Rakel Herr, 2004). When the patient cannot report his/her subjective pain experience, proxy measurements of pain must be used, such as pain behaviours and reactions that may indicate that the person is suffering painful experiences. Besides communication difà ¯Ã‚ ¬Ã‚ culties caused by language problems, patients in the extremes of age, and critically ill patients in the intensive care setting, are common assessment problems. Older patients may prefer to use alternate means to express their pain through the use of word descriptors that best characterize the pain, such as aching, hurting, and soreness (Herr Garand, 2001). Significant challenges occur when assessing patients who are unable to communicate verbally, in writing, or by gestures, or when they are cognitively impaired. Pain assessment should be ongoing at regular intervals, individualised and documented clearly to facilitate treatment and communication among health care clinicians. Conclusion In conclusion, adequate assessment of pain, using validated tools appropriate to the population or individual, is an essential prerequisite of successful pain management. It has been shown in many countries that inadequate pain assessment is common, with resultant failings in management of pain. Inadequate pain control can prolong the recovery period, increase length of stay, and increase overall health care costs ( Shang Gan, 2003) Only by regularly assessing and measuring pain, as routinely as the other vital signs, can we hope to make pain visible enough to those caring for patients and thus improve management. This is especially true for the patients that anaesthetists care for every day, those with acute pain after surgery, trauma, and in the intensive care unit.

Title IX: Leveling the Playing Field Essay -- gender equity in sports

How does one define the success of a high school and college? Is it through standardized test scores, graduates, and college applicants? Is it through winning games and playing beyond the school? Yes, in fact it’s all of these things. America is based on freedom and equality. America is created with â€Å"Liberty and Justice for All†. America is only now starting to treat women as the equals they are. Although Title IX has improved athletic opportunities for women, the ratio of women to men athletic funds is uneven because of the revenue main stream men’s sports bring to the schools. As colleges grew in people and pride, football became the new sensation. With the predominant â€Å"football schools† nationwide, female athletic programs weren’t given much thought. Football provides the schools funding through its massive packed stands. The revenue made funneled back into the football programs and left little funding for any other sport, male or female. In 1972, the nation finally decided to make a stand, and force schools to create and sponsor other athletic teams for females, besides cheerleading and square dancing. Title IX was enacted in 1972 by President Richard Nixon. It â€Å"requires† gender equity for boys and girls in every educational program that is federally funded. Many people do not even know that Title IX exists, or if they do, that it applies to more than sports. However it applies to sports, access to higher education, career education, education for pregnant and parenting students, employment, learning environment, math and science, sexual harassment, standardized testing and technology. It forced schools to even the playing field and implement women’s sporting teams. Before Title IX, it was nearly impossible to get a f... ...011. Davis, Paula M. "Imagine Fund Will Offer Race and Gender-based Scholarships in Response to 2006 Anti-affirmative Action Law." MLive. Michigan Live LLC, 20 Aug. 2008. Web. 06 Feb. 2011. Grant, Christine. "A Title IX Presentation." Bailiwick. The University of Iowa Libraries, 25 Sept. 1995. Web. 10 Feb. 2011. Lopiano, Donna. "Title IX Q & A - Women's Sports Foundation." Title IX. Women's Sports Foundation, 26 May 2005. Web. 10 Feb. 2011. Rhode, Deborah L., and Christopher J. Walker. "Gender Equity in College Athletics: Women Coaches as a Case Study." NCAA. National College Athletics Association, 26 Mar. 2008. Web. 6 Feb. 2011. Weistart, John. "Equal Opportunity? Title IX and Intercollegiate Sports." Wilson Web, Fall 1998. Web. 2 Feb. 2011. "Christine Grant | Sports Management Resources." Our Consultants. Sports Management Resources. Web. 10 Feb. 2011.

The Presence of Christianity in American Law :: Friedrich Nietzsche Genealogy of Morals Essays

The Presence of Christianity in American Law In his Genealogy of Morals, Friedrich Nietzsche presented his theory on the ascetic priest and how Christianity used the concept of original sin to give man meaning for his suffering. Christianity also gave people a way of channeling their resentment and breaking down socioeconomic barriers under the protection of God. With Christianity came altruism and compelled charity, but moreover, the formation of the congregation where the masses participated in an overwhelming act of self-deception (according to Nietzsche). In the American democracy, socioeconomic barriers are surpassed under the court of law, but this court is supposedly unattached from religion. Nonetheless, the influence of Christianity on American law and morality is such that one can call the U.S. democracy a secularized church (i.e. has the same behavior and structure as a church but without the imposed religiousness). An analysis of the comparison between the Christianity Nietzsche so adamantly criticized a nd the modern American society reveals that a secularized church as such can thrive and prosper despite its â€Å"weaknesses† due to the Christian origin. In Human, All-Too-Human, Nietzsche wrote, â€Å"Christianity came into existence in order to lighten the heart; but now it has first to burden the heart so as afterwards to be able to lighten it†. He criticized Christianity because it promoted suffering and belittled the value of earthly life. Not only were Christians expected to accept suffering as the means to salvation (â€Å"Therefore, since Christ suffered in his body, arm yourselves also with the same attitude, because he who has suffered in his body is done with sin† (1 Peter 4:1)), but the Christian God accepted pain and allowed it to occur. Nietzsche saw this approach to â€Å"life† as a means of self-deception, since one is upholding a divine being who is responsible for this pain (and who may well not even exist) and one is disguising pain as happiness: â€Å"Rejoice that you participate in the suffering of Christ† (1 Peter 4:13). To him, Christianity was a â€Å"dangerous narcoticà ¢â‚¬  (Genealogy of Morals, 3rd Essay, Section 17). With the formation of the Christian congregation, a community formed (which was, according to Nietzsche, implemented by the ascetic priest) that taught social equality.

Great Expectations Notes on Guilt Essay

In analysing Great Expectations, Dorothy Van Ghent maintains that there are two kinds of crime that drive the moral plot of the novel: the crime of parent against child and the calculated social crime â€Å"of turning the individual into a machine†. Thus, in the same way that the parent or the parent figure abuses the child, social authority also participates in creating parents who participate in the dehumanization of the children. (sons heir of fathers sin, repeat in society over n over) Van Ghent puts forward many of her ideas in an extremely extravagant, descriptive and floury manner, which at times is difficult to follow. I feel that Van Ghent approaches `Great Expectations` from a mainly`Psychoanalytical literary criticism approach`, because her analysis of the text is primarily concerned with the idea of feelings, desires and guilt that Pip carries and because guilt and desire are repressed by Pip they can only appear indirectly in the text. In Great Expectations Pip`s repressed guilt and †¦.occur and appear indirectly through. Van Ghent identifies a psychic context for Great Expectations in which I feel she focuses on Pip`s psycho drama competing desires of trying to redeem himself of sins (his and his fathers) and of wanting to attain the status of being a gentleman and no longer being coarse and common. I feel this represents a psychoanalytical approach because these issues frame Van Ghent analysis, above the significance of the social, historical or other contexts which could be used by critics. Van Ghent focuses on the â€Å"unconscious motives and feelings of a character (Pip) depicted in the text† – one of the psychoanalytical theorists do (P100 Beginning theory)

Size 0 Ban

Jenny’s 2nd rebuttal (: (2 minutes) Size zero In our society, image is everything. We strive for what is considered to be the â€Å"ideal appearance†. For the modern generation, fashion is uppermost. For some girls their ambition is to become â€Å"size zero†. We want or need to show we are following the latest fashion trends. However, recent news reports indicate that size zero models are so obsessed with their size that they become anorexic. Being fascinated by the fashion industry myself, it is important to explore the question: â€Å"Why should or should not size zero models be allowed to walk on the catwalk? Size zero models should not be allowed on the catwalk. They are a bad influence on teenage girls who desire to look like these size zero â€Å"role† models. Young girls who attempt a â€Å"zero† do not develop as they should. They are more likely to have severe health concerns later on in life. Also Karl Largerfield from Chanel explained t hat the fashion industry only used skinny models becasue they were literally meant to be moving mannequins/hangers so that the clothes would be seen at their minimum potential.But the media twisted things. A further argument that we frequently encounter, is that size zero puts pressure on young women who are overweight. By comparing themselves to â€Å"zeros† young women only achieve low self-esteem. They are made to think they are unattractive. They go through the stress of unsafe cosmetic surgeries such as tummy tucks, to appear like fashion icons. Celebrity nutritionist Dr Adam Carey says that, â€Å"I think the current vogue is disgusting. I think it is very unhealthy. It is also argued that many girls who are wanting to become models in the future, put themselves through a lot of anxiety to be slim, so they get accepted in the fashion industry. These girls attempt to try to be lean by starving themselves which can result in eating disorders. Some people believe that siz e zero models should not be banned because they have the same right as everyone else to become a model. However, if everyone did have the right to become a model, then the runways would be filled with a wide variety of different sized girls, not just the same tiny girls over and over again.You can't see what's horrible about only taking models who are underweight? And it's a lot different to ask for brunette models only: What about the size 5 models who want to be in this organization? They would have to lose weight, and we all know the dire consequences that can arise out of this. It's disgusting that a requirement they have is to be amongst the skinniest of the skinniest. It's quite obvious that girls are needing to become smaller and smaller for the modeling industry. Just imagine what it's gonna be like for girls in the future.

Body Image Research Proposal

I have chosen to study this topic because body image is such a controversial issue in today’s society, especially with adolescent boys and girls. While reviewing select articles on this topic, I noticed that there was a drastic difference in body image between boys and girls. I began to wonder what the reason for this was and through further study of these articles, I realized it had a lot to do with media influences and the role that friends family play in developing body image and so my questions revolve around studying these roles and influences. Much of the media targeted towards girls focuses on portraying only women that fit societys unrealistic expectations of the perfect woman whereas media targeted at men has much more variance in the types of men they portray. According to much of the literature on this topic, this is seen as one of the largest contributing factors to negative body image in adolescent girls. PURPOSE OF THE STUDY RESEARCH QUESTIONS 1) How does the media and advertising contribute to adolescents body image? 2) How do body image issues differ among adolescent boys and girls? What role do family and friends play in developing adolescents’ body image? RESEARCH METHODOLOGY ROLE OF THE RESEARCHER PARTICIPANTS -individual interviews -observation in this situation would be too difficult as it develops over a length of time, not an instantaneous thing -interviews allow to create open ended questions that help the conversation flow to understand how body image has been influenced, types of friends, family involvement, interests, hobbies (are they into pop culture, do they admire celebs, do they spend lots of time watching tv/movies)

Western Australia economy Essay Example | Topics and Well Written Essays - 2000 words

Western Australia economy - Essay Example The economy of Western Australia is rich in resources.The development of economy of this State has been highly influenced by resources boom since 1890s.During the past few years,the industry of Western Australia’s resources had enjoyed excellent conditions instigated by its prevailing commodities’ demand in the international market The objective of this paper is to evaluate the probable effect of the commodity market boom in the Western Australian economy’s sector of the iron ore. The iron ore production in the Western Australian economy explicates 97% of total production in Australia. Most of the iron ore produced in Australia is predominantly exported to Asian market. Following the speedy growth during the last ten years in mainland China, Australian iron ore’s export market has significantly developed in China. This information is evident from the export amount in the year 2010 that amounted to 70 percent of the total iron ore in Australia. The followin g diagram represents the export figures of iron ore from Australia to the Asian market as compared to the rest of the world2. Source: 2. Effect of Increase in Demand for Iron-Ore in Western Australian Economy The production factor of iron ore in the Western Australian economy is primarily dependent on the demand prevailing in the Chinese market for iron ore. Development in the Chinese construction and industry sector is the major cause of increased demand of iron ore in China. As a result of the demand prevailing in China for iron ore with the expectations of even higher demand in the near future, the prices in the Australian iron ore will attain all time high this year, i.e., in 2011. According to the market expectations in Australia, the spot market price on an average for iron ore in the year 2011 would increase to US$153-US$154 from US$146 in the year 2010. The expected price increase for iron ore is generated by the steel output in higher amount due to increasing demand in the growing economy of China3. Source:4 The above figure illustrates the production of crude steel on a monthly basis in different countries. The illustration reveals that the steel production in China has been the highest compared to other countries of the world. From meeting up the demand for iron ore from the Asian market, especially China, Australian manufacturers are producing iron ore by utilizing their maximum capacity for exports. In this scenario, production of the optimum level of output for satisfying the international market’s demand is a matter of concern for the Australian manufacturers of iron ore. As the demand at present in the Asian market is expected to remain constant or even increase in the coming 15 years, the only concern for Australian market is to bank upon the amount of production5. The theory of isoquants and isocosts is applicable for this Australian scenario regarding the production of the optimum quality pertaining to the prevailing demand in the Asi an market. A clearer prospect of the theories can be evolved after explanation of the input requirements in the commodity production with reference to the input demand and prices. The most important inputs for production of iron-ore in Australia are capital and labor. As the concern for the Australian market is to produce maximum amount of iron ore through finding the optimum combination of the inputs required for production, implementation of the concept of isoquants would be most helpful for the economy. An isoquant is that curve which depicts all efficient combination of inputs such as capital and labor by considering their technological efficiency. The quantity to be produced remains constant, but the combinations of