Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain); sudden or slow onset of any intensity from mild to severe, constant or recurring without an anticipated or predictable end and a duration of greater than 6 months
Defining Characteristics of Chronic Pain
Altered ability to continue usual activity
Atrophy of involved muscle group
Changes in sleep pattern
Fear of injury
Protective or guarding behavior
Reduced social action
Weight gain or loss
Related Factors of Chronic Pain
Chronic physical disability
Chronic psychological disability
Nursing Diagnosis for Chronic Pain | Assessment of Chronic Pain
Nursing Diagnosis for Chronic Pain | Assessment Focus of Chronic Pain; Expected Outcomes of Chronic Pain; Suggested NOC Outcomes of Chronic Pain.
Assessment Focus of Chronic Pain (Refer to comprehensive assessment parameters.)
Expected Outcomes of Chronic Pain
The patient will
Identify characteristics of pain and pain behaviors.
Develop pain management that includes activity and rest, exercise, and medication regimen that isn’t pain contingent.
Carry out resocialization behaviors and activities.
State relationship of increasing pain to stress, activity, and fatigue.
State importance of self-care behavior or activities.
Suggested NOC Outcomes of Chronic Pain
Comfort Level; Depression; Depression Self-Control; Pain Control; Pain Level; Quality of Life; Sleep; Symptom Control
Nursing Diagnosis for Chronic Pain | Nursing Interventions of Chronic Pain
Nursing Diagnosis for Chronic Pain | Nursing Interventions of Chronic Pain with Rationale
Nursing Interventions and Rationales of Chronic Pain
Assess descriptive characteristics of pain, including location, quality, intensity on a scale of 1–10, temporal factors and sources of relief; pain tolerance; ethnicity; self-image, coping behaviors, sleep patterns, activity level, attitude, and values. Assessment will provide information to help identify interventions for that specific patient.
Set up a behavior-oriented plan; for instance, set up a plan to follow the activity schedule. Behavioral–cognitive measures can help patient modify learned pain behaviors.
Contract with patient to increase probability that he or she will follow the plan for pain management that has been developed with him. A contract is an agreement that can always be referred to when the patient attempts to make decisions outside the provisions of the plan.
Schedule self-care activities for the patient. This reduces dependence on caregivers and others in the patient’s environment.
Administer analgesic pain medication as outlined in the plan. When a patient requests more than the plan allows, reiterate the terms of the plan in order not to overmedicate.
Teach patient relaxation techniques such as guided imagery, deep breathing, meditation, aromatherapy, and progressive muscle relaxation. Practice with the patient frequently and especially at bedtime. Purposeful relaxation efforts may help promote sleep.
Instruct patient to eliminate or reduce caffeine and alcohol intake and avoid foods that interfere with sleep (e.g., spicy foods). Foods and beverages containing caffeine consumed fewer than 4 hr before bedtime may interfere with sleep. Alcohol disrupts normal sleep, especially when ingested immediately before retiring.
Work closely with staff and family to achieve pain management goals and maximize the patient’s cooperation.
Encourage patient and family to express feelings associated with diagnosis, treatment, and recovery to help patient and family cope with treatment.
Schedule time to spend with the patient’s family. They need time with healthcare providers to ask questions.
Encourage activities that provide distraction, such as reading, crafts, television, and visits to help patient focus on non-pain-related matters.
When possible, allow patient to use alternative pain treatments common in his or her culture (such as acupuncture) as a substitute or a complement to Western treatments to promote nonpharmacologic pain management.
Arrange for frequent multidisciplinary/family care conference to keep care goal-oriented.
Refer patient to support group to help deal with pain, depression, etc.
Refer to social worker/case manager for follow-up care.