title: Clinical judgments in pain management.
abstract: From research reports published over the last 20 years, it appears that moderate to severe uncontrolled pain may be the norm for hospitalized patients despite recent advances in the management of pain. Research on the extent of under-management of pain and the factors associated with it is examined and summarized in this paper. Methodological imperfections of the research are identified. Several explanations for pain under-management have been proposed and these are reported. A clinical decision making model is also reviewed and it is suggested that this model could be applied to pain management problems. Further, it is suggested that this model may be very useful in developing educational interventions to improve health practitioners' clinical skills in pain management.
authors.affiliation: 3-103 Clinical Sciences, University of Alberta, Edmonton, Alberta T6G 2G3 Canada.
authors.forename: Janice
authors.initials: J
authors.lastname: Lander
mesh_terms: D000698:Analgesia / Q000523:psychology / Q000706:statistics & numerical data*; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003657:Decision Making; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007600:Judgment; D009726:Nurses / Q000523:psychology; D010146:Pain / Q000188:drug therapy* / Q000523:psychology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D010564:Personnel, Hospital / Q000523:psychology*; D019966:Substance-Related Disorders / Q000517:prevention & control
chemical_list: D000700:Analgesics