Issues in effective pain control. 1: Assessment and education.
Pain is a complex phenomenon to which an individual's response is determined by the interactions of physical, psychological, cultural and social factors (Melzack and Wall, 1988; Woodward, 1995; Horn and Munafo, 1997). It cannot be measured, and self-assessment by patients is increasingly recognized as the most accurate means of evaluating their pain. However, research indicates that even self-assessment remains problematic because nurses frequently either do not use pain tools effectively, or do not always accept the self-assessment. Reasons for this seem to be rooted in the attitudes and beliefs of nurses, and inadequate communication. The latter problem could be improved by more effective use of pain tools, but attitudinal problems are more difficult to address once the barriers have become established. This article suggests that the most effective way to prevent such barriers arising is to ensure that nurses receive a focused, substantive input on pain assessment and pain control within their preregistration studies. Referring to proposals put forward several years ago by the Royal College of Nursing (Davis and Seers, 1991), the authors suggest that the process should begin very early in preregistration studies, preferably within the first 6 months, and involve teaching and learning strategies that encourage personal exploration and so are conducive to personal growth and development. In this way, postregistration studies could realistically focus on specialist aspects of pain care more appropriate to 'continuing education'.
Davies
J
J
School of Health Care Practice, Anglia Polytechnic University, Chelmsford, UK.
McVicar
A
A
D001291:Attitude of Health Personnel; D003479:Curriculum; D004509:Education, Nursing, Continuing / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009730:Nursing Assessment / Q000379:methods*; D009740:Nursing Staff / Q000193:education* / Q000523:psychology; D010146:Pain / Q000175:diagnosis* / Q000451:nursing* / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing*; D013727:Terminal Care / Q000379:methods*