Nursing assessment and measurement of pain

  • Susan Broekmans

    Clinical Nurse Specialist, University Hospital Leuven, Center for Pain Management and Algology, Belgium
  • Petra Mandysová

    Associate Professor, Faculty of Health Studies Department of Nursing University Pardubice, Czech Republic
  • Nadja Nestler

    Registered Nurse, Paracelsus Medical University Salzburg Institute of Nursing Sciences and Practice, Austria

Chair: Susan Broekmans, Belgium
Comprehensive pain assessment
Susan Broekmans, Belgium
Culturally sensitive pain assessments
Petra Mandysová, Czech Republic
The provision of culturally sensitive pain assessment can be guided by models of culturally competent care. The LEARN model is a mnemonic for five guidelines: Listen, Explain, Acknowledge, Recommend and Negotiate. It is a communication and education model that can help nurses help their patients engage in health promoting behaviors while taking into account the patients’ cultural norms. The Cultural competence continuum emphasizes that the process of achieving cultural proficiency occurs along a continuum and sets forth six levels from “cultural destructiveness to “cultural proficiency”. The ETHNIC model is a mnemonic for Explanation, Treatment, Healers, Intervention, and Collaboration. This framework for culturally competent clinical practice includes questions that health care providers could ask as they assess their patients.

Cultural differences exist in the meaning and role of pain, which can lead to over or underestimation of the severity of pain. People from cultures that value stoicism tend to avoid vocalizing with moans and screams when they are in pain and they may try to not to show their pain by grimacing. Other cultural groups tend to be more expressive. Various problems may complicate pain management, such as language barriers, nonverbal communication problems or the fact that pain assessment tools developed for use in Western countries may not be culturally and linguistically appropriate in some cultures.

Culturally sensitive pain assessment will allow nurses to develop a pain management plan that meets the professional standard of care and is culturally acceptable to the patient. Cultural practices that are beneficial to the patient's health should be encouraged whereas the ones that are harmful should be changed.
Vulnerable groups: Critical care
Nadja Nestler, Austria

Pain in critical ill patients is a frequent phenomenon. 30-50% of all ICU patients have pain at rest and many patients are unable to express pain verbally.

Though most of the patients aren’t able to verbalize the pain, a systematic pain assessment does often not take place especially with sufficient tools. In the session a problem analysis will be presented as well as recommendations for a pain assessment of verbal and nonverbal critical ill patients. Also, possible barriers for a sufficient pain assessment will be presented for finding a solution in real life.


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