Concept Analysis : Nursing Analysis

acute pain-a protective mechanism that alerts the individual to a condition or experiece that is immediately harmful

2. One of the important factors that you need to establish is how much pain the person is feeling. This can be difficult as we all have different pain levels. Several methods have been developed to measure pain but the most common one is to ask the person to describe it on a scale 1 to 10, with 1 being the mildest to 10 being the worst pain they have ever felt. It is about individual experience and you need to react to the level at which that person describes their pain as one persons pain thresholds may be different to another.

The purpose of this paper is to create a concept analysis and identify a nursing concept that is within a nursing theory. A concept analysis is a process where concepts and their characteristics are researched and clarified. The eight steps on conducting a concept analysis include selection of a concept used in a nursing theory, identification of the aims or purposes of the analysis, identification of possible use of the selected concept, determination of defining attributes, identification of model cases, identification of antecedents and consequences, and lastly definition of empirical referents (Walker & Avant, 2011). The nursing concept selected for this paper is “empowerment” within the nursing profession. The nursing theory from which the empowerment concept was obtained is Kanter’s Theory on Structural Empowerment. In order to empower someone, an individual needs the tools and resources to feel powered. According to Laschinger, Gilbert, Smith, & Leslie (2010), Kanter defines power as the ability to mobilize information, resources and support to get things done in an organization. The role of management is to provide employees with power tools that empower them to maximize their ability to accomplish their work in a meaningful way. Kanter goes on to describe two primary empowerment structures in organizations, first being the structure of opportunity and second the structure of power. The structure of opportunity relates to job conditions that provide

Gertler clarifies that pain refers to the sensation and not the common cause, which is C-fibers firing in a specific area with tissue damage. (109) She asserts that pain is not essentially connected to tissue damage of a particular location, indicating to me inadequate understanding of the concept. If one pinches one's arm, though the sensation of pain may not be necessarily located in the arm, I contend that the pain felt is relevantly connected to the location pinched. Gertler provides the alleviating effect of painkillers as an example of a non-essential feature of pain. (117) Location is unlike this property, however, and is essential in conceptualizing pain. For instance, even an amputee, who had a leg removed and experiences a phantom leg-pain, is unable to describe the sensation they feel without making reference to a specific body part. Whether or not the pain is actually “located” anywhere is irrelevant, it matters only that the pain is conceptualized as having a location. Our understanding of pain relies fundamentally on where the pain is thought to be “located.” The fact that it is impossible to conceive of pain without reference to the “location” of the sensation proves that location is an essential feature of

There are many concepts in nursing theory that need further clarification. A concept analysis can provide a thorough explanation of a term in nursing theory that will help healthcare professionals better communicate. The Walker and Avant approach to perform a concept analysis was specifically formulated with nurses in mind (McEwen & Wills, 2014). Walker and Avant proposed a concept analysis be used to further understand the meaning of a term or concept in anticipation that those using the term would have the same understanding (McEwen & Wills, 2014). When a term or concept is in question or needs further questioning in any field of nursing, a concept analysis is indicated (McEwen & Wills, 2014). Walker and Avant’s concept analysis is comprised of eight steps; select a concept, determine the aim of the concept, list all possible uses of concept, defining attributes, model case, alterative case (borderline, related, contrary, invented, and illegitimate), list antecedents and consequences, and lastly list empirical referents (McEwen & Wills, 2014). The defining attributes are deemed most beneficial in obtaining comprehension due to the fact that these attributes show which show up in regularity when relating to the concept (Linda & Judith, 2011). Using the Walker and Avant concept analysis model a formal concept analysis will be performed on the term “pain”. Middle range nursing theory gave the example of pain as one of many concepts used in nursing (McEwen & Wills, 2014).

What is the point in measuring something that is unique to every individual? In “The Pain Scale,” the author, Eula Biss, attempts to convey her pain to the reader. She tells the reader how she has tried to describe and measure her pain. There is a system set up for doing so, but it leaves much up to individual interpretation. The arbitrary process by which we are supposed to evaluate the level of pain we are experiencing doesn’t seem to accomplish much. Throughout the essay, Biss uses unique ways of comparing the suggested levels of pain to other “scales.” This raises the question, why can the scale, itself, doesn’t do adequate job of helping people understand pain.

This paper will define the term pain and how it pertains to the comfort theory. Next, there will be discussion from relevant literature in regards to pain. Its defining attributes will be

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,

Each individual have experience pain differently. This is usually due to the factors of ethnicity, genetics and sex. This is known as pain perception. Different pain experiences are usually based on the location and severity of pain of an injury. However, evidence has shown that pain perception is not entirely dependent on physical injury; when pain perception is less/greater than expected from the extent of a physical injury, cases where the site of injury and site of pain differs.

Since Abdalrahim et al. (2010) stated that nurses are not being properly educated in pain and pain management here is some different definitions and examples. According to Engebretson, Monsivais, & Mahoney (2006), “Pain

Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations

The major concepts of this theory are defined theoretically since the use of these definitions is from a broader theoretic concept. Therefore, an operational concept could be developed from them. There is consistency in the use of these concepts throughout the theory of acute pain management with examples given using the same language as well as maintaining the integrity of the concepts.

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

Pain is something that connects all of us. From birth to death we can identify with each other the idea and arguably the perception of it. We all know we experience it, but what is more important is how we all perceive it. It is known that there are people out there with a ‘high’ pain tolerance and there are also ones out there with a ‘low’ pain tolerance, but what is different between them? We also know that pain is an objective response to certain stimuli, there are neurons that sense and feel pain and there are nerve impulses that send these “painful” messages to the brain. What we don’t know is where the pain