Literature Review on Pain Management

Summary 1P10 –

In the article “Culture’s Effects on Pain Assessment and Management by Mary Curry Narayan (2010) describe some aspects in the process to treat and manage a client during the process of pain. Although illness demonstrated some specific aspects to care, cultural and linguistic aspects of the patient must be considered relevant all the time. As a result, the cultural paradigms draw the correct methods to understand and act in all situations, which can be demanded. Indeed, culture has an important influence in the process of prevention – promotion diseases and treatment- care – helping the illness process so that these factors must be influenced by the person’s beliefs. According to Narayan (2010) an example of the cultural influences in the process to attend a client is that “it influences how each person experiences and responds to pain, including when and how to ask for treatment (pg. 40).” Nevertheless, nurses must be conscious about the client cultural aspects because it will manage the client’s care.

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Also, before, during, and after the treatment/care some cultural aspects can do some influences to decrease the environmental aspects between a nurse – patient. Some of these aspects are: “language and interpretation problems”, which has focus in the language deficit, where second language demonstrate a barrier in the treatment although it cannot be a problem if it has a translate or health professional who speaks the client’s language; “nonverbal communication problem”, which is a fundamental key factor in the treatment because body language does a roll process all time to care; “underreporting”, which describes the client’s thoughts about a correct personality/comportment during the treatment because some clients think that a good patient is who does not bother the health professional for simple aspects. This fact can be interpreted how a cultural factor where some communities have this fact in the educational process (Narayan/2010).

In fact, culture is an important part of a person’s identity where the person grow up understanding the general aspects of the life with his/her thoughts/views, so Narayan (2010) reinforces the principles of the patient-centered care movement such as “1- understand the patient as a unique person; 2- explore the patient’s experience of illness and pain (if present); 3- perceive the illness management from the patient’s perspective; and 4- promote shared decision making and adapt care to meet the patient’s need and expectations (pg.43).” To understand the key factor, it promotes the correct and adequate method to help the client. Likewise, people can change their cultural norms when it is necessary because nurses teach their clients so there must make an informed choice. This choice increases the evaluation of the treatment and a successful promotion the client’s process. Another fact in this process is to use the LEARN, which is a fundamental method to use in the client’s attainment, means five factors in the process to cure a patient, so these factors are to listen, explain, acknowledge, recommend, and negotiate. It demonstrates to be a simple, although this method is fundamental because the nurse can understand different fact, in the client’s culture, which can contribute to treat or had contributed to the illness is present.

In the article “Nurse-patient interaction and communication: A systematic literature review” by Steffen Fleischer, Almuth Berg, Markus Zimmermann, et al. (2009) demonstrates different concepts in the process of communication. It involves more than cultural and linguistic aspect, but all the factors present in the client. Also, communication can be seen as a dynamic, complex, and context-related ongoing multivariate process in which the experiences of the participants (for example the nurse and client) are shared. In addition, culture does a strong process of dependence on communication, which helps in the process of exchange information in the objective to transmit ideas, feelings, and specific situation present in the person’s mind.

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Therefore, communication constitutes an important part of the quality of nursing care and predominantly influences patient and resident satisfaction; it is a core element of nursing care, a fundamentally required nursing skill. All the processes are developed during the process of care, and these factors are compiled by nurses daily because it needs to have time and amend day by day. Still, language can be expressed in different aspects although the most common process is the verbal and nonverbal communication. Hence, body language does a key factor in the process to communicate and interact which other. For example, the nurse-patient relationship is primarily mediated by verbal and nonverbal communication, so both aspects need to be understood. Although client can have a lack of knowledge in the language process, it can difficult in the process of communication (Fleischer, Berg, Zimmermann, et al., 2009). Instead, these facts are reinforced by Fleischer, Berg, Zimmermann, et al. (2009) “a minimal mutual compatibility of the communicators’ realities like language has to be existent to achieve a successful exchange of information between nurse and patient (pg. 350).” In fact, culture does a key role in the communication, which works in the language communication. Nurses should understand these facts about the culture and methods to communicate, so they can promote a correct and satisfied treatment for the client in the process to care.

In the article “Communication for Better Care – Improving nurse-physician communication” by Marina Burke, Jeremy Boal, and Ruth Mitchell (2004) explains the factor where communication is more than a client and health professional, so this process is fundamental between health professionals (nursing and physicians). When a deficit the communication among providers occurs, it develops conditions for acrimony, frustration, and distrust, which can lead to inferior care and a greater risk of error. It can be seen an unfamiliar factor although lack of communication must develop problems in the process to care. Burke, Boal, and Mitchell (20014) emphasizes “it is important to note that there are many problems related to communication and collaboration that can only be fixed with broader changes in systems (pg. 43).” The language problems between professionals and, also, clients must be avoided. As a consequence, some aspects, which are necessary, promote better communication are: 1- health professionals are a unique team; 2- nurses and physician are equal when it comes to care the client, so superiority must be avoided; 3- nurses and physicians talk face to face, so this process promotes better communication and minimize situations not understood; and, 4- good news about the client’s process must provide an evaluation in the process of care and environment present. These are simple methods to promote better care and communication in general life process, so every professional needs to understand and begins promoting it.

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