Improving our communication with patients with pain . Joanna M. Zakrzewska. AIMS and OBJECTIVES. AIM: Change your perception about how you communicate with a patient in pain At the end of the presentation you should: Understand the need for good communication and how this can be improved
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Joanna M. Zakrzewska
AIM: Change your perception about how you communicate with a patient in pain
At the end of the presentation you should:
How much time does the average patient need?
90 – 150 seconds
In a survey of 74 consultations patients were allowed to complete their opening statement in only 23% of cases
Nader, Clinical J Pain 2003
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
The inability to communicate in no way negates the possibility that an individual is experiencing pain and is in need of appropriate pain relieving treatment .
Pain is ALWAYS accompanied by an emotion
Although a personal experience it results in observable pain behaviour
Pain that has outlived its usefulness
What other data do you need to ascertain?
Any measure is addressed to the listener , the clinician , so it requires a comment - shared trust
Verbal descriptor rating scales
Numeric rating scale
Reliable in the elderly
anchors : no pain max pain
no relief max relief
no distress max distress
10 cm line
Children over 8 can use these
Reliable in elderly
In the last month have you
felt a lack of pleasure in life?
felt depressed ?
Hospital Anxiety and Depression Scale
Beck Depression Inventory
How you look when in pain, screw up your faceMakes you tensePain makes you loose sense of control as it prevents you doing certain things
Pain is complicated took years to find out what pain was
Nothing positive comes out of what I am going through
Deep depression, only see black and white
Want to hold head and scream just to release it
Geometrical summing up of where pain moves out and radiates
Shooting throbbing sensation
I feel much better as a person
the flowers, living
would love to be there
There is two of me
Its red but not solid, some bits are light some solid
The solid bits are worst
Perceptions of pain Padfield D
Like an animal pawing away inside me and tearing away the flesh from the inside out
With these pictures everyone’s imagination can hopefully realise the extremities of your pain – a picture is worth a thousand words
Perceptions of pain Padfield
Greenhalgh and Hurwitz 1999
Frank AW 2003