Ethical Aspects of Chronic Pain Management with Opioid Analgesics
Relevance and Applicability to Nursing Practice Pain is caused by both physiological and psychological processes and is mediated by a host of external and internal factors. Health care providers rely primarily on the patient's own report of pain when considering treatment options. Previous experiences, cultural norms, access to alternative coping mechanisms, along with a multitude of other determinants alter a person's perception of pain. The health care provider has the responsibility to interpret subjective data presented by the patient along with their physical examination. Treatment options must be considered by weighing the importance of effective pain management against associated risks.
Pain Assessments Of primary importance in treating pain appropriately is pain assessment. Oftentimes a unidimensional tool, such as a 0-10 numerical scale where 0 is no pain and 10 is the worst pain imaginable, is used in a hospital setting. Pain assessments should include the quality, location, and pattern of the pain as described by the patient. Multidimensional pain questionnaires explore the “sensory, affective, and emotional components of the patient's pain experience” (Cox, 2010). In the hospital setting,