Page 58 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Defining Pain 31

Woo et al. 2008 ); or whether nocioceptive or neuropathic in
origin (Soon and Acton 2006 ); or temporary or persistent.
Krasner ( 1995 ) describes acute pain as cyclic (occurring
during regular procedures) or non-cyclic (occurring during
manipulation of wounds).
Furthermore since different forms of pain are often treated
differently it is important for the health care professional to
not only acknowledge any pain, but also correctly identify the
type of pain in order to implement an accurate intervention.
Finally, it should not be overlooked that wound pain is
extremely distressing for patients and can result in the presen-
tation of psychological problems, which can be costly both
financially and emotionally for all (Upton and Hender 2012 ).
Patients have highlighted pain as being a significant
stressor (Solowiej et al. 2009 ). This is particularly worrying
when considering the body of research that has demonstrated
the negative impact of stress in relation to wound healing
(Cole-King et al. 2001 ; Soon and Acton 2006 ; Walburn et al.
2009 ). Hence, there is a need for clinicians and health profes-
sionals in the field of wound care to consider the assessment
of wound pain, and any resultant stress, throughout the treat-

ment process (see Chap. 3 ). Despite this, some health care
providers have, traditionally, neglected pain and the need
for its assessment and documentation (Woo et al. 2008 ).
Indeed, many health-related organisations and care provid-
ers have highlighted the need for pain management to be
incorporated into routine wound care practice. For example,
the European Wound Management Association (EWMA)
developed clinical guidelines and recommendations that
highlighted best practice in relation to wound-pain assess-
ment and management (European Wound Management
Association 2002 ). Additionally, the World Union of Wound
Healing Societies (WUWHS 2004 ) have emphasised the
need for minimising wound-related pain. Within this consen-
sus document, the WUWHS recommended the assessment
of wound-related pain and its perceived intensity before,
during and after dressing procedures. This is in the hope
that, if needed, clinicians can review their practice if patients