Page 59 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

32 Chapter 2. Pain

perceive their experience of pain to be of a rating of mod-
erate or more (e.g. a pain score higher than 4 on a scale of
1–10). While clinicians have the tendency to consider would
healing to be of utmost importance, patients consistently rate
pain to be of most important to themselves.
In order to adequately treat pain, and attempt to negate its
adverse effects, it is important to record when it occurs, while
also identifying primary causes (White 2008 ). This would then
enable the clinician to determine the most appropriate means
for managing such pain including the application of support-
ive measures. There are a number of tools that can be adopted
in assessing patient’s pain throughout the treatment regime
(some of which will be discussed later in this chapter). The
adoption of these pain assessments would enable clinicians to
alter regimes in an attempt to meet the needs of individual
patients. Subsequently, the accurate assessment and manage-
ment of wound pain can establish a basis of trust on the part
of the patient, reduce the patient’s overall pain and stress,
contribute to patient quality of life (QoL) and increase treat-
ment concordance (Hollinworth 2005 ; Upton and Solowiej
2010 ).

Models of Pain

There are, as one would expect, various models that have
been developed in order to take into account the complex
phenomena of pain and it is worth exploring some of these
now in order to better understand the concept has been
described, and subsequently how best to both assess and
manage it (Upton 2012 ). Attempts at understanding pain
have a long history, with one of the first explanations being
provided by Descartes in 1644 who:

Conceived of the pain system as a straight through channel from
the skin to the brain (Melzack and Wall 1996 :126).
In other words, when you hit your thumb with a hammer
the hurt and damage from this area is sent up to the brain via
one channel that tells you that you are experiencing pain.