Page 71 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

44 Chapter 2. Pain

more marked when nursing home residents and older adults
with mild cognitive impairment are asked to put the faces in
the correct order. The Faces Pain Scale cannot, therefore, be
recommended for general clinical use with older adults or
nursing home residents” (British Pain Society and British
Geriatrics Society 2007 ).

Pain Management

If we consider the links that have been established between
the experience of wound-related pain and the occurrence of
psychological distress, it could be argued that if wound-pain
were to be managed accurately, psychological stress may
reduce substantially and their quality of life would increase.
That is, if the pain a patient experiences at dressing change or
wound manipulation is managed and subsequently reduced,
the pain-stress-pain cycle highlighted above may be inter-
rupted, consequently resulting in improved wound healing
and psychological health. So, how can pain be best managed?
One particular model that can prove effective in appropri-
ately managing a patient’s wound-related pain is the P.A.I.N.
model developed by Keyte and Richardson ( 2011 ). This
model consists of four elements, Preparation, Assessment,
Intervention and Normalisation, each of which will be briefly
outlined below.

Preparation

In order to appropriately manage pain it is essential to
acknowledge it as a biopsychosocial phenomenon. Thus, it is
necessary to consider not only the physiology but also the
social contexts and psychological aspects of pain. In order to
facilitate pain and stress management appropriately it is
imperative that, within the preparation stage, excellent
interpersonal skills and a good therapeutic relationship is
established. Care regimes need to include environmental
strategies that create a relaxed situation where patients feel