Page 76 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Pain Management 49

cheap to buy. Despite this, some health providers have
highlighted concerns over the repeated exposure to nitrous
oxide, although the majority of wound care clinicians would
be significantly below the limits proposed by the Health and
Safety Committee in relation to its use.
Limited evidence is available in relation to the effective-
ness of complementary therapies in the management of
wounds and wound-related pain. That said it would be inac-
curate to suggest that complementary therapies do not work.
Conversely, as suggested in the preparation element of the
P.A.I.N model, in order to maximise the efficacy of manage-
ment techniques, it is essential to control the psychological
state of the patient. Hence, the relaxation component included
in complementary therapies is highly advantageous to the
pain-management process. There are a number of non-
pharmacological interventions considered useful for the care
and management of wound, although the coverage of these is
beyond the remit of this book. Nonetheless, recent publica-
tions have discussed one specific non-pharmacological issue
associated with wound care.
In a review of the psychological models that have been
used to conceptualise chronic pain, Turk et al. ( 2008 ) sug-
gested that a more realistic approach to eliminate pain will
likely combine pharmacological, physical and psychological
components tailored to each patient’s needs. In their review,
the greatest empirical evidence for success with psychological
interventions was found for Cognitive-Behavioural Therapy
(CBT) which includes stress management, problem solving,
meditation, relaxation and goal setting. In CBT, therapists
help patients build their communication skills, gain a sense of
control over their pain and cope with the fear of pain.
Patients are taught positive coping strategies so that they will
gain control over their pain, resulting in improved mood
(Turk et al. 2008 ).
It has been discovered that when dressings are applied to a
patient’s wound it can create analgesia (Charles et al. 2002 ;
MacBride et al. 2008 ), although it is not clear whether this is, in
part, due to the extreme pain experienced during the dressing