Chronic pain syndromed

Domain 12. Comfort
Class 1. Physical comfort
Diagnostic Code: 00255
Nanda label: Chronic pain syndromed
Diagnostic focus: Chronic pain syndrome

Nursing Diagnosis Chronic Pain Syndrome

Chronic pain syndrome (CPS) is a condition characterized by long-term pain or discomfort which can last for months to years. It can cause significant psychological and physical distress and can affect individuals’ quality of life. CPS is one of the most common issues encountered in nursing practice.

Introduction to Nursing Diagnosis of Chronic Pain Syndrome

Nursing diagnosis for chronic pain syndrome (CPS) requires accurate assessment, identification of contributing factors, providing comfort measures and individualization of care. The nursing assessment should include establishing the main source of pain and evident gestures that contribute to the syndrome. The subsequent nursing diagnosis, health promotion and intervention measures should be in accordance with the individual’s behavior and lifestyle. Nursing interventions should focus on pain relief, anxiety management, health education, medication compliance and influencing positive attitude towards the disorder.

NANDA Nursing Diagnosis Definition

According to Nursing Diagnosis Handbook An Evidence-Based Guide to Planning Care, Tenth Edition, the nursing diagnosis of chronic pain syndrome is defined as follows: “Chronic pain syndrome is a chronic condition characterized by persistent or continuous pain that impairs body functions, activities, and quality of life of an individual.

Defining Characteristics

• Subjective Characteristics: verbal reports of pain; reluctance or inability to participate in activities due to chronic pain; difficulty in sleeping or fatigue
• Objective Characteristics: evidence of pain from observation; muscle tenderness; restlessness; decreased range of motion; altered vital signs; loss of appetite; decrease in functional level or ability to perform activities of daily living

Related Factors

• Excessive involvements in other activities resulting in the overuse of muscles, joints, and tendons
• The presence of psychological conditions such as depression or anxiety
• Past medical history of nerve and musculoskeletal disorders
• Environmental factors including cold, humidity, or poor posture
• Medications that affect the central nervous system

The presence of any of these related factors can lead to the development of chronic pain syndrome or make it worse for an individual.

Suggestions of Use

The main goal in managing chronic pain syndrome is to reduce the pain's intensity and duration while improving the individual’s activity level and ability to participate in their daily activities. There are a few strategies that can help nurses in providing effective care to those affected by CPS:

• Proper assessment and monitoring of the pain's severity and location
• Medication compliance to relieve the pain
• Encouraging the patient to maintain an active lifestyle
• Providing support and educating patients on the disorder and its treatment
• Incorporating relaxation strategies into the treatment plan

Suggested Alternative NANDA Nursing Diagnoses

Alternative NANDA nursing diagnoses for those with chronic pain syndrome include:

• Disturbed Sleep Pattern related to pain
• Activity Intolerance related to pain
• Fatigue related to pain
• Risk for Injury related to overexertion
• Ineffective Coping related to unpredictable episodes of pain

These diagnoses provide guidance in choosing the best interventions to relieve the pain and improve the individual’s quality of life.

Usage Tips

The most effective approach to treating chronic pain syndrome is to include both physical and psychological therapies. For example, relaxation techniques such as progressive muscle relaxation, guided imagery, and mindfulness can help individuals to cope with their condition and reduce the severity of their symptoms. In addition, cognitive-behavioral therapy can be beneficial in helping individuals learn to manage their negative thoughts and emotions.

NOC Outcomes

Nursing outcomes classified associated with chronic pain syndrome are:

• Pain Management: Demonstrates the ability to use appropriate techniques to effectively manage pain including medication and nonpharmacological interventions.
• Functional Status: Demonstrates the ability to perform activities of daily living with minimal assistance.
• Sleep/Rest: Reports the ability to attain satisfactory sleep.
• Physical Mobility: Demonstrates the ability to perform physical activity without harm to self.
• Coping: Demonstrates the ability to adapt to the stressful situation.
• Safety: Identifies and adheres to safety measures pertaining to activities of daily living, home and workplace.

Evaluation Objectives and Criteria

Evaluation objectives for chronic pain syndrome should be individualized according to the needs and expectations of the patient. Common evaluation criteria for this disorder include determining the level of physical activity the patient is able to engage in, assessing the patient’s ability to sleep and rest comfortably, determining the presence and absence of any coexisting disorders, and reporting any adverse reactions to medications or treatments.

NIC Interventions

Interventions recommended for chronic pain syndrome according to the Nursing Interventions Classification system are as follows:

• Analgesic Administration: Administering prescribed analgesics to control pain.
• Behavioral Pain Control: Teaching pain-relieving techniques such as relaxation.
• Educating the Patient: Providing information about chronic pain syndrome, lifestyle modifications, and other helpful resources.
• Exercise: Encouraging physical activity as tolerated to restore or maintain mobility and function.
• Promote Comfort: Distributing heat or cold therapies, providing massage.

Nursing Activities

Nurses can help individuals with chronic pain syndrome by creating a comprehensive care plan to achieve maximum reduction or remission of the pain, identifying potential triggers that may cause flare-ups, providing support, guidance and education to the patient, adhering to medication protocols, and encouraging rest, relaxation, and activity as appropriate.

Conclusion

Chronic pain syndrome is a debilitating condition that can cause physical and mental distress. Nurses play a key role in the care of individuals with this disorder by providing assessment, support, medication management and education. Implementing strategies to reduce pain, improve physical functioning, and enhance emotional well-being can help individuals to achieve better quality of life.

5 FAQs

• Q. What is chronic pain syndrome?
  A. Chronic pain syndrome (CPS) is a condition characterized by long-term pain or discomfort which can last for months to years.
• Q. What are some of the defining characteristics of chronic pain syndrome?
  A. Defining characteristics of chronic pain syndrome are verbal reports of pain, reluctance or inability to participate in activities due to chronic pain, difficulty in sleeping, evidence of pain from observation, muscle tenderness, and restlessness.
• Q. How is chronic pain syndrome treated?
  A. Treatment for chronic pain syndrome usually involves a combination of physical and psychological techniques and therapies. These may include relaxation techniques, cognitive-behavioral therapy, as well as medications and interventions to relieve the pain.
• Q. What are some of the nursing activities involved in caring for patients with chronic pain syndrome?
  A. Nursing activities include proper assessment and monitoring of the pain's severity, medication compliance, encouraging the patient to maintain an active lifestyle, providing support and education to the patient, incorporating relaxation strategies into the treatment plan, and identifying potential triggers that may cause flare-ups.
• Q. What is the primary goal of managing chronic pain syndrome?
  A. The primary goal in managing chronic pain syndrome is to reduce the pain's intensity and duration while improving the individual’s activity level and ability to participate in their daily activities.

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