Chronic pain is an issue that affects many individuals, regardless of age, gender, and background. Nursing diagnosis for chronic pain can help identify the right treatment plans so that patients can find some relief. We will look at what nursing diagnosis for chronic pain entails, including the definition and defining characteristics of nursing diagnosis. Additionally, we will explore associated conditions, at-risk populations, suggested alternative nursing diagnoses, practical usage tips, and a NOC Outcomes and NIC Interventions nurses can use in their assessment and evaluation measures.
Nursing Diagnosis Definition
This nursing diagnosis is “a clinical judgment about individual, family and community responses to actual or potential health problems and life processes.” Nursing diagnosis for chronic pain is established when nurses assess the patient’s individual circumstances and consider the implications of any underlying medical conditions that may be causing the persistent pain. The primary goal of the nursing diagnosis is to create the most appropriate plan of care so the patient can achieve relief, thereby restoring quality of life.
Defining Characteristics
Defining characteristics are the signs and symptoms that indicate the presence of chronic pain. These can be subjective or objective and may vary from person to person. Some common defining characteristics of chronic pain include:
Subjective
- Reports of pain
- Reports of fatigue
- Reports of sleep disturbances
- Reports of anxiety and depression
- Reports of decreased quality of life
Objective
- Guarding or protecting the painful area
- Decreased range of motion
- Muscle tension or spasms
- Elevated blood pressure or heart rate
- Decreased appetite or weight loss
Related Factors
Related factors are the underlying causes or contributors to chronic pain. These can be physical, psychological, or social in nature. Some common related factors of chronic pain include:
Physical
- Injury or trauma
- Surgery or medical procedures
- Chronic illness or disease
- Inflammation or nerve damage
Psychological
- Anxiety or depression
- Stress or trauma
- Learned pain behaviors
Social
- Lack of social support
- Financial or employment stressors
- Cultural or societal attitudes toward pain
At Risk Population
There is no one size fits all when it comes to nursing diagnosis for chronic pain. Certain populations are more susceptible to experiencing this particular condition, however. Older adults tend to report higher levels of chronic pain while younger populations may experience shorter bouts of severe pain. Individuals facing psychological issues, such as depression and anxiety, can find comfort in therapeutic interventions such as cognitive behavioral therapy, although those involved in high-stress professions may have difficulty managing the continuous pain levels.
Associated Conditions
Many medical conditions can be associated and may contribute to chronic pain. For instance, conditions like diabetes, arthritis, and cancer can lead to a sensation of discomfort and pain, both acute and chronic. Diseases limitation of mobility, such as cerebral palsy and muscular dystrophy, are also known contributors to chronic pain. Neurological conditions, headaches, and back pain can all lead to chronic symptoms as well.
Suggestions of Use
Nurses can use the nursing diagnosis for chronic pain to help determine the best plan of care to manage and reduce pain. Exercise and physical therapy are two of the more common approaches to treatment. Additionally, educational interventions, such as teaching the patient self-management techniques, may prove beneficial. Cognitive therapies, such as relaxation training and meditation, can be used in tandem with medication to help compassionately address chronic pain. Nurses can also recommend activity modifications and physical activity options, as well as suggest lifestyle changes, such as quitting smoking or losing weight.
Suggested Alternative Nursing Diagnoses
If chronic pain is not the most appropriate nursing diagnosis for the individual, there are several alternative NANDA nursing diagnoses that may be more suitable. These include:
- Acute pain
- Anxiety
- Chronic sorrow
- Disturbed sleep pattern
- Ineffective coping
- Powerlessness
- Impaired physical mobility
Usage Tips
It is also important for nurses to understand the differences between acute and chronic pain, as symptoms can vary greatly. Nurses should be aware of the specific forms of assessment techniques and behatioral observations they can utilize to appropriately diagnose a patient’s chronic pain. Additionally, they should become familiar with published guidelines and evidence-based resources to ensure they make the best possible decision when determining the plan of care.
NOC Outcomes
The Nursing Outcomes Classification (NOC) provides a standardized language for describing the expected outcomes of nursing interventions. Some common NOC outcomes related to the nursing diagnosis of chronic pain include:
- Pain level
- Pain control
- Physical functioning
- Emotional functioning
- Sleep quality
- Quality of life
Evaluation Objectives and Criteria
To evaluate the effectiveness of the nursing care plan for chronic pain, it is important to establish clear objectives and criteria for evaluation. Some common evaluation objectives and criteria for the nursing diagnosis of chronic pain include:
- Reduction in pain level or intensity
- Improved physical functioning, such as increased mobility or decreased muscle tension
- Improved emotional functioning, such as decreased anxiety or depression
- Improved sleep quality
- Increased use of pain management strategies
- Increased satisfaction with pain management
NIC Interventions
The Nursing Interventions Classification (NIC) provides a standardized language for describing the interventions that nurses use to address nursing diagnoses. Some common NIC interventions related to the nursing diagnosis of chronic pain include:
- Pain management techniques, such as pharmacological and non-pharmacological interventions
- Education about pain management strategies and resources
- Relaxation techniques, such as deep breathing or guided imagery
- Therapeutic communication to address emotional aspects of pain
- Physical therapy or rehabilitation to address functional limitations
- Referral to other healthcare providers, such as a pain management specialist or psychologist
Nursing Activities
To effectively implement the care plan for chronic pain, nurses may engage in various activities, such as:
- Conducting a thorough pain assessment
- Educating the individual and their caregivers about pain management strategies and resources
- Administering medications or other pain management interventions
- Monitoring the individual’s pain level and response to interventions
- Providing emotional support and counseling to address the psychological aspects of pain
- Facilitating referrals to other healthcare providers as needed
Conclusion
Nursing diagnosis for chronic pain should focus on providing relief, reducing symptoms, and restoring quality of life. To achieve this, nurses must evaluate the patient’s individual circumstances, along with any related factors, to develop a comprehensive plan of care based on nursing diagnosis. Through the implementation of appropriate interventions and nursing activities, nurses can offer the necessary support and relief to those suffering from chronic pain.
FAQs
1. What does nursing diagnosis for chronic pain involve?
Nursing diagnosis for chronic pain involves understanding the patient’s individual circumstances and evaluating any underlying medical conditions that could be contributing to the persistent pain. The primary goal is to create the most appropriate plan of care, based on nursing diagnosis, so that the patient can achieve relief and restore quality of life.
2. What type of criteria do nurses assess when diagnosing chronic pain?
Nurses typically assess a combination of subjective and objective criteria when diagnosing chronic pain. Subjective qualities can include pain, dyspnea, sleep disturbances, poor appetite, fatigue and decrease in activity. Objective characteristics often point to a physical cause, such as muscle tension or spasms, deformity, lack of range of motion and decreased sensation.
3. Does the nursing diagnosis for chronic pain differ for different populations?
Yes, the nursing diagnosis for chronic pain can differ for different populations. Older adults tend to report higher levels of chronic pain while younger populations may experience shorter bouts of severe pain. Individuals facing psychological issues, such as depression and anxiety, can find comfort in therapeutic interventions such as cognitive behavioral therapy.
4. What type of interventions are used to treat chronic pain?
Interventions such as exercise, physical therapy, educational interventions, cognitive therapies, activity modifications, lifestyle changes and medication may all be used to treat chronic pain. The selection of interventions depends on the individual’s unique circumstances and personal preferences.
5. What type of outcomes are used to evaluate the effectiveness of treatment?
The Nursing Outcomes Classification (NOC) system provides a set of standardized outcomes that can be used to assess the effectiveness of treatment. Examples can include functional ability, pain level reduction, sleep quality, comfort level, activity tolerance and emotional well-being. Additionally, the Nursing Interventions Classification (NIC) system can provide a set of standard interventions to assist nurses with their treatment plans.