ConceptualComponents of Theory
ConceptualComponents of the Theory of Pain: A Balance between Analgesia andSide-effects
Amiddle range theory is a limited scope theory that aims at theintegration of theory and empirical research[ CITATION Mar131 l 1089 ].These kinds of theory are mostly applied in the nursing practice as aguide to both research and practice. Such theories are made toconsolidatedifferent theories. One of the middle range theories is the theory ofpain: a balance between analgesia and side-effects.
Themain concept in this theory is to establish a balance betweenanalgesia and side effects of the medication. This was developed inreference to theories that define pain and the mechanisms of pain,but lack of a theory that covers the relief of pain. Potent painmedication in this theory refers to the method used for pain reliefincluding opoid analgesics, intramuscular and intravenous injections.Opoid analgesics however, have side effects, such as vomiting,diarrhoea, nausea and urinary retention[ CITATION Ian13 l 1089 ].Epidural analgesics can be delivered by injection into the epiduralspace of the backbone, but even this has a side effect of extremenumbness. Other methods of delivering analgesics include use ofperipheral nerve blocks and post-incisionalinfiltration, all of which have uncomfortable side effects.
Observationand measurements of the concepts in study
Thistheory was therefore developed to help attain a balance between painrelief and analgesics[ CITATION Ana14 l 1089 ].As a result of this study, several ways to measure the extent of painhave been developed and adopted by nurses over the years. Some of themeasures include the use of pain scales such as the Visual AnalogScale for sensory pain and the Descriptive Pain Distress Scale foraffective pain.
Developmentand change in the theory based on testing of concepts
Thedevelopment of this theory has seen the development of threepropositions. The first one makes use of pharmacological,non-pharmacological adjuvants and pain medication to achieve thedesired balance. The second proposes the use of attentive care. Thisrequires nurses to assess, intervene and re-assess and re-interveneto achieve the desired effect. The third proposition requires patientteaching and mutual goal-setting. This involves the nurse documentinginstructions that the patient will make use of and dailynurse-patient discussions which are also documented.
Ana Manzano, L. Z. (2014). Exploring Interference from Analgesia in Patients with Cancer Pain: A Longitudinal Qualitative Study. Journal of Clinical Nursing, 1877-1888.
Ian Gilron, T. S. (2013). Combination pharmacotherapy for management of chronic pain: from bench to bedside. The Lancet Neurology, 1084-1095.
Mary Jane Smith, P. R. (2013). Middle Range Theory for Nursing: Third Edition. New York: Springer Publishing Company.