PAIN ASSESSMENT AND THE USE OF MEDICAL AMONG SKILLED WORKERS

1.1       BACKGROUND TO THE STUDY

Pain is defined as an unpleasant sensorial and emotional experience, associated with real or potential harm of tissues, or described in terms of such harm. The experience of pain is a complex phenomenon and it involves social, cultural, emotional, physiological and psychological components. Pain in critical care areas is triggered by anxiety, fear and difficulties in communication (Adams & Osborne, 2017). There is no an exclusive relationship between pain and tissue injury, and the sensitive, emotional and cultural aspects cause perception to be a subjective and personal experience. Knowledge about these concepts is key to understand pain and to define the domains it is comprised of, the methods that will be used to assess it and the strategies to guarantee its control.  It is estimated that the majority of patients in America suffers from pain and many of those patients suffer from acute or chronic pain during their hospitalization (McCarberg, Nicholson, Todd, Palmer, & Penles). In fact, people associate illness with pain and include the existence of pain as a sign that something is wrong, ignoring the fact that many diseases do not have pain as a symptom.

A cross sectional study in South West Nigeria determined the prevalence and risk factors for low back pain within the community. The prevalence among males (44.7%), was higher than among females (35.6%). The prevalence of low back pain was highest among farmers (mostly men) and lowest among petty traders (mostly women). Male preponderance was related to occupational factors. It was concluded that low back pain is prevalent in rural income communities and may occur at levels similar to those reported in high income countries (Omokhodion, 2016).

Omokhodion and Sanya (2014) reported 46% and 38% as the prevalences of lower back pain in Nigerian urban and rural hospital workers respectively (Omokhodion, 2014), while Adedoyin et al. (2015) reported a prevalence of 74% among computer users in Nigeria (Adedoyin, 2015). The phenomenon of pain related to work done on a daily basis must therefore be treated very seriously. Musculoskeletal disorders have a range of causes; the exact cause depends on age, occupation, activity level and lifestyle (Pinder, 2015). These musculoskeletal disorders have a considerable socio-economic impact. First, they drive up costs for workers, companies, and society in general. This involves both direct costs (compensation of victims, Medicare, etc.) and indirect costs (loss of production, replacement costs, absenteeism, etc.) associated with occupational diseases and industrial accidents. Yet, despite the scale of the economic repercussions, the serious and sometimes dramatic consequences of work- related musculoskeletal disorder (WMSD) on victims must not be overlooked. Physical and mental sufferings, compensation difficulties and temporary or permanent limitations in their professional activities are just a few aspects of the tragedy that can strike people afflicted with WMSD (Serge, 2014).

Vital signs are body temperature, pulse, respiration, blood pressure. Recently, many agencies such as veterans’ affairs (VA), California legislature, have designated pain as fifth vital signs, to be assessed at the same time as each of the other four. (Barbara et al., 2012, kozier et al 2012 & Smeltzerand Bare 2010).Pain reveals a lot about a person’ health, which is why it is often called the fifth vital sign. Not only does pain affect a persons’ physical health, but it also, affects their mental health and quality of life through things such as mood, activity, sleep, hygiene, appetite, and the ability to focus and concentrate (JCAHO 2018).

Culture is a distinguishing factor between individual actions, guiding their beliefs, acts, perceptions and emotions, in addition to having a powerful effect on tolerance to pain or not. This is observed when one individual cannot bear a certain stimulus, while another can tolerate it. Moreover, the cultural question plays an important role in the actions of health professionals, having a direct effect on pain management. Some professionals, based on their own experiences, assess pain in a superficial way and do not give this event the due importance. Based on the multiplicity and different ways of perception and appreciation that change from person to person, it is essential that professionals pay attention to this phenomenon for better assessment and comprehensive care (Calil AM, Pimenta CAM 2017).

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