Keywords

pain assessment, facial pain expression, primal face of pain, pfp, pediatric pain

Abstract

Pain assessment continues to be poorly managed in the clinical arena. A review of the communication process in pain assessment is carried out and the hierarchical approach often recommended in the literature -with self-report as its "gold-standard," is criticized as limited and simplistic. A comprehensive approach to pain assessment is recommended and a model that conceptualizes pain assessment as a complex transaction with various patient and clinician dependant factors is proposed. Attention is then focused on the pediatric patient whose pain assessment is often dependent on nonverbal communicative action. The clinical approaches to pain assessment in this population -mainly the use of behavioral/observational pain scales and facial pain scales, are explored. The primal face of pain (PFP) is identified and proposed theoretically as an important link in the function of facial pain scales. Finally, the existence of the PFP is investigated in a sample of 57 neonates across differences in sex and ethnic origin while controlling for potentially confounding factors. Facial expression to a painful stimulus is measured based on the Neonatal Facial Coding System (NFCS) and applying an innovative computer-based methodology. No statistically significant differences in facial expression were found in infant display thereby supporting the existence of the PFP.

Notes

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Graduation Date

2007

Semester

Summer

Advisor

Byers, Jacqueline

Degree

Doctor of Philosophy (Ph.D.)

College

College of Nursing

Department

Nursing

Degree Program

Nursing

Format

application/pdf

Identifier

CFE0001808

URL

http://purl.fcla.edu/fcla/etd/CFE0001808

Language

English

Release Date

September 2007

Length of Campus-only Access

None

Access Status

Doctoral Dissertation (Open Access)

Included in

Nursing Commons

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