Friday, March 27, 2015

"Phantom Limb Pain: A Nursing Perspective"

There are a few good websites that discuss nursing care of patients with PLP. 

This Nursing Times article discusses pain assessment tools specifically for PLP. Furthermore, it describes "five key facts" regarding PLP, as well as discussing the etiologies of PLP. Importantly, the article discusses the lack of consensus of treatment as well as the physical, psychological, social, and spiritual impacts of pain. In this way, it addresses not just the obvious symptoms of pain, but also the holistic effects on the individual. Finally, the article discusses drug treatment options. Unfortunately, mirror therapy is not mentioned.

Although not an official article, AllNurses discussion boards such as this one have the potential to propagate useful (and admittedly false) information and tips regarding the nursing care of phantom limb pain. 

Comparative Pain Scale
Accessed through pinterest.com



Intervention
Rationale
Support the patient in seeking care
There exists today echoes of the attitude of disbelief towards patients who discuss their PLP. It is essential that the nurse express belief in the patient’s condition. This way, the patient will not fear judgment of their PLP and will be more encouraged to seek care and the relief they deserve.
Refer to appropriate health professionals
Appropriate professionals may include not only a specialist in pain relief or specifically PLP relief, but also a psychotherapist and occupational therapist. PLP may cause depression, and it may cause debilitating impact on quality of life, where an OT may be able to discuss techniques that may help to manage daily life while the pain is still occurring.
Detailed assessment of pain
Both the quantity and the quality of pain must be assessed in order to understand the patient’s condition and to inform treatment.
Monitor for change
Change should be monitored before and after treatment, of course, but pain should also be measured and recorded long-term. Since some patients’ PLP may increase or decrease as time goes by, it’s essential to be aware of the patients’ trends to inform treatment and communicate this information to health care collaborators.
Pain management
Ensure that pain is managed appropriately. Since some patients may be hesitant to discuss their PLP, it is all the more essential that the nurse medicate appropriately to ease suffering.


Sources:


Fieldson, D., & Woods, S. (2011, November 1). Nurses must conduct holistic assessments to manage this condition appropriately Dealing with phantom limb pain after amputation. In Nursing Times.

allnurses. (2008, April 4). phantom limb pain. In allnurses. Retrieved March 27, 2015.


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