Pain, Compliance, and Family, Research Paper Example

The first concept that applies to Mr. F’s concern is pain: after all, he came to the emergency room complaining of chest pain. Pain can be defined in a number of ways: from Merriam-Webster (2012), pain can be defined in terms of physical suffering; in terms of the sensation of pain itself as transmitted by the nerves, and in terms of grief or other emotional distress. The first and second definitions are relevant to Mr. F. Pain also has psychological aspects and effects, which are captured in the Gate Control Theory of pain formulated by Melzack and Wall (1965) (Hadjistavropoulos et al., 2011). The definition of emotional pain comes from the discipline of psychology: emotional pain is defined in terms of emotional or psychological distress, anguish, heartache, and the like (Snooks, 2009). The pain that Mr. F is feeling is primarily physical rather than emotional, but he may also be experiencing psychological distress and anguish. Thus, his pain is probably describable in terms of biopsychosocial effects (Barlow & Durand, 2012).

The second key concept that applies to Mr. F’s case is compliance. Etymologically speaking, to comply is “to accomplish, fulfill, [or] carry out” (Harper, 2012, para. 1). Though different disciplines have articulated different definitions of compliance, what all the definitions have in common is adherence to a set of rules or guidelines set forth by another. In the field of business, compliance can be defined as “the fact of obeying a particular law or rule, or of acting according to an agreement” (Compliance, 2011, para. 1). In physics, compliance refers to objects, not people’s behavior: it is an object’s ability to bend, mold, or conform without breaking (Evangelista, 1999). In psychiatry, by contrast, compliance pertains to “concordance” and to the “therapeutic alliance” between doctor and patient (Jaeschke & Siwek, 2011, p. 53). In the social sciences, compliance is defined in terms of following the prescribed regimen set forth by a doctor; however, the ideal is for doctor-patient relations to be a unity, not a black and white instruction to the patient (Donovan & Blake, 1992).  In health care, compliance consists of the patient following a determined set of rules, typically formulated by the doctor or nurse for that particular patient. In nursing, compliance has been used in a variety of ways, but in essence the term is a description of the patient’s “submission or yielding to predetermined goals” (Bastable, 2008, pp. 200-202). In terms of nursing theory, patient compliance can be defined in terms of “the patient’s regular and consistent adherence to a prescribed treatment regimen” (p. 201). Compliance is not an all-or-nothing phenomenon: nursing definitions of compliance have typically used it to capture “the extent to which patients/families followed the wishes, orders, or advice of health care providers” (Doane & Varcoe, 2004, p. 279). Thus, Mr. F’s compliance is the extent to which he follows medical advice, i.e. by taking his medication and following directives, etc.

Finally, family is a concept that pertains to Mr. F’s case as well, with his wife and his mother. Family is a very broad concept: a literature review expert used it to cover anyone who encourages and takes care of a patient (Malusky, 2005). Families can encompass members with related morals, beliefs, customs, and visions of the future that gives the individual a sense of self and accord (Schor, 2003). Family can be defined in terms of individuals who provide financial and emotional support, as well as in terms of parental figures and children (Tillman & Nam, 2008). In a more basic and literal sense, a family can be defined in terms of individuals in a nuclear parent-child relationship, though this definition can also be extended to include individuals who are incorporated by birth, marriage, adoption, or co-residence (Klever, 2009). As Jenkins (2006) explained, for the purposes of nursing practice a family is the “family unit”: it may be the conventional nuclear family, but it may also involve “cohabitation; single-parent families; reconstituted or stepfamilies; [and] extended families” (p. 38).

References

Bastable, S. B. (2008). Nurse as educator: Principles of teaching and learning for nursing practice (3^rd ed.). Sudbury, MA: Jones and Bartlett Publishers.

Doane, G. H., & Varcoe, C. (2004). Family nursing as relational inquiry: Developing health-promoting practice. Philadelphia, PA: Lippincott Williams & Wilkins.

Jenkins, R. L. (2006). Caring for families in the home. In R. Rice (Ed.), Home care nursing practice: Concepts and application (4^th ed.) (pp. 38-48). St. Louis, MO: Mosby Elsevier.