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Interprofessional Pain Management Competency Program

Interprofessional Pain Management Competency Program

Key concepts and definitions

Pain

"An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

Note: The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. Biologists recognize that those stimuli which cause pain are liable to damage tissue. Accordingly, pain is that experience we associate with actual or potential tissue damage. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience. Experiences which resemble pain but are not unpleasant, e.g., pricking, should not be called pain. Unpleasant abnormal experiences (dysesthesias) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain."

Addiction

"Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving."

  • Savage, S. R., Joranson, D. E., Covington, E. C., Schnoll, S. H., Heit, H. A., & Gilson, A. M. (2003). Definitions related to the medical use of opioids: evolution towards universal agreement. [Research Support, Non-U.S. Gov't Review]. J Pain Symptom Manage, 26(1), 655-667.

Advocacy

Advocacy broadly includes “interventions targeting individual empowerment, interpersonal interactions, organizational and cultural changes, and policy development related to healthcare delivery and design” (Earp, French, & Gilkey, 2008). Advocacy involves ensuring that “patients have enough information to exercise autonomy; their legal and moral rights are respected; and health care resources allow appropriate quality and quantity of care” (Baldwin, 2002).

  • Earp, J.A.L., French, E.A., Gilkey, M.B. (2008) Patient Advocacy for health care quality: strategies for achieving patient-centered care. Sudbury, MA: Jones & Bartlett Publishers.
  • Baldwin, M. A. (2002). Patient Advocacy: a concept analysis. Nursing Standard, 17(21), 33-39.

Comprehensive Care

"The practice of continuing comprehensive care is the concurrent prevention and management of multiple physical and emotional health problems of a patient over a period of time in relationship to family, life events and environment."

Cultural Inclusiveness

A culturally inclusive health-care team provides “services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients."

Evidence-Based Practice

"The integration of best-researched evidence and clinical expertise with patient values."

  • Sackett, D. L. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Edinburgh; New York: Churchill Livingstone.

Interprofessional Teamwork

"The levels of cooperation, coordination and collaboration characterizing the relationships between professions in delivering patient-centered care."

  • Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

Misuse

"Use of a substance for a purpose not consistent with legal or medical guidelines, as in the non-medical use of prescription medications."

  • World Health Organization. (1994). Lexicon of alcohol and drug terms. (p. 45). Geneva: World Health Organization.

Non-Adherence

"Deviation from the prescribed medication regimen sufficient to influence adversely the regimen’s intended effect."

  • Fine, R. N., Becker, Y., De Geest, S., Eisen, H., Ettenger, R., Evans, R., et al. (2009). Nonadherence consensus conference summary report. [Consensus Development Conference Review]. Am J Transplant, 9(1), 35-41. doi: 10.1111/j.1600-6143.2008.02495.x

Patient-Centered

"Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions."

  • Institute of Medicine (U.S.). Committee on Quality of Health Care in America. (2001). Crossing the quality chasm : a new health system for the 21st century. (p. 6). Washington, D.C.: National Academy Press.

Professional Competencies

"Integrated enactment of knowledge, skills and values/attitudes that define the domains of work of a particular health profession applied in specific care contexts."

  • Hopkins D (ed). (2010) Framework for action on interprofessional education & collaborative practice (p. 7). Geneva: World Health Organization.

Social Support System

A social support system is the support available and identified by individuals within their communities – including, but not limited to family, friends, informal caregivers and ombudsmen – “which can provide a buffer against adverse life events and living conditions, and can provide a positive resource for enhancing the quality of life."

Suffering

"Suffering is the reaction to the physical or emotional components of pain with a feeling of uncontrollability, helplessness, hopelessness, intolerability, and interminability. Suffering implies a threat to the intactness of an individual’s self-concept, self-identity, and integrity."

  • Turk DC, Okifuji A. (2010). Pain terms and taxonomies of pain. In: S. Fishman; J. Ballantyne; JP Rathmell, (Eds.) Bonica's management of pain. (p. 17). 4th ed. Baltimore, MD: Lippincott, Williams & Wilkins

Tolerance

"Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time."

  • Savage, S. R., Joranson, D. E., Covington, E. C., Schnoll, S. H., Heit, H. A., & Gilson, A. M. (2003). Definitions related to the medical use of opioids: evolution towards universal agreement. [Research Support, Non-U.S. Gov't Review]. J Pain Symptom Manage, 26(1), 655-667.