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Concept Analysis, Chronic Pain


Chronic pain causes are not the same for every patient. Many individuals worldwide suffer from chronic pain, the majority of which is lower back or other discomfort caused by another disease. When dealing with chronic pain patients, nurses confront several problems. This study will investigate the idea of chronic pain related to nursing practice. Chronic pain can be caused by several factors, such as damage to joints and bones or damage of nerves. Some diseases associated with chronic include gallbladder diseases, multiple sclerosis, stomach ulcers, HIV, and cancer. Chronic pain is more common among the elderly.

Chronic pain causes disability and sufferings such as a worse quality of health and life, drug dependence, anxiety, depression, movement restriction, and restriction of everyday activities. Chronic pain is linked to neurological changes because it causes a decrease in neurotransmitters and chemicals in the brain. Many patients in nursing homes suffer from undiagnosed and untreated chronic pain. Psychological therapies, multimodal rehabilitation, and cognitive behavioral therapy techniques may all assist with chronic pain management.


This paper aims to examine the term “chronic pain” using concept analysis. Concept analysis is a method used in examining concept for their semantic structures. The primary goal of concept analysis is to provide a clear operational description for a theory’s conflicting ideas (Walker & Avant, 2011). Over time, these terms lose their meaning due to being overused or misused (Walker & Avant, 2011). The primary goal of concept analysis is to establish operational definitions for research purposes. The word “chronic pain” is an example of a term that has been so overused that it has lost its genuine meaning. This is one of the reasons why the phrase “chronic pain” was chosen for concept analysis.

Defining of the Concept

Understanding the concept involves having a grasp of individual terms within the concept. It is important to understand the term chronic pain. In simple terms, pain can be defined grief, suffering emotional distress, mental distress or bodily disorder (Vos and Vitali, 2018). People fail to evaluate pain as a consequence of pathological tissue damage and instead assume that pain is caused by psychological factors. Persistent pain is a major reason for seeking therapy for injuries on nerves, body tissues, or other body parts at various stages of disease infections. Pain can have psychological components that lead to psychometric dysfunction and depression. Chronic pain is differentiated from acute pain in terms of quality of life, potential impact on productivity, physiological mechanism, and duration. In conclusion chronic pain can be described as a continuous feeling of pain which lasts longer than acute pain.

The concept of chronic pain was chosen since “I currently deal with chronic pain in my knee related to a childhood injury”. Therefore, this write-up aims to explore chronic pain better to understand the overall condition, education, and treatments.

Causes of Chronic Pain

The topic of chronic pain is particularly relevant in today’s healthcare dynamic, especially in nursing studies. This is attributed to multiple factors, one of which is the common occurrence of chronic pain. Around 25 million people in the US suffered from chronic pain in 2018 (Andraka-Christou, et al., 2018). Despite the common occurrence of chronic pain, no long-term study on chronic pain or chronic pain treatment has been undertaken (Alford, 2018). None of the few trials that have been done have a period longer than 12 months (Alford, 2018). This underscores the need for greater study into the idea of chronic pain, particularly nursing research.

A variety of factors can cause chronic pain. For example, back pain can be caused by traumatic injury, sleeping on a poor mattress, improper lifting of heavy objects, congenital conditions like the curvature of the spine. In the elderly chronic pain may be due to affected bones and joints. Other causes of chronic pain are injuries that fail to heal correctly, damaged nerves, and diseases, including stomach ulcers, gallbladder diseases, multiple sclerosis, cancer, and HIV (WebMD, 2021).

Literature on Chronic Pain

Defining Attributes

Identifying concept features the initial stage of analysis in the definition. As defined from various literature, durability is the most notable feature. Defining attributes identifies illegitimate use of the concept, “chronic pain” Defined attribute include the chronicity of pain’s presence and presence of pain. “Defining attributes are attributes that are commonly associated with the concept being studied and are not considered flexible with time” (Walker & Avant, 2011).

Presence of pain can be defined as a twinge, tingle, throe, sting, smart, shoot, prick, pang or an ache (Ernst, 2007). The person reporting pain is the most reliable source of information about its aggravating factors, precipitating, onset, intensity, quality and its location (Ernst, 2007). Pain is a subjective phenomenon and is present when the person experiencing it says it. The difference in sensory experience are important in treatment of pain and subjective ratings are important in diagnosis and treatment of pain.

The second attribute is longevity of the pain. Chronic as applied in chronic pain is the process of occurring repeatedly for a long period or pain that has been encountered and always present (Vlaeyen, & Crombez, 2020). “Chronic pain is defined as long-term pain that lasts longer than the normal healing period or a discomfort that lasts for more than 12 weeks” (Wilson, 2017). Chronic pain can be malignant pain or nonmalignant pain. The top cause of malignant pain is Cancer. In contrast, in nonmalignant pain, the original injury to the tissue is not progressive, and it has been recovered through the patient’s experiences of pain.

Chronic pain is applied in nursing education and research. According to a study by Molton & Terrill (2014), chronic pain is more likely to occur in older adults, resulting in suffering and disability. The study reveals that more psychologists in the US will be required to provide clinical services to many adults living with chronic pain (Molton & Terrill, 2014). The study by Dahlhamer et al. (2018) reveals that many adults in the US live with chronic pain, which prompts the elderly to seek medical care (Dahlhamer et al., 2018). Individuals with chronic pain experience suffering, including restriction in daily activities, limitation in movement anxiety and depression, dependence on opioids, reduced quality of life, and poor perceived health.

Chronic pain results in neurological changes, as revealed by a study conducted by Flor (2014). These neurological changes include the changes in the function and structure of the brain, and this needs psychological interventions to curb the condition. The study discovered that individuals with chronic pain have a chemical imbalance in their brains, making regulating emotions difficult. Additionally, these people have low levels of neurotransmitters (Flor, 2014). The study suggests psychological intervention to be best when it comes to chronic pain management.

Additionally, management of chronic pain among residents in nursing homes is vital to enhance the quality of life, as revealed by Mamhidir et al. (2017) study. The study shows that chronic pain is high in patients with activities of daily living dependency and those with cognitive impairment. Some patients have chronic pain that is undermanaged or unidentified, which negatively impacts many residents in their lives; therefore, this study suggests most assessments to be done to help manage the identified residents with chronic pain (Mamhidir et al., 2017). Another study conducted by Wilson (2017) shows that chronic pain brings significant impacts on a patient’s life, bringing difficulties in successful treatment. However, Wilson’s study shows that chronic pain management programs use multidisciplinary rehabilitation and cognitive behavioral therapy approaches to facilitate functional improvement (Wilson, 2017).

Conclusively, this paper has explored a shred of information concerning chronic pain. The paper has discovered that chronic pain can lasts for more than three months. The pain results from various factors, including some diseases, damage of nerves, and effects on bones and joints. Chronic pain is the more common elderly population. Chronic pain has adverse impacts on the health of the individual. Therefore, the information herein is helpful to anyone hinting to understand chronic pain.


Andraka-Christou, B., Rager, J. B., Brown-Podgorski, B., Silverman, R. D., & Watson, D. P. (2018). Pain clinic definitions in the medical literature and U.S. state laws: an integrative systematic review and comparison. Substance Abuse Treatment, Prevention, And Policy, 13(1), 17.

Alford, D., MD. (2018, October 4). Addressing the Opioid Crisis in the Acute and Ambulatory Settings. Lecture presented at Opioid Crisis in the Acute Setting and Ambulatory Setting in St. Francis Hospital, Tulsa.

Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., … & Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—the United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001.

Ernst, E. (2007). Complementary therapies for pain management: an evidence-based approach. Elsevier Health Sciences.

Flor, H. (2014). Psychological pain interventions and neurophysiology: Implications for a mechanism-based approach. American Psychologist, 69(2), 188– 196.

Vos, J., & Vitali, D. (2018). The effects of psychological meaning-centered therapies on quality of life and psychological stress: A metaanalysis. Palliative & supportive care16(5), 608 632

Mamhidir, AG., Sjölund, BM., Fläckman, B. et al. Systematic pain assessment in nursing homes: a cluster-randomized trial using a mixed-methods approach. BMC Geriatr 17, 61 (2017).

Molton, I. R., & Terrill, A. L. (2014). Overview of persistent pain in older adults. American Psychologist, 69(2), 197– 207.

Walker, L. & Avant, K. (2011). Strategies for theory construction in nursing (5th ed). Pearson. Chapter 10

Vlaeyen, J. W., & Crombez, G. (2020). Behavioral conceptualization and treatment of chronic pain. Annual review of clinical psychology16, 187-212.

WebMD. (2021). What Causes Chronic Pain?

Wilson, I. R. (2017). Management of chronic pain through pain management programs. British medical bulletin, 1-10.


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