2.2 Encourage an individual to express their pain or discomfort

This guide will help you answer 2.2 Encourage an individual to express their pain or discomfort.

Supporting an individual in expressing their pain or discomfort is an essential aspect of care. Effective communication and understanding in this process lead to better care outcomes and help maintain the individual’s dignity. By taking proactive steps, care workers can create an environment where individuals feel comfortable sharing their experiences and needs.

What is Pain and Discomfort?

Pain and discomfort are subjective experiences. This means what one person feels as painful, another might not. Pain can be physical (such as a sore back or a headache) or emotional (like feeling distressed or anxious). Discomfort, on the other hand, can result from things like an ill-fitting chair, being too hot or cold, or even embarrassment.

Each individual expresses pain and discomfort in their way based on their experiences, culture, beliefs, and personality. Some may verbalise clearly, saying, “My hip hurts,” while others express signs non-verbally, like frowning, withdrawing, or becoming irritated.

Barriers to Expression

Not everyone finds it easy to express their pain or discomfort. Some common barriers include:

• Feeling embarrassed or shy
• Thinking they might be ignored or judged
• Worrying about being seen as a burden
• Cognitive impairments, such as dementia
• Communication difficulties, such as aphasia or limited language skills

Your role as a care worker involves breaking down these barriers to encourage open communication.

Creating a Safe Environment

Individuals need to feel safe to talk about their pain or discomfort. A trusting relationship between the care worker and the individual is essential. Here’s how you can help create that environment:

• Show empathy: Listen actively and acknowledge their feelings. Avoid interrupting or dismissing their concerns.
• Use clear and simple language: Avoid using medical terms unless the individual understands them. For example, say, “Can you describe where it hurts?” instead of “What’s the nature of the discomfort?”
• Maintain privacy: Discuss sensitive matters in a private, quiet place. This can prevent embarrassment and allow the individual to open up.
• Be patient: Give the individual plenty of time to respond without interrupting. Sometimes, they may need extra time to find the right words or show how they feel.

Open-Ended Questions

Asking open-ended questions encourages individuals to share more about their experiences. Instead of asking, “Does your leg hurt?” try saying, “Can you tell me how your leg feels today?” This invites the individual to provide more detail.

Examples of open-ended questions include:

• “Can you describe what you’re feeling?”
• “What makes the pain better or worse?”
• “How does this affect your mood or energy?”

Non-Verbal Communication

Some individuals may find verbal expression difficult. In these cases, non-verbal cues become essential for understanding pain or discomfort. Keep an eye out for:

• Facial expressions like frowning, grimacing, or clenching teeth
• Body language, such as holding a specific area of the body or avoiding movement
• Changes in behaviour, like withdrawing from social activities or appearing agitated
• Vocalisations, such as moaning, sighing, or crying
• Changes in appetite or sleep patterns

If the individual cannot speak, you might use tools like pain scales that use faces or numbers to assess their level of discomfort.

Using Pain Assessment Tools

Pain assessment tools are helpful when verbal communication is challenging. You can introduce these tools while explaining their purpose. Commonly used tools include:

• Numerical Pain Scales: These ask the individual to rate their pain on a scale from 0 (no pain) to 10 (worst pain possible).
• Visual Analogue Scales: A line with labels such as “no pain” at one end and “severe pain” on the other.
• Faces Pain Scale: Useful for children or individuals with cognitive difficulties, this uses facial expressions to represent pain levels.

You should adapt the method to the individual’s needs, abilities, and preferences.

Building Individual-Centred Care

Encouraging the expression of pain or discomfort fits into the broader principle of person-centred care. This means focusing on the individual’s unique needs, preferences, and wishes. It’s about treating them as a whole person, rather than just a list of symptoms.

To achieve this:

• Respect their opinions and choices, even if they differ from your perspective.
• Consult with family members or friends if they permit this, particularly if the individual struggles to communicate their needs.
• Regularly review their care plan to account for any changes in their condition or feelings.

Cultural Sensitivity

Cultural beliefs can influence how people perceive and express pain. Some cultures may discourage openly showing pain, while others might encourage seeking help. Some individuals may turn to spiritual or traditional remedies before discussing their discomfort.

Always respect an individual’s cultural context. For example, if someone hesitates to describe their pain, you can gently reassure them that it’s okay to talk about it. Avoid making assumptions, and if needed, ask questions to understand their viewpoint better.

Role of Active Listening

Active listening is a fundamental skill for encouraging expression. It involves more than just hearing; it means focusing on what the individual is saying and showing that you value their words.

Steps to actively listen include:

• Maintaining eye contact at a comfortable level
• Nodding or using short verbal cues like “I see” to show you’re engaged
• Reflecting back what they say, e.g., “So, you feel uncomfortable after sitting for too long?”
• Asking follow-up questions to gain clarity
• Avoiding judgement or offering unsolicited advice

Responding Appropriately

When an individual expresses their pain or discomfort, your response matters greatly. React with compassion and professionalism. Some ways to respond include:

• Acknowledging their feelings: “That sounds really uncomfortable. Let me see how I can help.”
• Taking action, such as repositioning someone in bed or passing on information to their primary health professional.
• Offering reassurance, e.g., “We’ll work together to make this better.”

Always follow up after an initial response, asking whether the steps taken have eased their discomfort.

When to Escalate Concerns

Sometimes, an individual’s pain or discomfort requires input from healthcare professionals. You must recognise when a situation is beyond your ability or authority to resolve. Escalate concerns if:

• Pain worsens suddenly or becomes unmanageable
• There are unusual symptoms, such as swelling, redness, or high fever
• The pain does not improve despite interventions
• The individual becomes unresponsive or shows signs of distress

Follow your organisation’s reporting and escalation procedures in these situations.

Adapting to Different Communication Needs

Some individuals, such as those with learning disabilities or sensory impairments, may face specific challenges in expressing pain and discomfort. Adapt your communication approach to suit their needs. For example:

• Use visual aids or symbols for those with limited verbal ability.
• Write down questions or provide a communication board for individuals with hearing impairments.
• Touch the affected area gently (if appropriate and consented) to indicate the focus of the discussion.

Collaborate with speech and language therapists when necessary to improve communication strategies.

Documentation

All expressions of pain or discomfort should be documented accurately and promptly. This ensures continuity of care and helps identify patterns or triggers over time. When documenting:

• Include the individual’s description of the pain or discomfort.
• Record non-verbal cues or any pain assessment scores.
• Note actions taken and their outcomes.
• Inform others, such as colleagues or medical staff, as appropriate.

Follow your workplace protocols for record-keeping to maintain accuracy and confidentiality.

Respecting Their Autonomy

Respect an individual’s right to make decisions about their own care. If they prefer not to discuss their pain or decline a particular intervention, honour their choice. Offer alternative options where possible and ensure they feel supported rather than pressured.

Final Thoughts

Encouraging an individual to express their pain or discomfort involves empathy, communication, and creating a safe environment. By recognising barriers, using assessment tools effectively, and respecting individual needs, you can make a significant difference in their quality of care. Always listen actively, address their concerns, and document information to promote a well-rounded approach to managing pain and discomfort.