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Pain is a universal phenomenon. Pain is the fifth vital sign and its assessment is crucial in the comprehensive care of every patient. Pain is a subjective concept and is whatever the client says it is. Pain is experienced across all age groups, across all socioeconomic levels, and in all settings and exists within the context of a culture, as well as within personal, physical, and psychological history. Pain and the search for relief is one of the primary reasons a client accesses the healthcare system. It is also one of the most complex and challenging problems in health care and biology.

The outcome of this course is for the learner to describe the types and physiology of pain, variables that affect it, strategies for conducting a complete pain assessment, barriers to assessment, the role of culture, and appropriate pain documentation.

Effective pain management begins with effective pain assessment. Only after an assessment is completed can the healthcare provider determine how to best manage a client's pain. Barriers to pain management that can lead to the undertreatment of pain need to be evaluated and, if relevant, addressed appropriately. Once an assessment is completed, interventions and treatment options are implemented and evaluated. Interventions and treatment options can include traditional pharmaceutical options as well as integrative therapies.

The outcome of this course is for the learner to describe the medications commonly used for pain relief, the physical and behavioral strategies used for pain relief, the factors that result in the undertreatment of pain, and the management of acute and/or postoperative pain.

Health care professionals often face difficult challenges when working with clients who have undergone surgery or who have cancer or human immunodeficiency virus (HIV). These clients encounter unique problems with their health conditions, especially when trying to manage their pain.

The outcome of this course is for the learner to describe the types of pain seen in clients who have undergone surgery or are coping with cancer or HIV and to describe the methods, both traditional and nontraditional, for managing these challenging pain concerns.

Acute and chronic pain in the adult client have different causes, methods of diagnoses, and interventions. Effective health care providers understand these differences when they assess and manage their clients' pain.

The outcome of this course is for the learner to describe the differences between acute and chronic pain, describe causes and symptoms for each, explain pharmacologic and nonpharmacologic interventions for each type of pain, list barriers to effective pain management, and identify factors to consider when educating clients about their pain management regimens.

Helping pediatric and geriatric populations manage their pain requires special consideration regarding the types of medications and strategies chosen, the route through which medications are delivered, and specific comorbidities or metabolic issues that may be present.

The outcome of this course is for the learner to describe issues unique to the pain management of the pediatric or geriatric patient, including assessing and managing pediatric pain, physiologic changes in aging, behavioral strategies for pain relief, nonpharmacological options for pain control in pediatric and geriatric patients, and pain management in the client with an altered mental status.

Regardless of the cause, pain is a common symptom in clients who are near death. Healthcare providers must understand the tremendous implications of pain and pain symptoms and prioritize the assessment and optimal treatment of pain in clients near the end of life. They must be knowledgeable about alternative routes for analgesia and analgesic dosing and understand when to make referrals to palliative care providers and/or specialists to assist in the compassionate and effective management of pain during this time.

The outcome of this course is for the learner to describe key concepts related to effective pain management at the end of life, including the roles of the caregiver, hospice provider, and palliative-care provider.

Many advances have been made in the treatment of cancer during the last several decades and yet effective cancer pain management remains an overwhelming issue for more than 80% of patients. Today, there are numerous options for cancer pain management, ranging from more traditional pharmacological treatments to integrative therapies, including complementary and alternative modalities. Increasingly, research links adequate pain control with improved survival for patients with cancer. The effective treatment of pain for cancer patients must include an examination of all possible treatment modalities in order to ensure the patient receives the most compassionate care available.

The outcome of this course is for the learner to provide a description of the pharmacologic and integrative therapeutic options for individuals with cancer pain.