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Osmany Rafael Gil Figueredo

Theory of Unpleasant Symptoms

Using the theory of unpleasant symptoms as a guide, what would you look for in an assessment tool for patient symptoms?

The theory of unpleasant symptoms was developed in an effort to help those in the nursing profession identify the symptomatology of patients and proposes that some of the same elements influence different symptoms and the experiences of patients, these are the philosophical underpinnings behind the creation of this theory and its use in the practice of nursing. Using this theory as the centerpiece and as an overall guide there are several elements of an assessment tool that would be vastly preferred over the rest. One of the most crucial aspects would be the inclusion of self-reported patient symptoms within the assessment tool and all the pertinent variables affecting those symptoms. The theory of unpleasant symptoms places a heavy emphasis on three fundamental components of an assessment tool that include patient self-reported symptoms, the symptoms’ influencing factors that affect the patient’s experience, and the resulting consequences of those symptoms. The influencing factors may include specific characteristics, history of present illness, time of onset, location of illness, aggravating factors, and remitting factors. These would all be elements that would need to be included in any thorough assessment tool for use within the healthcare field by all medical professionals, as they will aid in determining the effect of the illness and guide the course of therapy for the individual patient.

This theory also places a strong focus on non-physiological factors that can impact a patient’s condition and their perception of that condition. These factors can include a patient’s culture, race, religion, gender, age, environmental circumstances, and even childhood experiences. It is important to not leave these factors out of any assessment tool as they can immensely influence how the patient perceives their symptoms themselves and the treatment courses they will prefer and be able to adhere to. A very important example would be the use of blood transfusions in severely anemic patients, not only would it be essential to take note of symptomology and the need for said blood transfusions, but it is also crucial to consider the patients’ religious beliefs when deciding on the best treatment course for a specific patient or patient population. Leaving social factors and characteristics out of an assessment tool used for patients who may or may not require the use of blood transfusion would be a grave mistake.

In conclusion, using the theory of unpleasant symptoms, an efficient assessment tool would be one that focuses on patient-reported symptoms, factors influencing the development and characteristics of those symptoms, and the consequences that follow, while also including non-physiological situational elements with a high degree of effect on both the perceptions and treatment courses for the patients. This theory focuses on the need for a tool that is relevant for many different types of presenting symptoms rather than a tool that can only be used for one or a small group of symptoms. However, at times this methodology for creating an assessment tool can limit the usefulness of the tool for specific disease states due to its generalizability and lack of specificity which can lead to deficiencies in the reporting of crucial information that would only be pertinent to certain disease states, this would be my only critique of using this theory in the development of an assessment tool. On the other hand, current professional nursing practice needs an initial assessment tool that is in fact generalizable to many disease states due to the vast variety seen on a day-to-day basis and the theory of unpleasant symptoms is a strong representation of the basis for constructing such a tool.

References:

1.     Lenz ER, Pugh LC, Milligan RA, Gift A, Suppe F. The middle-range theory of unpleasant symptoms: an update.  ANS Adv Nurs Sci. 1997;19(3):14-27. doi:10.1097/00012272-199703000-00003

2.     Lee SE, Vincent C, Finnegan L. An Analysis and Evaluation of the Theory of Unpleasant Symptoms.  ANS Adv Nurs Sci. 2017;40(1):E16-E39. doi:10.1097/ANS.0000000000000141

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Yunia Carmenate Leyva

 Using the Theory of Unpleasant Symptoms as a Guide, What Would You Look for in an Assessment Tool for Patient Symptoms?

The theory of unpleasant symptoms is a guide that can be used to assess patient symptoms. This theory is a tool that can be implemented to help with the identification and treatment of patients who are experiencing unpleasant symptoms. Four main concepts are associated with this theory: symptom perception, symptom distress, symptom interference, and symptom management. Each of these concepts can help assess patient symptoms and determine the best course of treatment.

Symptom perception is the first concept that can be used to assess patient symptoms. This concept refers to how patients perceive their symptoms. Some patients may be more aware of their symptoms than others. This can be due to some factors, such as the severity of the symptoms, the type of symptoms, and the individual's sensitivities. Symptom perception can be assessed using various methods, such as interviews, questionnaires, and observation.

Symptom distress is the second concept. This concept refers to the amount of distress a patient experiences due to their symptoms (Secinti et al., 2019). Some patients may be more distressed by their symptoms than others due to symptoms severity, the type of symptoms, and the individual's sensitivities. Symptom distress can be assessed using various methods, such as consultations, surveys, and reflection.

Symptom interference is the third concept. This concept refers to how a patient's symptoms interfere with daily activities (Mosher et al., 2019). Certain patients’ ability to perform these daily activities may be more drastically impacted by symptoms when compared to other patients. This may be the result of several elements, including the diagnosis's degree, kind, and responsiveness. There are many ways to measure symptom interference, including discussions, assessments, and inspections.

Symptom management is the fourth and final concept. This concept refers to how patients manage their symptoms (Inojosa et al., 2019). Some patients may be better than others at controlling their symptoms. This may result from several elements, including the symptoms' degree, kind, and intensity. Various techniques can be used to evaluate symptom control, including assessments, surveillance, and conversations.

            The concept of unpleasant symptoms may be utilized to aid in identifying and treating people who are suffering unpleasant symptoms. This theory is associated with four significant concepts: ailment perception, symptom distress, symptom interruption, and management of symptoms. Each of these ideas can aid in analyzing a patient's symptoms and determining the best course of therapy

References

‌ E. Secinti, D. B. Tometich, S. A. Johns, and C. E. Mosher (2019). A meta-analytic study of the association among tumor acceptance and discomfort. 27-38 in Clinical Psychology Review, vol. 71.  https://doi.org/10.1016/j.cpr.2019.05.001

C. E. Mosher, E. Secinti, A. T. Hirsh, N. Hanna, L. H. Einhorn, S. I. Jalal, G. Durm, V. L. Champion, and S. A. Johns (2019). A Pilot Controlled Trial of Acceptance and Commitment for Symptom Interference in Late Lung Cancer and Carers Distress. Pain and Symptom Treatment, 58(4), 632–644.  https://doi.org/10.1016/j.jpainsymman.2019.06.021

Inojosa, H., Proschmann, U., Akgün, K., & Ziemssen, T. (2019). A focus on secondary progressive multiple sclerosis (SPMS): challenges in diagnosis and definition. Journal of Neurology, 268(4), 1210–1221.